• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4653-4658
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• 2015

Background: Palliative therapies have an important role in increasing the quality of healthcare and in dealing with physical and psychosocial problems due to cancer. We here aimed to evaluate the managerial perspectives and opinions of the hospital managers and clinical directors about specialized palliative care centers. Materials and Methods: This study was conducted in two large-scale hospitals in which oncology care is given with medical directors (n:70). A questionnaire developed by the researchers asking about demographic characteristics and professional experience, opinions and suggestions of medical directors about providing and integrating palliative care into healthcare was used and responses were analyzed. Results: Potential barriers in providing palliative care (PC) and integrating PC into health systems were perceived as institutional by most of the doctors (97%) and nurses (96%). Social barriers were reported by 54% of doctors and 82% of nurses. Barriers due to interest and knowledge of health professionals about PC were reported by 76% of doctors and 75% of nurses. Among encouragement ideas to provide PC were dealing with staff educational needs (72%), improved working conditions (77%) and establishing a special PC unit (49)%. An independent PC unit was suggested by 27.7% of participants and there was no difference between the hospitals. To overcome the barriers for integration of PC into health systems, providing education for health professionals and patient relatives, raising awareness in society, financial arrangements and providing infrastructure were suggested. The necessity for planning and programming were emphasized. Conclusions: In our study, the opinions and perspectives of hospital managers and clinical directors were similar to current approaches. Managerial needs for treating cancer in efficient cancer centers, increasing the capacity of health professionals to provide care in every stage of cancer, effective education planning and patient care management were emphasized.

• Journal of Hospice and Palliative Care
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• 제13권1호
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• pp.32-40
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• 2010

목적: 호스피스 완화의료 전문인력의 질 관리를 위해 요구되는 자격인증체계 마련을 위해 전문인력들을 대상으로 자격인증체제의 필요성 및 구체적 방안에 대한 설문조사결과를 분석 제시하여 제도 마련의 기초자료로 삼고자 하였다. 방법: 국립암센터와 한국 호스피스 완화의료학회에서는 2009년 6월 17일부터 23일까지, 보건복지가족부지정 34개 암환자 완화의료기관에 등록된 전문인력인 의사, 간호사, 사회복지사, 성직자와 한국 호스피스 완화의료학회 회원들을 대상으로 온라인 설문조사를 실시하였으며, 그 중 총 220명이 설문에 참여하였다. 결과: 의사는 90% (46/51)가 자격인증이 필요하다고 하였고, 간호사는 84% (113/134), 사회복지사의 경우 89% (31/35)가 자격인증이 필요하다고 하였다. 자격인증 방안에 관해서는 의사의 경우 일정한 교육만 받으면 인정의 자격을 부여해 주는 방법을 가장 선호하였고(46%), 사회복지사의 경우도 일정교육을 받은 의료사회복지사에게 자격을 부여하는 것을 가장 선호하였다. 자격인증 주체에 있어서는 의사의 경우 한국 호스피스 완화의료학회 또는 보건복지가족부가 주체가 되어야 한다는 의견이 각각 45%로 가장 많았고, 간호사와 사회복지사의 경우 보건복지가족부가 주체가 되어야 한다는 응답이 각각 50%, 66%로 가장 높았다. 교육프로그램개발 및 인정주체에 관한 의견으로는 의사의 경우 한국 호스피스 완화의료학회가 51%로 가장 높았고, 간호사의 경우 보건복지가족부(또는 국립암센터)와 한국 호스피스 완화의료학회가 함께 주체가 되어야 한다는 의견이 23%로 가장 높았다. 사회복지사의 경우 보건복지가족부(또는 국립암센터)와 대한의료사회복지사협회가 주체가 되어야 한다는 의견이 37%로 가장 많았다. 마지막으로 교육운영방식은 세 직종 모두 주말을 이용한 강의와 일부 실습이 결합된 형태를 가장 선호하였다. 결론: 국내 호스피스 완화의료 전문인력은 자격인증체제에 대한 높은 요구도를 가지고 있으며, 각 직종별요구를 반영하는 적절한 자격인증체제 및 교육프로그램개발이 시급하다.

• 의료법학
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• 제23권1호
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• pp.37-80
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• 2022

이 논문에서는 현행 응급의료에 관한 법률이 규정하고 있는 응급의료에서의 설명·동의의 원칙과 응급의료거부죄를 검토함으로써 응급의료종사자의 환자에 대한 생명보호 의무가 환자의 자기결정권 보장보다 중요한 경우에 한하여 응급의료거부죄가 성립함을 제시한다. 응급의료에서도 일반 의료상황과 마찬가지로 의료행위 시행 전 환자에게 응급의료의 필요성이나 방법 등에 관하여 설명하고 동의를 받아야 함이 원칙이다. 다만, 설명·동의 절차를 예외적 방법으로 이행하거나 생략할 수 있음에도 그 절차 준수를 이유로 응급의료를 거부·기피한 응급의료종사자는 응급의료거부금지에 따른 행정처분과 행정벌을 부담하게 된다. 즉, 설명·동의 절차 생략 가능성에 관한 판단에 따라 응급의료거부죄가 성립할 수도 있는 것이다. 환자가 미성년이거나 의사결정능력이 없는 경우 그 법정대리인이 환자의 의학적 이익에 반하는 결정을 하더라도 법정대리인의 의견이 무조건적으로 존중되는 것은 아니다. 미성년 환자도 원칙적으로 자신의 신체에 관하여 결정할 권리가 있고, 법정대리인의 결정 역시 환자의 최선의 이익을 위한 것일 때 유효하기 때문이다. 환자가 치료를 거부하는 상황에서도 원칙적으로 응급의료종사자의 생명보호의무가 더 우선한다. 그러나 현행법은 여러 예외 상황에 대해 명문의 규정을 두고 있지 않아 응급의료 현장에서 그 해석에 어려움이 있다. 한편, 우리 대법원 및 하급심 판례는 응급의료종사자의 응급의료의무와 설명의무 사이의 이익형량이 불가피한 상황에서 환자의 생명상실이 문제되는 경우 설명의무보다 응급의료를 시행하여 환자의 생명을 보호하여야 할 의무가 우선이고, 예외적으로 사전에 치료 여부·방법에 대해 환자의 진지한 숙고가 있었던 경우 환자의 자기결정권이 응급의료의무와 대등하게 고려될 수 있다는 취지로 설시하고 있으므로, 이를 체계적으로 정리하고자 한다. 나아가 현행법의 해석만으로 해결이 어려운 부분에 대하여는 1) 미성년자에 대한 응급의료의무 조항 신설, 2) 응급환자의 의사결정능력 판단 기준을 의학적 내용을 중심으로 수정·보완, 3) 응급처치시 의료인의 추가 동의가 불요함을 명시, 4) 복수의 의견 충돌이 있는 경우에 대한 제도적 보완, 5) 응급의료 중단시 벌칙조항 신설 등 입법 과제를 제시한다.

• 한국치위생학회지
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• 제9권1호
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• pp.169-180
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• 2009

This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제16권1호
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• pp.116-132
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• 2022

Automated medical claims processing and billing is a popular application domain of information technology. Managing medical related data is a tedious job for healthcare professionals, which distracts them from their main job of healthcare. The technology used in data management has a sound impact on the quality of healthcare data. Most of Information Technology (IT) organizations use conventional software development technology for the implementation of healthcare systems. The objective of this experimental study is to devise a mechanism for use of rule-based expert systems in medical related edits and compare it with the conventional software development technology. A sample of 100 medical edits is selected as a dataset to be tested for implementation using both technologies. Besides empirical analysis, paired t-test is also used to validate the statistical significance of the difference between the two techniques. The conventional software development technology took 254.5 working hours, while rule-based technology took 81 hours to process these edits. Rule-based technology outperformed the conventional systems by increasing the confidence value to 95% and reliability measure to 0.462 (which is < 0.5) which is three times more efficient than conventional software development technology.

• 대한임베디드공학회논문지
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• 제17권5호
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• pp.265-272
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• 2022

As the risk of lung cancer has increased, early-stage detection and treatment of cancers have received a lot of attention. Among various medical imaging approaches, computer tomography (CT) has been widely utilized to examine the size and growth rate of lung nodules. However, the process of manual examination is a time-consuming task, and it causes physical and mental fatigue for medical professionals. Recently, many computer-aided diagnostic methods have been proposed to reduce the workload of medical professionals. In recent studies, encoder-decoder architectures have shown reliable performances in medical image segmentation, and it is adopted to predict lesion candidates. However, localizing nodules in lung CT images is a challenging problem due to the extremely small sizes and unstructured shapes of nodules. To solve these problems, we utilize atrous spatial pyramid pooling (ASPP) to minimize the loss of information for a general U-Net baseline model to extract rich representations from various receptive fields. Moreover, we propose mixed-up attention mechanism of reverse, boundary and convolutional block attention module (CBAM) to improve the accuracy of segmentation small scale of various shapes. The performance of the proposed model is compared with several previous attention mechanisms on the LIDC-IDRI dataset, and experimental results demonstrate that reverse, boundary, and CBAM (RB-CBAM) are effective in the segmentation of small nodules.

• 한국임상약학회지
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• 제20권1호
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• pp.56-65
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• 2010

Objective: This study aimed to develop information materials on vaccine's safety and adverse events which can be utilized by healthcare professionals when prescribing, dispensing and administering vaccines and also by non-healthcare professionals such as pharmaceutical distributors of vaccine. Methods: Information materials regarding vaccines from domestic and foreign governmental organizations, academies, medical organizations and pharmaceutical companies were reviewed. Advisory Committee which consisted of experts in the areas of the vaccine's safety verified the contents and the final information material. Results: Based on the collected data, we developed general guidelines including vaccine constituents, safety information and adverse events of each vaccines, storage and handling, and labeling information. The information materials were developed for both healthcare professionals and non-healthcare professionals such as vaccine distributors. Conclusion: Information materials on vaccine's safety and adverse events developed from this study could be utilized to provide useful information on the vaccine to the medical institutions and distributors.

• 대한후두음성언어의학회지
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• 제12권1호
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• pp.17-21
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• 2001

Aims of study : The purpose of this study is to measure the chronic and daily voice burden of the professionals in their actual working places. These will be a valuable guideline for preventing and controlling the voice production of professionals. Material and method : Our study was selected to the 10 female telephone operators in the Asan Medical Center, ages ranging from 22 to 38 years old. The symptoms and acoustic analysis of both telephone operators and the controls were evaluated before and after their working. The symptoms were evaluated with questionaires, and the acoustic analysis was measured by using CSL (computerized speech laboratory) system. Results : The symptoms of the professional voice abusers are same as those symptoms in laryngeal fatigue. The acoustic analysis before their working were significantly increased in jitter and shimmer, in comparison with the data of the control. This shows that the experimental group is exposed to the chronic burden of voice production. The jitter, shimmer, and NHR after their working are significantly increased in comparison with the data of the acoustic analysis before their working. This also shows that the experimental group is exposed to the daily burden of voice production. Conclusion : The acoustic analysis of the professional voice overusers has objectively measured that there are chronic and daily overloading to the voice of operators, and these will be a valuable data for preventing and controlling the professionals that abuse their voice.

• 성인간호학회지
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• 제22권6호
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• pp.582-593
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• 2010

Purpose: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. Methods: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. Results: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. Conclusion: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.

• Child Health Nursing Research
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• 제14권3호
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• pp.295-304
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• 2008

Purpose: This study was conducted to identify the status of health management and to evaluate the need for health professionals in day care centers in the South Korea. Method: Data were obtained from 360 child care providers in 16 provinces from May to August, 2007. Data was analyzed using SPSS WIN 14.0. Results: Safety education (traffic. 83.8% general safety. 71.6%) was provided more often than the other topic of education. All health related education was provided by child care providers. When minor health problems occurred, the most common management strategy was to send the child home (36.1%). During emergency conditions, majority of child care providers preferred taking the children to medical centers without giving any emergency care and 19.4% reported sending the child home without any immediate care. Child care providers recognized the need for health care professionals. Conclusion: The results of this study suggest the need for services of health professionals in day care centers to satisfy the needs and expectations for health management in these centers. As health professionals, public health nurses or pediatric nurse practitioners may play an important role in health management of children in day care centers.