• 제목/요약/키워드: medical trust

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의료서비스에 대한 환자신뢰가 관계몰입에 미치는 영향 (The effects of Patient Trust on Relationship Commitment in Healthcare Settings)

  • 최진희;임정도
    • 보건의료산업학회지
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    • 제4권1호
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    • pp.1-10
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    • 2010
  • The purpose of this study is to investigate the effects of provider and consumer characteristics, and patient trust on relational commitment among healthcare customers of an university hospital, and to suggest some implications for improving customer relation management of hospitals. Data were collected from 250 patients of an university hospital located in Ulsan using structured self-administered questionnaire. Major result of the analysis is as follows: First, study variables are significantly varied by age and income among socio-economic factors. Second, assurance, and empathy among provider characteristics and customer satisfaction and reputation among consumer characteristics are found to be significant affecting factors on patient trust. Third, trust affects significantly both on re-visit and recommendation among relationship commitment, while reputation affects on re-visit and customer satisfaction and reputation affect on recommendation. Above results imply that relationship management strategy for enhancing patient trust is crucial to improve competitiveness of hospitals in turbulent competition environment.

Does an extensive diagnostic workup for upfront resectable pancreatic cancer result in a delay which affects survival? Results from an international multicentre study

  • Thomas B. Russell;Peter L. Labib;Jemimah Denson;Fabio Ausania;Elizabeth Pando;Keith J. Roberts;Ambareen Kausar;Vasileios K. Mavroeidis;Gabriele Marangoni;Sarah C. Thomasset;Adam E. Frampton;Pavlos Lykoudis;Manuel Maglione;Nassir Alhaboob;Hassaan Bari;Andrew M. Smith;Duncan Spalding;Parthi Srinivasan;Brian R. Davidson;Ricky H. Bhogal;Daniel Croagh;Ashray Rajagopalan;Ismael Dominguez;Rohan Thakkar;Dhanny Gomez;Michael A. Silva;Pierfrancesco Lapolla;Andrea Mingoli;Alberto Porcu;Teresa Perra;Nehal S. Shah;Zaed Z. R. Hamady;Bilal Al-Sarrieh;Alejandro Serrablo;Somaiah Aroori
    • 한국간담췌외과학회지
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    • 제27권4호
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    • pp.403-414
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    • 2023
  • Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

2012년 주요 의료 판결 분석 (Review of 2012 Major Medical Decisions)

  • 이정선;이동필;유현경;정혜승
    • 의료법학
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    • 제14권1호
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    • pp.303-354
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    • 2013
  • In 2012, the major jurisdictions regarding medical cases caused the controversial issues towards medical and legal fields by getting the judgments from the Supreme Court, which admitted the exceptional admissibility on discretionary grant. By regarding the serial negligence of medical organizations as a separate tort, the sentences which made up irrationality, were spoken by the court. As a result, if the treatment was made, which did not follow the entered matters in medical documents attached, the court announced the jurisdiction that presumes the negligence, which provided the evidence of negligence; on the other hand, this gave had the burden to medical branch to take great care for medicinal treatment. To be applicable for the Principle of Trust, the doctors have to give and take the necessary information for the treatment process and symptom decisions, which also commented in the court. Thus, this case made it difficult to apply the Principle of Trust and considered all the conditions as tough ones, which eventually induced lesser faults for patients' care. Moreover, the court confirmed that the medical ads sending the emails to the members belong to the internet portal sites, are not the inducing behavior by considering that the actions are only medical ads. Furthermore, in the case of Namsu Kim, the court's interpretation was rather limited the definition for medical practice that announced limited Erweiterung der Strafbarkeit cases by lower courts. As a consequence, it is very interesting whether the Supreme Court may change their position and concerning the duty of explanation, the trend to expand the contents and scopes for the duty of explanation continues by admitting instruction explanation obligation and all the compensations and so on.

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간호원의 신뢰수준에 관한 연구 (A study on Trust Level of Nurses)

  • 임현빈
    • 대한간호학회지
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    • 제7권1호
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    • pp.10-19
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    • 1977
  • Trust is an essential factor in human relations, as it enables man to accept and also disclose self. Today's health care demands nursing personnel with high level of trust . This study was designed and carried out in May through June, 1976 to measure the level of trust on nurses through the trust scale of Nurses (75- N) made by Kenneth et al. and the Parent Inventory made by Rake and to provide data for management of nursing personnel. 150 junior nursing students, 164 professional nurses from 5 universities and their medical centers and 55 nurse- educators from 8 baccalaureate nursing programs in Seoul were randomly sampled. Results are as follows : 1. The rank order of the level of trust revealed that nurse educators the highest and nursing students the lowest. 2. The level of trust revealed to be influenced by the relationship with parents at the early stages of life ; Group who appeared to have shared intimacy with their parents were the highest. 3. Factors such as ; number of siblings and birth order among them, religious affiliation, parental presence revealed to have had no influence on the level of trust in all three group. 4. No significant difference were revealed between the group who had put their names down on the questionnaire and the others. 5. Clinical specialities of practice revealed to have no signigicant influence on trust in nurses. 6. Marital status revealed to have significant influence : in nurses and nurse- educators, the mastered re vented to have significantly higher level of trust. (difference by Recommendations : 1. A study on trust level of patients and Nurses in Nurse- patient Relationship. 2. A longitudinal study to investigate the influence of Nursing education on the development of trust in Nurses are recommended. 3. A comparative study on trust level of students of Nursing & non- Nursing major.

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주보호자가 지각하는 요양병원 서비스품질이 고객충성도에 미치는 영향 (The Effects of Medical Service Quality for the Main Caretaker of Patients at the Convalescent Hospital for Seniors on Customer Loyalty)

  • 최동춘
    • 벤처혁신연구
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    • 제6권4호
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    • pp.133-151
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    • 2023
  • 본 연구의 목적은 요양병원의 입원결정 및 유지에 관한 영향력이 가장 큰 주보호자들이 지각하는 요양병원의 의료서비스 품질이 고객충성도에 미치는 영향을 실증적으로 분석하는 것이다. 또한 요양병원의 의료서비스품질이 고객신뢰와 고객만족에 어떠한 영향을 미치는지를 검증하고, 고객신뢰와 고객만족이 고객충성도에 미치는 영향을 검증하여 요양병원의 생존에 필요한 이론적, 실무적 시사점을 제공하는 것을 목적으로 하고 있다. 본 연구의 결과는 다음과 같다. 첫째, 요양병원 의료서비스품질의 구성요소인 유형성, 신뢰성, 반응성, 공감성의 4가지 요인이 고객신뢰에 유의한 영향을 미치고 있는 것으로 나타났다. 둘째, 요양병원 의료서비스품질의 구성요소인 유형성, 신뢰성, 확신성, 반응성, 공감성의 5가지 요인이 고객만족에 유의한 영향을 미치고 있는 것으로 나타났다. 셋째, 요양병원 의료서비스품질의 구성요소인 유형성, 신뢰성, 확신성, 반응성, 공감성의 5가지 요인 중에서 신뢰성 요인이 고객충성도에 유의한 영향을 미치고 있는 것으로 나타났다. 이는 의료서비스품질은 고객신뢰와 고객만족의 매개변수를 통하여 고객충성도에 영향을 미치고 있음을 의미한다. 넷째, 요양병원 주보호자가 지각하는 고객신뢰는 고객충성도에 유의한 영향을 미치고 있는 것으로 나타났다. 다섯째, 요양병원 주보호자가 지각하는 고객만족은 고객충성도에 유의한 영향을 미치고 있는 것으로 나타났다.

아웃소싱 성과에 영향을 미치는 선행요인에 대한 의료기관과 호텔산업 간의 비교연구 (Comparative Study on Factors that Affect Outsourcing Performances in Medical Institutions and Hotel Industries)

  • 류세선;이준범;정문석
    • CRM연구
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    • 제3권2호
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    • pp.21-41
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    • 2010
  • 본 연구는 의료기관과 호텔산업에서의 아웃소싱 성과에 영향을 미치는 선행요인을 비하여 서비스기관에 따른 차이가 존재하는지를 밝히고자 하였다. 이를 위해 의료기관과 호텔을 중심으로 실제 아웃소싱 업무를 담당하고 있는 관리자를 대상으로 약 2개월 간 조사를 실시하였다. 총 350부를 배포하여 325부를 회수하였으나 이 중 불성실한 응답으로 분석대상으로 적합하지 않는 자료 6부를 제외한 319부를 최종분석에 사용하였다. 이 중 의료기관은 155부이었으며, 호텔은 164부를 최종분석에 사용하였다. 첫째, 아웃소싱 위탁업체와 수행업체 담당자간의 비공식적 인간관계는 의료기관과 호텔산업 모두 신뢰에는 유의한 영향을 미치지 않는 것으로 나타났으나 아웃소싱 수행정도에는 의료기관만이 영향을 미치는 것으로 나타나 차이를 보였다. 특히 의료기관의 경우 아웃소싱 수행업체와의 관계형성이 인턴부터 전문의가 될 때까지 오랜 기간동안 꾸준하게 형성된 비공식적 인간관계 특성에 따른 결과로 이해된다. 둘째, 의료기관 및 호텔산업 모두 의사소통이 신뢰에 유의한 영향을 미치는 것으로 나타나 아웃소싱의 특성상 상호간 원활한 의사소통이 긍정적인 관계형성이 이루어질 수 있다는 것을 강조하고 있다. 셋째, 아웃소싱 수행업체의 기회주의적 행동이 신뢰 및 아웃소싱 수행정도에 두 기관 모두 부(-)의 유의한 영향을 나타내 수행업체의 기회주의적 행동은 상호간 우호적인 관계형성보다는 불편한 감정이나 갈등을 유발할 가능성이 크다는 것을 나타냈다. 넷째, 서비스 인프라가 신뢰에 미치는 영향은 의료기관의 경우 유의한 영향을 미치지 않은 것으로 나타났으나 호텔산업은 유의한 영향을 미치는 것으로 나타나 차이를 보였다. 또한 서비스인프라가 아웃소싱 수행정도에는 두 기관 모두 유의한 영향을 미치는 것으로 나타났다. 다섯째, 아웃소싱 위탁업체인 의료기관 및 호텔과 수행업체간 신뢰는 아웃소싱 수행정도에 두 기관 모두 유의한 영향을 미치지 않는 것으로 나타났다. 반면에 신뢰는 아웃소싱 성과에 두 서비스기관 모두 유의한 영향을 미치는 것으로 나타나 의료기관 및 호텔에서 아웃소싱을 수행함에 있어 계약적 측면의 업무수행보다는 아웃소싱업체와의 상호 파트너십을 통해 관계적 측면을 강화하는 것이 상호간 신뢰뿐만 아니라 업무에 대한 성과도 높게 이끌 수 있음을 나타냈다. 마지막으로 아웃소싱 위탁업체의 아웃소싱 수행정도가 아웃소싱 성과에 두 기관 모두 유의한 영향을 미치는 것으로 나타나 아웃소싱의 수행이 활발할수록 이에 따른 성과도 증대됨을 나타내고 있다.

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의료오류 공개 교육의 현재와 나아가야 할 방향 (Medical Error Disclosure: 'Sorry' Works and Education Works!)

  • 명선정
    • 의학교육논단
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    • 제21권1호
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    • pp.13-21
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    • 2019
  • Patient safety and medical errors have emerged as global concerns and error disclosure has been established as standards of practice in many countries. Disclosure of medical errors to patients and their families is an important part of patient-centred medical care and is essential to maintaining trust. However, physicians still hesitate to disclose errors to patients despite their belief that errors should be disclosed. Multiple barriers such as fear of medical lawsuits and punishment, fear of damaging their professional reputation, and diminished patient trust inhibit error disclosure. These barriers as well as lack of training or education programs addressing error disclosure contribute to a low estimated disclosure rate in real situations. Nowadays, the importance of patient safety education including error disclosure is emphasized and related research is increasing. In this paper, we will discuss the background of medical error disclosure and studies on education programs related to error disclosure. In this regard, we will examine the content and methods currently being taught, discuss the effects or outcomes of such education programs and obstacles or difficulties in implementing them. Finally, the direction of future error disclosure education, support systems, and education strategies will also be covered.

시군구 수준의 사회자본 추이와 사회자본과 COVID-19 관련 행위와 인식 간의 관계 (Social Capital Trends and the Relationship between Social Capital and COVID-19-Related Behaviors & Perceptions)

  • 이근찬
    • 보건행정학회지
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    • 제33권3호
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    • pp.338-354
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    • 2023
  • Background: The influence of social capital on the spread of coronavirus disease 2019 (COVID-19) and related behaviors and perceptions has been recognized during the COVID-19 pandemic. This study aims to analyze the trends in social capital using primary data from the Korean Community Health Survey, which is the only available source in Korea for local-level social capital analysis. It also investigates the relationship between various variables, including social capital, as factors influencing COVID-19-related behaviors and perceptions. Methods: The study analyzed the temporal trends of social capital using raw data from four community health surveys conducted in 2017, 2019, 2020, and 2021. A multilevel analysis was conducted to examine the relationship between social capital and COVID-19-related behaviors and perceptions following the onset of the COVID-19 pandemic in 2020. Results: Social capital consists of trust, bonding social capital, and bridging social capital. Within the trust sub-factor, trust in neighbors (Trust-1) declined after the COVID-19 pandemic, whereas trust in safety and general environment (Trust-2) and trust in medical services and public transportation (Trust-3) increased. Additionally, the gap between municipalities narrowed. COVID-19-related behaviors and perceptions, such as adherence to COVID-19 prevention measures, return to normal activities, and fear of COVID-19, showed improvement in 2021 compared to the previous year. Individual-level trust in neighbors was associated with reduced fear of COVID-19, while community-level trust in neighbors was associated with increased fear of COVID-19. Conclusion: Social capital plays a role in mitigating public health crises, and it is necessary to implement active policies that address the gap in social capital between metropolitan and rural areas. Strengthening risk communication regarding emerging infectious diseases such as COVID-19 is crucial.

진료기록에 대한 일반인의 인식과 태도 : 오픈노트(Open Notes) 운동을 중심으로 (A Study of General Population's Awareness and Attitudes Toward Medical Records : Focusing on Open Notes)

  • 최주희;천경주;이상옥;김유리;백주현;장철훈;김성수
    • 한국콘텐츠학회논문지
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    • 제16권9호
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    • pp.512-522
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    • 2016
  • 본 연구는 진료기록에 대한 일반인의 인식과 태도를 오픈노트(Open Notes)운동을 중심으로 알아보고, 우리나라 임상진료현장에서 오픈노트제도의 도입 가능성을 확인하는 것을 목적으로 한다. 연구 결과를 요약하면 다음과 같다. 일반인들은 주로 인터넷을 통해 건강정보를 얻고 있으며, 병원의 진료정보와 관련하여서는 보험회사에 제출하기 위한 진료비관련 기록을 주로 이용하였다. 또한 진료기록에 대해서는 의사나 병원이 위조 혹은 변조할 가능성이 있다고 인식하고 있었으며, 대부분의 응답자가 진료기록을 언제든 확인할 수 있다면 병원이나 의사에 대해 더 신뢰할 수 있다고 응답하였다. 한편 오픈노트 운동에 대해서는 대부분 좋은 아이디어라고 생각하고, 우리나라에서도 오픈노트제도가 시행되어야 한다는데 동의하였으며, 오픈 노트제도가 시행된다면 참여하겠다고 응답하였다. 결론적으로, 진료기록의 투명성을 추구하는 오픈노트제도의 도입은 의사-환자 간 신뢰에 기여하여, 의사-환자 간 커뮤니케이션에도 긍정적인 영향을 기대할 수 있을 것이다.

병원조직 구성원의 조직정치지각과 조직유효성과의 관계: 조직신뢰의 조절효과 (An Empirical Analysis of The Relationship between Hospital Employees' Perception of Organizational Politics, Organizational Effectiveness, and The Moderating Role of Organizational Trust)

  • 이경희;윤혜정;유명순;이왕준
    • 한국병원경영학회지
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    • 제22권2호
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    • pp.70-86
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    • 2017
  • The purpose of this study was to empirically investigate the relationship between hospital employeesʼ perceptions of organizational politics, organizational effectiveness such as job satisfaction, organizational commitment, and turnover intention. We also evaluated the moderating effect of organizational trust on the relationships between POPs and organizational effectiveness. By analyzing 726 employeesʼ data including physicians, nurses, medical technicians, and administrators from one private hospital, POPs was found to have had a highly negative relationship with job satisfaction and organizational commitment while a highly positive relationship with turnover intention. Furthermore, organizational trust moderated the relationship between POPs and job satisfaction, and also POPs and turnover intention, while no moderating effect appeared between POPs and organizational commitment. Within the organization, employees who are in a group with high organizational trust have low job satisfaction and high turnover intention when they have high POPs rather than a group with low organizational trust. Further the implications of these results and future directions of the study have been discussed.