• 중환자간호학회지
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• 제7권1호
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• pp.40-46
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• 2014

Purpose: In Korea, about 30,000 people die in intensive care units annually. However, their quality of life at the end-of-life seems very low. The purpose of this study was to describe palliative care models that could be applied in intensive care units and examine nurses' roles in the models. Methods: A conventional literature review was performed focusing on palliative care in intensive care units and nursing roles in the approaches identified. Results: There are two different models regarding the implementation of palliative care approaches in the intensive care unit. Those are the consultative model and the integrative model. Each model has advantages and disadvantages. Therefore, an appropriate model must be chosen according to the setting. Nurses' roles could vary depending on the setting. Conclusion: Palliative care in the intensive care unit is important to improve patients' quality of life. Moreover, nursing roles are important in providing comprehensive palliative care in intensive care units.

• Journal of Hospice and Palliative Care
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• 제14권2호
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• pp.71-80
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• 2011

The growth of the aging population in Korea will challenge health and social services. As Korean society changes, the U.S. models of end-of-life care and geriatric care for frail older adults may have increasing relevance for the Korean healthcare system. This article reviews three U.S. models of care for frail older adults: hospice and palliative care, the Program for All-Inclusive Care for the Elderly (PACE), and the transitional care model. We describe the strengths and limitations of each model and discuss ways in which these models could be adapted for the Korean healthcare system.

• Journal of Hospice and Palliative Care
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• 제21권2호
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• pp.41-50
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• 2018

영성은 인간의 본질적인 부분으로 말기 환자와 가족의 실제적인 영적요구 충족을 위한 영적돌봄은 HPC에서 가장 중요한 영역이다. 말기환자와 가족의 실제적인 영적요구에 부응하는 돌봄모형을 확인하기 위해 최근 보건의료계에서 가장 많이 사용하는 국 내외 database를 검색하여 분석한 결과, 영성은 전인적 존재인 인간의 본질적인 부분으로, 삶의 위기상황에 더욱 충족되어야 할 존재론적 특성으로서, 말기 환자의 영성평가는 HPCT이 기본적으로 갖추어야 할 역량임이 확인되었다. HPC에 evidence based theory로 활용 가능한 총 10개의 모델이 제시되었다. 세 개의 모델들은 영적돌봄 결과에 초점을 둔 모델로서, spiritual health, QOL, and coping을 중요한 outcome으로 보는 모델들이었다. 영적돌봄수행에 초점을 둔 모델은 7개였으며, HPCT의 다학제간 협력을 통한 돌봄과정을 나타낸 'Wholeperson Care Model', 인간의 보편적인 실존적 요구충족이 보완된 'An Existential Functioning Model', 대상자의 문화적, 그 외 다양성을 고려하는 'An Open Pluralism View', HPCT와 말기환자와의 관계중심모델인 'A spiritual-relational view' and 'The Framework of Systemic Organization', 영적돌봄과정의 전체적 역동을 설명하는 'The principal components model' and 'The Actioning Spirituality and Spiritual care in Education and Training model'이 있다. 이러한 모델을 토대로 HPC에서 가장 최선의 영적돌봄 모델 구축을 위한 지속적인 임상연구 노력이 계속될 필요가 있겠다.

• Asian Journal for Public Opinion Research
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• 제9권4호
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• pp.352-367
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• 2021

Purpose: This research aims to examine gender preferences for men and women advertising models in Saudi advertisements. Saudi Arabia is known as one of the most gender-segregated society in the world, and it has gender-specific roles, characteristics, and behaviors that are undesirable for the other gender. Methodology: The questionnaire was developed with the help of earlier studies on perceptions towards advertising models and validated by a jury of experts and focus groups. The gender preferences for ten product categories (including automobiles, baby care products, cigarettes, cosmetics for women, fashion, food & beverages, motorcycles, personal care for men, personal care for women, sporting goods) were examined for men and women models. Similarly, three personal preferences characteristics for both genders (face beauty, voice quality, and Islamic dress), two characteristics for women models (body shape, femininity), and two characteristics for men models (height-weight balance, masculinity) were examined for men and women models separately. Finally, a survey was conducted to solicit responses from respondents (N=412). Findings: Results indicated significant gender preferences for gender-specific product categories and typical gender stereotypes in advertising models. Men models were preferred in men-specific products, and women models were required in women-specific products. Some product categories (including personal care for men and sporting goods) were ranked higher for men advertising models, while for women advertising models, other product categories (including personal care for women and cosmetics for women) were ranked higher. Masculinity was ranked highest as the preferred personal characteristic for men advertising models, while voice quality was highest for women advertising models. Finally, there is a significant difference between the preferred personal characteristic for men and women advertising models for three characteristics, including face beauty, Islamic dress, and masculinity and femininity. Implications: Saudi Arabia is a unique society with predominantly unique cultural dominance. Consequently, local culture greatly influences advertisements. It has stereotyped gender roles even in advertisements. This study will establish a baseline for further research on the subject area.

• 품질경영학회지
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• 제31권2호
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• pp.82-97
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• 2003

The study attempts to review TQM models used in the health care sector and the obstacles to the application of TQM in the sector. Even though the TQM models in the manufacturing and service sectors were successfully applied, the applicability of TQM in the health care sector is still in question. The reason is the unique characteristics of the medical sector such as medical and management practices. The most of the TQM models in the health care sector come from manufacturing industries. The importance of the professional groups is, however, more emphasized in the sector than in manufacturing sector. The role of the groups are idiosyncratic to the sector. They generate some obstacles to the application of TQM in the sector. The barriers include cultural obstacles of health care organization. It naturally follows that the TQM in the health care sector requires the change of the organizational culture of the sector. The culture embraces the norms, rules, regulations, compensation system, morale, practices, and common experiences. To change the culture needs long term effort and modification of the rules, regulations, compensation system, and practices. It also requires staffs' training in the problem solving methods. The TQM in the health care sector needs that the interested parties should change. Since doctors group and nurses group are controlled in the bureaucratic and authoritative manner, they should learn the problem solving techniques which require the interaction with other groups. The management also needs to learn management skills and get thorough training on them.

• Journal of Preventive Medicine and Public Health
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• 제18권1호
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• pp.13-24
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• 1985

This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Anderson Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows : First, the causal models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted $R^2$ is .144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the valiance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and edabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.

• 한국노년학
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• 제30권4호
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• pp.1027-1044
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• 2010

본 연구는 노인장기요양보험제도의 도입으로 공식적 보호가 확대되고 있지만 여전히 장기요양대상노인의 케어에는 비공식적 보호 욕구가 줄어들지 않고 있는 현상에 대해 효과적인 장기요양서비스 제공체계 고찰의 필요성에서 시작되었다. 따라서 본 연구의 목적은 장기요양대상노인의 비공식적·공식적 자원연계 유형을 도출하고 각 유형에 따른 서비스 만족도의 차이를 살펴봄으로서 효과적인 장기요양서비스 제공 모델을 발견하는 것이다. 이를 위해서 비공식적·공식적 자원연계 유형은 장기요양대상노인에게 15가지 케어관련과업을 제공하는 비공식적 보호제공자와 공식적 서비스제공자의 서비스 제공정도를 군집분석으로 구분하였고 각 유형에 따른 서비스 만족도의 차이는 다중회귀분석으로 분석하였다. 연구결과 비공식적·공식적 자원연계 유형은 가족수발 중심형, 상호 보완형, 과업 분리형, 공식적 수발 중심형으로 구분되었고 서비스 만족도가 가장 높게 나타난 유형은 상호 보완형 이었으며 이를 바탕으로 다음과 같은 점을 논의하였다. 첫째, 비공식적 보호와 공식적 서비스가 상호 보완적으로 제공되기 위해서는 공식적 서비스 제공체계에 비공식적 보호제공자의 역할을 결합시키는 노력이 필요하다. 둘째, 15가지 케어관련과업 중 개인적 및 일상생활지원 과업과 건강보호 과업은 서비스 제공자가 분리되어 있어 의료 및 장기요양서비스의 연계를 위한 통합적 케어 방안이 필요하다. 셋째, 공식적 서비스 제공자가 거의 모든 케어를 제공하는 공식적 수발 중심형은 상대적으로 서비스 만족도가 낮게 나타나 이에 대한 대책이 필요하다. 이상의 결과를 바탕으로 본 연구는 장기요양서비스의 효과성 향상을 위해서는 서비스의 양(量)과 질(質)적 차원에서 비공식적·공식적 자원연계 유형을 파악하고 서비스 제공 방안을 모색할 필요가 있다는 제언을 하였다.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• 임상간호연구
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• 제16권1호
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• pp.167-175
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• 2010

Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.

• Tuberculosis and Respiratory Diseases
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• 제86권3호
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• pp.203-215
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• 2023

Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R² and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R² value was 0.27 and in set II, LightGBM was the best model with the highest R² value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R² value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.