• 대한방사선기술학회지:방사선기술과학
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• 제45권6호
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• pp.543-552
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• 2022

This study compared and analyzed with the United States(USA) to evaluated the level of readability of radiotherapy information (English text) provide to foreign patients with cancer by medical institutions in South Korea (KOR). A total of 20 the KOR and USA medical hospitals in 10 each provide information for radiation therapy technology were selected. The readability was comparatively analyzed a total of three aspects (lexical, syntactic, cohesion and readability) by using a Coh-Metrix on-line web program. In readability respect, the mean of the Flesch Reading Ease (FRE) was lower in the KOR (8.3) than in the USA (23.2), Flesch-Kincaid grade level (FKGL) was higher in the KOR than in the USA (14.2) indicating that KOR was less readable than the US (p<.05). In both KOR and USA, the reading level (literacy) of the English text for the radiation therapy was found to be higher than high school (FRE level 50 or lower). Therefore, text information in English for the radiation therapy to foreign patients with cancer should be lowered to elementary school level and read to improve the quality of medical services.

• 한국의학물리학회지:의학물리
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• 제33권4호
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• pp.158-163
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• 2022

Purpose: We subjected scanning electron microscopic (SEM) images of the active layer of EBT3 film to texture analysis to determine the dose-response curve. Methods: Uncoated Gafchromic EBT3 films were prepared for direct surface SEM scanning. Absorbed doses of 0-20 Gy were delivered to the film's surface using a 6 MV TrueBeam STx photon beam. The film's surface was scanned using a SEM under 100× and 3,000× magnification. Four textural features (Homogeneity, Correlation, Contrast, and Energy) were calculated based on the gray level co-occurrence matrix (GLCM) using the SEM images corresponding to each dose. We used R-square to evaluate the linear relationship between delivered doses and textural features of the film's surface. Results: Correlation resulted in higher linearity and dose-response curve sensitivity than Homogeneity, Contrast, or Energy. The R-square value was 0.964 for correlation using 3,000× magnified SEM images with 9-pixel offsets. Dose verification was used to determine the difference between the prescribed and measured doses for 0, 5, 10, 15, and 20 Gy as 0.09, 1.96, -2.29, 0.17, and 0.08 Gy, respectively. Conclusions: Texture analysis can be used to accurately convert microscopic structural changes to the EBT3 film's surface into absorbed doses. Our proposed method is feasible and may improve the accuracy of film dosimetry used to protect patients from excess radiation exposure.

• 한국방사선학회논문지
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• 제5권4호
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• pp.207-215
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• 2011

본 연구는 암 환자가 암 검사를 받으면서 지각하는 의료서비스품질이 환자의 만족도에 미치는 영향을 고찰함으로써, 의료서비스품질의 어떤 점이 부족한지를 발견하고, 이에 대한 개선점을 찾는데 그 목적을 두었다. 이를 위해 본 연구는 의료서비스와 고객만족간의 관계에 관한 모델을 수립하고 의료서비스의 구성개념으로 유형성, 전문성, 신뢰성, 대응성을 제시하였고, 이들 의료서비스 품질과 고객만족 간의 관계에 관한 모형을 개발하고, 이 모형에 따라 4개의 가설을 설정하였다. 설문에 응답한 총 220명의 가설검정을 위한 실증조사 분석은 SPSS (Statistical Package for Social Sciences) for Windows 14.0K를 사용하여 분석하였다. 모든 가설은 다중회귀분석으로 검정한 결과 연구가설 H1, H2, H3, H4는 모두 채택되었다. 네 가지 연구모형 변수 중 에서 서비스 품질에 따른 고객만족에 가장 큰 영향을 미치는 요인은 유형성이 0.298(t=5.541)로 가장 중요한 영향으로 나타났으며, 다음은 전문성이 0.237(t=-3.687)로 그 다음으로 중요한 영향요인으로 나타났다. 위와 같은 연구 결과 다음과 같이 의미를 제안해 볼 수 있다. 첫째 의료 기관은 유형성, 전문성, 신뢰성, 대응성을 중심으로 의료서비스를 개발하고 시행한다면 현재보다 더 높은 고객 만족을 이끌어 낼 수 있다는 시사점을 제시하였다. 둘째, 이러한 서비스는 높은 고객 만족도를 가지고 있습니다. 셋째, 이는 날로 새로워지는 의료시장의 경쟁 환경 가운데서도 의료기관의 본연의 목적인 환자 치료를 통한 생명 연장의 역할을 해낼 수 있다. 넷째, 이러한 서비스는 보다 높은 고객만족을 통한 의료기관의 생존과 보다 나은 의료서비스를 제공하는 전략개발에 활용할 수 있을 것이다.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.92-106
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• 1999

Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

• 한국방사선학회논문지
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• 제6권2호
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• pp.143-149
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• 2012

오늘날 의료영상매체의 획기적인 발전으로 각 병원에서 최신 의료장비를 도입함으로써 첨단화, 디지털화로 급변하는 추세이다. 이러한 움직임에 발맞추어 방사선 종양학과에서도 CR system을 도입하여 film system의 단점을 보완하고 병원에서 사용하고 있는 Picture Archiving and Communication System(PACS)과 Electronic Medical Record (EMR) , 그리고 Radiation therapy Treatment Planning system(RTP)의 network를 원활히 하여 업무효율 증대 및 환자에 대한 의료의 질 개선과 서비스 향상을 이루고자 하고 있는데, 방사선 종양학과의 Computed Radiography system(CR system)을 이용하여 PACS에 통합한 사례를 소개하고 그 유용성을 평가하고자 한다. 의료용 선형가속기인 MEVATRON-MX를 이용하여 현재 시행하고 있는 정도관리 중 Gantry, Collimator Star Shot, Light vs. Radiation Field Accuracy, HDR QA(Dwell position accuracy)를 시행하여 PACS 상에 구현하였고 모니터 상에서 디지털 영상을 통한 QA가 가능한지 확인하였다. 또한, 현재 S병원에서 사용 중인 Operation Control System(OCS)과 연동하여 치료에 필요한 코드를 각각의 치료에 부과하여 네트워크로 연결, CR상에 입력한 order가 나타나도록 하였으며, Planning System인 Pinacle과 PACS상의 지원 data 오류를 해결하여 PACS 상에서도 Planning 영상을 볼 수 있도록 하였다. CR system을 이용하여 L-gram, simulation image, planning image를 병원 내 어느 곳에서나 영상을 조회하고 볼 수 있게 PACS에 통합 구축되어있다. Filmless 환경에서 Dosimetry용 IP를 이용하여 Light/Radition field size 일치, gantry rotation axis의 정확성, collimator rotation axis의 정확성, brachy therapy의 Dwell position check등 QA의 시행이 가능하였다. CR system을 이용하여 방사선 종양학과에서 얻어지는 영상을 PACS에 통합함으로써 작업시간 단축과 그에 따른 불필요한 인력소모의 감소 등으로 인하여 업무효율이 증대되었지만 향후 환자정보에 대한 보안을 필요로 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.349-353
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• 2014

Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.

• Safety and Health at Work
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• 제2권3호
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• pp.260-272
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• 2011

Objectives: The promotion of health and safety (H&S) awareness among hospital staff can be applied through various methods. The aim of this study was to assess the risk level of physical hazards in the hospital sector by combining workers' perception, experts' evaluation and objective measurements. Methods: A cross-sectional study was designed using multiple triangulation. Hospital staff (n = 447) filled in an H&S questionnaire in a general hospital in Athens and an oncology one in Thessaloniki. Experts observed and filled in a checklist on H&S in the various departments of the two hospitals. Lighting, noise and microclimate measurements were performed. Results: The staff's perception of risk was higher than that of the experts in many cases. The measured risk levels were low to medium. In cases of high-risk noise and lighting, staff and experts agreed. Staff's perception of risk was influenced by hospital's department, hospital's service, years of working experience and level of education. Therefore, these factors should be taken into account in future studies aimed at increasing the participation of hospital workers. Conclusion: This study confirmed the usefulness of staff participation in the risk assessment process, despite the tendency for staff to overestimate the risk level of physical hazards. The combination of combining staff perception, experts' evaluation and objective measures in the risk assessment process increases the efficiency of risk management in the hospital environment and the enforcement of relevant legislation.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2045-2049
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• 2014

Background: Functional status is the ability to perform daily activities. Little is known about quality of life and health status of gynaecological cancer patients. The present study therefore aimed to evaluate the functional status of women receiving treatment for gynecological oncological disease while not hospitalised. Materials and Methods: This descriptive study covered 42 patients monitored by the Gynecological Oncology Unit in 2011. Data were collected using the Functional Living Index-Cancer and analysed with the chi square test, independent samples t-test, Mann-Whitney U test, one-way ANOVA test and the Kruskal-Wallis H test. Results: Of the 42 cases, 66.7% had been diagnosed within the previous year and 90.5% were undergoing chemotherapy. The most severe symptoms experienced were pain (35.7%), fatigue-weakness (40.5%) and nausea and vomiting (56.5%). Daily activities where the most difficulty was experienced were housework (28.6%), average pace walking (31.0%), carrying more than 5 kg (28.6%). The mean Functional Living Index score was quite high ($103.5{\pm}24.1$). FLIC-C scale scores did not vary with the educational status, diagnosis duration, and family history of cancer (p>0.05). Conclusions: Evaluation of the functional status of gynecological cancer patients and how they cope with problems should indicate to healthcare professionals what help can be given to maintain quality of life.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.195-204
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• 2017

Objective : This 2009-2011 nation-wide study of adult Koreans was aimed to provide characteristics, medical utilization states, and survival rates for newly diagnosed patients with primary nonmalignant and malignant spine tumors. Methods : Data for patients with primary spine tumors were selected from the Korean Health Insurance Review and Assessment Service database. The data included their age, sex, health insurance type, co-morbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person occurring in one calendar year were used. In addition, survival rates of patients with primary malignant spine tumors were evaluated. Results : The incidence rate of a primary spine tumor increased with age, and the year of diagnosis ($p{\leq}0.0001$). Average annual medical costs ranged from 1627 USD (pelvis & sacrum & coccyx tumors) to 6601 USD (spinal cord tumor) for primary nonmalignant spine tumor and from 12137 USD (spinal meningomas) to 20825 USD (pelvis & sacrum & coccyx tumors) for a primary malignant spine tumor. Overall survival rates for those with a primary malignant spine tumor were 87.0%, 75.3%, and 70.6% at 3, 12, and 24 months, respectively. The Cox regression model results showed that male sex, medicare insurance were significantly positive factors affecting survival after a diagnosis of primary malignant spine tumor. Conclusion : Our study provides a detailed view of the characteristics, medical utilization states, and survival rates of patients newly diagnosed with primary spine tumors in Korea.

• 간호행정학회지
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• 제17권2호
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• pp.168-179
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• 2011

Purpose: The purpose of this study was to identify level of recognition of the importance, satisfaction and contribution of APNs' role by physicians, nurses, and advanced practice nurses. Method: Perceived importance and satisfaction were measured with a 23-item questionnaire on APN role with 5 subcategories. APNs' contribution was investigated using a 13-item outcome questionnaire developed by the researchers. Between August 15 and October 31, 2009, the researchers collected data from 68 physicians, 265 nurses, and 23 APNs all working in a single tertiary hospital. Data were analyzed using descriptive statistics, Kruskal-Wallis Test with Bonferroni's Correction and scatter plot. Result: The importance (3.24~3.39, 4 point scale), satisfaction (3.02~3.13, 4 point scale), and contribution of APNs' role (3.39~4.12, 5 point scale) were well recognized by the health care professionals. All the three health care professional groups rated APNs' contribution high in medical service management, continuity of care, patient accessibility, improvement in patient satisfaction, and patient and family education. 'Importance-Satisfaction Analysis' showed that patient data management by APNs needed greater effort. Conclusions: The findings show that the importance, satisfaction, contribution of APNs' role are recognized, and indicate a need for further development of APNs' role through efforts to overcome the gaps identified through this research.