• 제목/요약/키워드: out patient

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구급대원을 대상으로 한 환자평가 교육 전·후 수행도의 비교 (Pre-post comparison Analysis of Patient assessment education for Emergency Medical Technicians(EMTs))

  • 이무상;이슬기;김기운
    • 한국산학기술학회논문지
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    • 제17권7호
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    • pp.211-219
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    • 2016
  • 본 연구는 119구급대원을 대상으로 환자평가 수행도에 대한 교육 전 후를 비교함으로써, 구급대원을 대상으로 한 적절한 교육방법 및 기초자료를 제시하기 위해 진행하였다. 전국 4개 시 도 119구급대원 26명을 대상으로 하였으며, 연구는 2015년 12월 14일부터 17일까지 시행하였다. 구급대원이 직접 모의환자를 대상으로 환자평가 및 보고를 시행하도록 하였고, 환자평가를 진행하는 동안 각각의 증상(두통, 가슴통증, 호흡곤란)에 대한 체크리스트(checklist)를 사용하여 교육 전 후를 평가하였다. 연구 결과는 중앙값(사분위값)으로 기술 분석하였고, 교육 전 환자평가 수행도는 100점 만점에 66점(54.00-80.25)이었으나 교육 후 88.5점(80.00-93.00)으로 유의한 상승을 보였다(p<0.001). 환자평가 수행도 중 가슴통증 증례 5개의 항목, 두통 증례 7개의 항목, 호흡곤란의 증례 9개의 항목에서 교육 후에 유의한 증가를 보였고, 환자와의 관계형성에서는 구급대원을 다시 만나고 싶은 정도의 평가점수가 유의한 상승을 보였다(p<0.01). 또한 환자상태 보고 적절성의 모든 평가항목은 교육 후 수행도가 유의하게 상승하였다(p<0.01). 본 연구의 결과는 시뮬레이션 실습에 의한 교육이 119구급대원들의 환자평가 수행도 개선에 필요하다는 것을 보여준다. 따라서 119구급대원에 대한 실질적이고 체계적인 환자평가 교육은 필요하며, 지속적이고 많은 교육의 기회가 주어져야 할 것이다.

한방의료 품질 향상을 위한 신뢰구현 체계구축 연구 (A Research on Trust Realization Strategies for Oriental Medical Quality Improvement)

  • 김현지;김소연;지영승;남승규;김정호;김영일
    • Journal of Acupuncture Research
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    • 제31권1호
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    • pp.75-93
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    • 2014
  • Objectives : This study was designed to establish medical trust realization system by finding factors influential to it using questionnaire. Methods : 277 subjects were participated in this study. After a treatment, we conducted a survey from April 1st to October 31th about medical service perception index, medical trust index, patient satisfaction index, patient reliability index, patient flow degree index, recall intension index, and hospital image index. To evaluate the influence of medical service perception with other 6 indexes, we statistically made regression analysis of the results through the survey. Results : By the results of the analysis, evaluation of hospital image influenced all 6 indexes. The systemicity of treatment process had an effect on 5 indexes except for the flow degree of patients. The humanity of medical team brought out the estimation of 4 indexes except for the patient flow degree and hospital image. The empathic ability of doctor and appropriacy of medical costs hold the next rank influencing 3 indexes. It reached the conclusion that the systemicity of medical team tend to determine the medical trust and patient reliability. The expertise, professional skill of doctor, the fault, commercial application, fame of medical team, the speed of treatment process, the newest and clean medical facility affected each one index. Conclusions : Korean medicine should find a way to consider the mind of patients for improving the medical quality through trust realization system, keeping up with times. As a result of this research, we can find out important causes which influence the trustful medical system. From now on, we should apply this result to actual treatment of psychology customized system. Also, more simple and clear questionnaire was organized through this research, it can be used to forward research to apprehend patient mentality more conveniently.

한국 침구 치료 현황 파악을 위한 설문조사 (A Survey of Actual State of Treatment with Acupuncture and Moxibustion in Korea)

  • 한창현;신선화;안상우;최선미
    • Journal of Acupuncture Research
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    • 제22권6호
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    • pp.141-153
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    • 2005
  • Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture treatment in real clinics. Methods : The survey questions were developed by the consensus from the professors who major in acupuncture and moxibustion. The questionnaire was given the 2731 Korean medical doctors at the mending education site; In addition, it was given to 793 doctors working at the 105 Korean medical hospitals listed on the National Korean Medical Hospital Associations Address book by postal mail; and also it was given to the 142 public health care Korean medical doctors who attended the conference for the municipal and provincial representatives of the public health service Korean medical doctors. Total of 1277 questionnaires were retrieved out of the 3666 subjects. Results : 1. Nine hundred out of 1277 Korean medical doctors used method of differentiation syndromes(70.4%) and 1184 out of 1277 Korean medical doctors convalescence decide with subjective symptom improvement of patient(92.6%). 2. Nine hundred eight out of 1277 Korean medical doctors used both local and remote points(71.0%) and 916 out of 1277 Korean medical doctors treat with method of reinforcement-reduction(71.7%). 3. Eleven hundred fifth five out of 1277 Korean medical doctors used cupping a boil(90.3%) and 1023 out of 1277 Korean medical doctors used moxibustion(80.1%). Conclusion : When Korean medical doctors treat with acupuncture, most of them diagnose with differentiation methods and meridian theory, decide convalescence with subjective symptom improvement of patient, select out of both local and remote acupuncture points, treat with method of basic reinforcement-reduction, apply moxa and cupping a boil when they are necessary. The cupping a boil comes to be used when being muscle and joint disease. The moxa comes to be used when being chronic disease.

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1977년도 년간 개심술 100례 보고 (One Hundred Cases of Open Heart Surgery in 1977)

  • 이영균
    • Journal of Chest Surgery
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    • 제11권2호
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    • pp.213-226
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    • 1978
  • One hundred cases of open heart surgery were done at this Department in 1977. There were 65 congenital anomaly and 35 acquired diseases. Out of 65 cases of congenital malformation 35 acyanotic and 30 cyanotic cases were found. Fifteen cases of ventricular septal defect and 29 tetralogy of Fallot were noted eight patients expired out of 65 congenital anomaly [12.3%] , 4 out of 35 acyanotic [11. 4%] and 4 among 30 cyanotic anomaly[13.3%]. Among 35 cases of acquired heart disease 3 atrial myxoma [2 left and one right] and 32 valvular lesions were noted. In two cases open mitral commissurotomy, and in 30 valve replacement were done. Twenty-two single valve and 8 double valve replacement were done. Seven patients expired out of 30 patients [23.3%]. Among 22 single valve replacement cases 2 and among 8 double valve 5 died. ~ In eighteen mitral valve replacement cases 2 deaths occurred. One mitral insufficiency patient who expired suffered from severe pulmonary` hypertension [PA=120/67mmHg], tricuspid insufficiency and a large ventricular septal defect. The patient underwent mitral valve replacement, tricuspid annuloplasty and patch closure of ventricular septal defect. Over all mortality rate for 100 open heart surgery cases was 15%. Since 1977 open heart surgery cases were done routinely in this institution and cases are increasing rapidly. With present rapid improvement of economical status and introduction of medical insurance system, open heart surgery will be firmly established in Korea in the very near future.

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개심술 134례의 임상적 고찰 (Clinical Experience of Open Heart Surgery - Review of 134 Cases -)

  • 이종태;유병하;박도웅
    • Journal of Chest Surgery
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    • 제21권4호
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    • pp.641-648
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    • 1988
  • Between April 9, 1986 and September 2, 1987, 134 patients underwent open heart surgery with hypothermic cardiopulmonary bypass and cold blood cardioplegia. There were 65 patients[48.5%] of acyanotic congenital cardiac anomalies, 19 patients[14.2%] of cyanotic congenital cardiac anomalies, and 50 patients[37.3%] of acquired heart diseases, which included 49 valvular diseases and 1 myxoma. In 84 congenital cardiac anomalies, 44 patients were male and 40 patients were female ranged in age from 2 years to 57 years. In 50 acquired heart diseases, 18 patients were male and 32 patients were female ranged in age from 10 years to 65 years. The common congenital defects operated were VSD in acyanotic cardiac patients, and Tetralogy of Fallot in cyanotic cardiac patients. Among 50 acquired heart diseases, 49 patient underwent operation for cardiac valvular lesions. 33 patients had mitral valve replacement and 7 patients had aortic valve replacement. 1 patient underwent aortic valvuloplasty and 8 patients had double valve replacement. The operative mortality rate was 3.1%[2 out of 65 patients] in acyanotic cardiac patients, 5.3%[1 out of 17 patients] in cyanotic cardiac patients, and 12.0%[6 out of 50 patients] in acquired cardiac patients, with overall mortality rate of 6.7%[9 out of 134 patients].

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3 차 의료기관에서의 영양업무 분석 : 업무수행 시간 및 적정인원 산출 (A Study for Dietetic Practitioner's Job Analysis : labor Time Spent and Staffing Need Indices)

  • 조미란;구정민;이혜옥;조여원
    • 대한영양사협회학술지
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    • 제7권1호
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    • pp.38-49
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    • 2001
  • This study was designed to analyze the dietetic practitioner's job in the over 600-ed hospitals in korea and to assess their labor time spent and staffing need indices. The actual time spent and expected labor time spent on dietitians' activities were investigated and the proper dietic staffing needs in the hospitals was also calculated. A job analysis questionnaires were developed and mailed to 20 hospitals. Completed questionnaires were received form 12 hospitals for a response rate of 60%. The followings are summary of the results. 1. The jobs dietitians at the hospitals were classified into the following 7 areas, direct patient care, indirect patient care, therapeutic patient care, education & counseling, meeting & research, delay & movement, and administration & food services. 2. The actual time spent on dietetic practice was 48.6 hours and expected labor time spent was 99.2 hours, Therefore, the proper time required to conduct classified jobs was 2.1 times higher than the time spent. Especially, the time required for performing clinical nutrition services including direct patient care, indirect patient care, therapeutic patient care was significantly higher than the time needed. 3. The average times required for the direct patient care was 1334.6min, for the indirect patient care was 796.3min, for the therapeutic patient care was 1634.5min, for the education & counseling was 265.2min, for the meeting & research was 366.7min, for the delay & movement was 327.3min, and for the administration & food services was 1170min. The staffing need indices was 12.3. As a conclusion, the standardized job descriptions for the dietitian to carry out their job at the hospital should be established. And the clinical dietitians as nutrition professionals have to be recruited to provide systematically hospitalized patients with medical nutrition therapy at each hospital.

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총의치 환자 만족도에 대한 정신의학적 측면 (PSYCHOLOGICAL ASPECT OF PATIENT SATISFACTION AND ACCEPTANCE OF COMPLETE DENTURES)

  • 정문규;이석원
    • 대한치과보철학회지
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    • 제37권4호
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    • pp.494-505
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    • 1999
  • In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.

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심리유형별 진료도구를 이용한 한방치료의 만족도 평가 연구 (A Study on Satisfaction Evaluation of Korean Medicine Therapy Using Treatment Tool by Psychological Type)

  • 지영승;이승민;김정호;남승규;김영일
    • Journal of Acupuncture Research
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    • 제30권3호
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    • pp.27-38
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    • 2013
  • Objectives : This study was designed to evaluate patient satisfaction of Korean medicine therapy using treatment tool by psychological type. Methods : 48 subjects were participated in this study. Before a treatment, we analyzed a patient's phychological type first by using a questionnaire. And then we divided 3 groups which were called a rational sympathy module group, emotional sympathy module group, control group. Manner of medical consultation according to patient's phychological type was carried out in all groups. After all treatment, we conducted a survey about medical service perception index, patient happiness index, medical satisfaction index. To evaluate a satisfaction degree, we analyzed results of survey statistically. Results : The results of the analysis, both rational sympathy module group and emotional sympathy module group got a higher score than control group statistical significantly on medical service perception index. Emotional sympathy module group got a higher score than control group statistical significantly on patient happiness index and medical satisfaction index. But rational sympathy module group only had a higher tendency than control group on patient happiness index and medical satisfaction index. Emotional sympathy module group got a higher score than rational sympathy module group on medical service perception index, patient happiness index and medical satisfaction index. Conclusions : Korean medicine therapy using treatment tool by psychological type consisted of patient's phychological type questionnaire and manner of medical consultation could improve a patient's satisfaction. It was more effective in emotional sympathy module group than rational sympathy module group.

환자중심성의 개념적 구성 요소: 환자와 가족구성원의 관점 (Conceptual Constructs of Patient Centeredness: Perspective of Patients and Family Members)

  • 김은나;옥민수;신유경;조민우;이진용;도영경
    • 한국의료질향상학회지
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    • 제25권2호
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    • pp.26-43
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    • 2019
  • Purpose:The objective of this study was to identify the conceptual constructs of patient centeredness from the perspective of patients and family members in Korea, and to compare them with those included in the Picker Institute framework. Methods: Two focus group discussions were conducted. Each focus group consisted of six participants who had experienced being either a patient or a caregiver. We carried out a thematic analysis, and then compared the contents of our focus group discussions with the components of patient-centered care outlined by the Picker Institute. Results: Six conceptual constructs of patient centeredness emerged from the focus group discussions. Five of these overlapped with those outlined by the Picker Institute: 1)respect for patients' values, preferences, and needs, 2) coordination and integration of care, 3) information, communication, and education, 4) physical comfort, and 5) emotional support and alleviation for fear and anxiety. A new component that was not mentioned in the Picker Institute framework emerged from this study: "ease of making a complaint." Currently, "involvement of family and friends" and "continuity and transition" were not prominent components of patient centeredness according to our focus group discussions. Conclusions: This study presents the conceptual constructs of patient centeredness, five of which overlap with those outlined by the Picker Institute, and provides a qualitative basis of the patient experience survey currently being implemented by the Health Insurance Review & Assessment Service in Korea.

정신과 외래환자의 자가간호수행 및 가족기능과 가족 부담감의 관계 (A study on the Family Caregiver Burden for Psychiatric Out-Patients)

  • 김연희
    • 지역사회간호학회지
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    • 제5권1호
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    • pp.64-80
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    • 1994
  • The purpose of this study was to identify factors affecting family caregiver burden, and to identify the relationship between family caregiver burden and family function /self-care of psychiatric out-patient. These data were collected by questionnaire from September 20 to October 8, 1993. The subjects were 285 family caregiver of psychiatric out-patients. The instruments used in this study were Caregiver Burden Inventory(CBI) by Novak(1989), self-care performing by Yu(1992), and Family APGAR by Smilkstein(1979). The data were analyzed by cronbach's $\alpha$, mean, standard deviation, percentage, t-test, ANOVA, Pearson's correlation coefficient, and Stepwise Multiple Regression with SPSS /pc+ program. The result of this study were as follows ; 1. The means of family caregiver Burden revealed total 2.00, Time-Dependence Burden 78, developmental Burden 2.22, physical Burden 1.90, social Burden 1.43, emotional Burden 2.18, financial Burden 1.51. family caregiver burden score showed moderate level. time-dependence burden showed the highest score and social burden showed the lowest score. 2. The means of family function revealed total 5.67. 7 through high-21.4% (61), low through 3-38.6%(110). family function score showed moderate level. 3. The means of patient's self-care performance revealed total 137.71. self-care performance showed moderate level. 4. A ststistically significant correlation between family caregiver burden and patient's demographic variables, age (F=3.83, p<.01), marrital status(F=3.50, p<.01), job(F=3.17, p<.01), diagnosis(F=4.46, p<.01), income (F=4.46, p<.01). No significant differences between family caregiver burden and prevalent period, religion, sex (p>.05). S. A ststistically significant correlation between family caregiver burden and family's demographic variables, age (F=7.34, p<.01), sex(t=-2.63, p<.01), education level(F=7.61, p<.01), income (F=8.13, p<.01), relation with patient (F=6.92, p<.01), job(F=2.03, p<.05), medical service (F=3.89, p<.05), presence of chronically ill without patient(t=-2.01, p<.05) 6. Family function was the highest factor predicting family caregiver burden(R=.4168, $R^2=.1737$), low education level of family, patient's self-care, family income accounted for 36% in family caregiver burden.

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