• Quality Improvement in Health Care
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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.

• Research in Community and Public Health Nursing
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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.

• The Korean Journal of Pain
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• 제3권2호
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• pp.165-171
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• 1990

The reflex sympathetic dystrophy syndrome (RSDS) consists of sustained burning pain and tenderness, vasomotor instabilitiy, swelling, occasional functional instability, trophic skin change and edema of extremity following trauma, peripheral nerve injury, spinal cord injury, infection, burn and other etiologic factors. The most important thing in RSDS is to start the treatment as soon as the disease was diagnosed. Most patients with RSDS respond dramatically and permanently to sympathetic blocks if treatment is instituted before irreversible trophic changes. The characteristic radiological finding in RSDS is a patchy osteoporosis in the cancellous bone. Periarticular hyperactivity is seen in RSDS by Tc99m bone scan. We have managed 4 cases of RSDS. The methods of management and effects are as follows: 1) In case 1, 28 lumbar sympathetic blocks in both sides were performed. The patient did not complain of pain or tenderness and the limping improved. 2) In case 2, 7 lumbar sympathetic blocks were performed, but we could find only a slight improvement in the symptoms. 3) In case 3, 8 stellate ganglion blocks were carried out. The patient refused the treatment of RSDS because of the lack of rapid improvement. 4) In case 4, total 64 stellate ganglion blocks were carried out; the patient was permanently improved.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.195-201
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• 2015

Objectives : The purpose of this study is to report on the improvement of respiratory function of a fascioscapulohumeral muscular dystrophy patient after receiving Korean medical treatment. Methods : This study was carried out on a 60 year-old male patient who suffered from fascioscapulohumeral muscular dystrophy. While we carried out Korean medical treatment, we observed $EtCO_2$ (end-tidal carbon dioxide), Vte (exhaled tidal volume) and PIP (peak inspiratory pressure). Results : $EtCO_2$ count decreased from 34 mmHg to 24 mmHg during the treatment period, and PIP count became stable. Vte count also did not worsen in this study. Conclusions : Based on this study, we concluded that Korean medical treatment could be effective in treating fascioscapulohumeral muscular dystrophy patients with respiratory failure.

• Korean Journal of Head & Neck Oncology
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• 제33권1호
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• pp.85-89
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• 2017

A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

• Journal of the korean academy of Pediatric Dentistry
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• 제24권4호
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• pp.776-780
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• 1997

Patient with alveolar abscess due to dental caries with severe alveolar bone loss, severe tooth mobility, root resorption need extraction of tooth because it is impossible to carry out pulp treatment and restoration by using conventional method. Early loss of primary molar might cause masticatory interference, extrusion of opposing tooth, problem in maintaining space and interference on eruption of permanent tooth. Especially, early loss of primary second molar before the eruption of permanent first molar might cause space closure by mesially erupted permanent first molar and impaction of second premolar. In such a case, distal shoe space maintainer and removable space regaining appliance was the first choice of treatment. But, distal shoe space maintainer need precise adaptation and might cause chronic inflammation if the oral hygiene is poor. In a case using removable space regaining appliance, patient's cooperation is most important. If the distal root of primary second molar is comparably sound and alveolar abscess with alveolar bone loss is localized at mesial root, hemisection should be carried out for precise guide to eruption of the permanent first molar, restoration of masticatory fuction and solution to the discomfort of the patient

• Quality Improvement in Health Care
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• 제5권1호
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• pp.2-14
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• 1998

The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patient satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7, 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those receiving free-care. There were, however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients. except for the dimension on sympathy and shape.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• 제24권2호
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• pp.87-95
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• 2011

Objective : Subcorneal pustular dermatosis is a rare, chronic neutrophilic dermatoses that was first described in 1956. The eruption is characterized by flaccid pustules grouped in a circinate pattern on normal or erythematous skin. We treated a case of subcorneal pustular dermatosis in one patient; there have been no former reports of this disease treated by oriental medicine. We present this case because we considered it to be useful as a possible Oriental medicine treatment for subcorneal pustular dermatosis, and something that canbe used for further study of neutrophilic dermatoses. Method : We used herbal medication, acupuncture, herbal wet dressing, herbal ointment, cupping therapy and phototherapy during treatment. We assessed symptoms during treatment and also carried out blood tests through out. Result : We observed and treated a case of subcorneal pustular dermatosis patient and after treatment the patient's objective and subjective symptoms showed noticeable improvement. Conclusion : We suggest that subcorneal pustualr dermatosis can be treated by Oriental medicine therapy effectively. We expect these study results will help provide useful evidence of Oriental medicine as an effective treatment for subcorneal pustualr dermatosis.

• Journal of Chest Surgery
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• 제54권6호
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• pp.543-546
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• 2021

A 55-year-old woman who had received an implantable left ventricular assist device 3 months earlier presented with dyspnea and a low-flow alarm of the device. Computed tomography and log-file analysis of the device system suggested inflow cannula obstruction. Since the patient had cardiogenic shock due to pump failure, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. With ECMO, surgical exchange of the pump was considered. However, the obstruction spontaneously resolved without surgical intervention. It turned out that an obstructive thrombus was washed out by rebooting the pump. Moreover, the thrombus was embolized in the patient's left subclavian artery. The patient underwent heart transplantation 4 months after the pump obstruction accident and continued to do well.

• Journal of Digital Convergence
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• 제18권7호
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• pp.299-306
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• 2020

The purpose of this study is to find out specific measures that can help the management strategy of patient-centered medical institutions by conducting research on patient experience surveys of convergence outpatient medical services using data mining techniques according to changes in patient-centered medical culture. Using the raw data of the 2018 Medical Service Experience Survey, 8,843 people over the age of 15 who had patient experience in outpatient medical services were analyzed. Decision tree analysis was performed. The determinants of satisfaction with outpatient medical services patient experience were the doctor's area and patient's rights protection area, and the determinants of intention to recommend outpatient medical services were the doctor's area and facilities comfort. Women evaluated the experience positively in overall satisfaction as compared to men, and those over the age of 60 positively evaluated the overall satisfaction and intention to recommend. It is significant that the outpatient experience decision-making model is presented, and that the doctor's area, patient's rights protection area, and facility comfort are important factors. Long-term research on the 'Medical Service Experience Survey' is needed, and research on the inpatient medical service experience is needed.