• 의학교육논단
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• 제17권1호
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• pp.5-9
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• 2015

A teaching hospital is a place where both patient care and learning occur together. To identify the role of the teaching hospital in an effective clerkship, we first determined the features of workplace learning and the factors that affect learning in the workplace, and then we proposed a role for the teaching hospital in the clinical clerkship. Features of learning in a clerkship include learning in context, and learning from patients, supervising doctors, others in the team, and colleagues. During the clerkship, medical students learn in three-way learner-patient-teacher relationships, and students' participation in the tasks of patient care is crucial for learning. Factors that influence learning in the workplace are associated with tasks, context, and learner. Tying the three factors together, we proposed a role for the teaching hospital in the three categories: involvement in the tasks of patient care, engagement in the medical team, and engagement in the learning environment and system. Supervising doctors and team members in a teaching hospital support students' deep participation in patient care, while improving the learning environment through organizational guidelines and systems. Gathering both qualitative and quantitative data for the evaluation of a teaching hospital is important.

• Journal of Preventive Medicine and Public Health
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• 제24권3호
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• pp.400-413
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• 1991

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows : (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and in-patient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity (3) In case of physician's inpatient and adjusted-patient service, nurses' role is greater than nursing aides'. Therefore, more extensive utilization of nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.

• 대한간호학회지
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• 제49권6호
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• pp.724-735
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• 2019

Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

• Asian Spine Journal
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• 제12권6호
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• pp.987-991
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• 2018

Study Design: Cross sectional study. Purpose: To assess the quality of anterior cervical discectomy and fusion (ACDF) videos available on YouTube and identify factors associated with video quality. Overview of Literature: Patients commonly use the internet as a source of information regarding their surgeries. However, there is currently limited information regarding the quality of online videos about ACDF. Methods: A search was performed on YouTube using the phrase 'anterior cervical discectomy and fusion.' The Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems were used to rate the first 50 videos obtained. Information about each video was collected, including number of views, duration since the video was posted, percentage positivity (defined as number of likes the video received, divided by the total number of likes or dislikes of that video), number of comments, and the author of the video. Relationships between video quality and these factors were investigated. Results: The average number of views for each video was 96,239. The most common videos were those published by surgeons and those containing patient testimonies. Overall, the video quality was poor, with mean scores of 1.78/5 using the DISCERN criteria, 1.63/4 using the JAMA criteria, and 1.96/8 using the HON criteria. Surgeon authors' videos scored higher than patient testimony videos when reviewed using the HON or JAMA systems. However, no other factors were found to be associated with video quality. Conclusions: The quality of ACDF videos on YouTube is low, with the majority of videos produced by unreliable sources. Therefore, these YouTube videos should not be recommended as patient education tools for ACDF.

• 한국융합학회논문지
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• 제10권4호
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• pp.265-275
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• 2019

본 연구는 간호대학생의 환자안전에 대한 태도, 임파원먼트, 표준주의지침 인지도 및 수행도 간의 관련성을 파악하고, 표준주의지침 수행도의 영향요인을 규명하고자 시도되었다. 연구대상자는 J시 소재 일 간호대학 재학생 185명이었다. 자료수집은 2018년 9월 10일에서 21일까지 진행되었으며, 수집된 자료는 SPSS Statistics 22.0 프로그램을 이용하여 Independent t-test, ANOVA, Pearson's correlation coefficient, stepwise multiple regression으로 분석하였다. 다중회귀분석 결과 표준주의지침 수행도의 영향요인은 인지도, 임파워먼트, 환자안전행사 참여로 나타났으며 수행도를 51.0% 설명하였다. 이에 간호대학생의 의료관련감염 관리를 위한 표준주의지침 수행도를 향상시키기 위해서는 인지도를 높이고 임파워먼트를 향상시킬 수 있는 다양한 융합적 교육프로그램의 적용과 환자안전행사에 간호대학생이 적극 참여할 수 있도록 하는 방안을 모색하여야 할 것이다.

• The Journal of Korean Physical Therapy
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• 제33권3호
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• pp.168-177
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• 2021

Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

• 한국응용과학기술학회지
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• 제40권4호
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• pp.773-785
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• 2023

본 연구는 노인 요양병원 간호사의 환자안전관리 활동 영향요인을 파악하여 노인 요양병원의 환자안전사고를 예방하기 위한 기초자료로 활용하기 위해 실시한 서술적 조사연구이다. 대상자는 노인 요양병원 간호사 220명이며, 자료수집은 2023년 2.1~2.28일까지 실시 하였으며, 수집된 자료는 SPSS 29.0 프로그램 이용하여 t-test, ANOVA, Scheffe's test, Person's correlation coefficients, Multiple linear regression으로 분석하였다. 환자 안전동기는 환자안전도(r=.41, p<.001), 환자안전도는 환자안전관리 활동(r=.18, p<.01)과 양의 상관관계를 보였으며, 환자안전관리 활동에 가장 유의한 영향요인은 환자안전도(𝛽=.21, p<.001)와 환자안전지침서(𝛽=.16, p<.001)로 나타났고, 설명력은 7.5%였다(Adj R²=.075, p<.001). 따라서 환자안전관리 활동 역량을 증진시키기 위해 안전사고 발생 이전에 사고를 미연에 방지하도록 위험예지 훈련과 함께 안전사고 후 효과적인 대처를 위한 실습교육을 강화하는 환자안전 교육 프로그램 개발과 적용을 제안한다.

• 한국산학기술학회논문지
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• 제12권12호
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• pp.5715-5721
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• 2011

본 연구에서는 뇌졸중 환자의 일상생활동작 수행도에 영향을 미치는 인지요인을 분석하여, 일상생활동작 향상에 기여하는 인지요소를 파악하고 이를 치료에 적용하고자 함에 있다. 본 연구는 뇌졸중으로 진단을 받고 A병원 재활의학과에 입원하여 포괄적인 재활치료를 받고 있는 환자 21명을 대상으로 전산화 신경인지기능검사(SCNT), MBI를 평가하였다. 뇌졸중 환자의 일상생활동작에 영향을 주는 인지요인에 대한 효과성을 평가하기 위해 일상생활동작 값을 종속변수로 하고 10개의 인지요인을 모형에 포함하여 다중회귀분석을 실시하였다. 연구 결과 뇌졸중 환자의 일상생활동작 수행도에 영향을 미치는 인지요인으로는 주의력 배분과 운동조절, 선택적 주의력이 가장 영향을 주는 것으로 나타났다. 또한 뇌졸중 환자의 일상생활동작 수행도에 대하여 인지요인은 69.8%의 설명력을 나타내었다. 따라서 뇌졸중 환자의 재활치료 시 주의력 배분과 운동조절, 선택적 집중력을 우선적으로 고려하여 중점적인 훈련을 한다면 일상생활동작의 수행도 향상에 효율적일 것이다.

• 한국치위생학회지
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• 제12권1호
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• pp.57-65
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• 2012

Objectives : The purpose of this study is to seek analysis of related factors for dental fear and to know the fear component affecting the treatment of the dental treatment. Methods : Total of 320 females and males aging from 10 to 40 years old with dental treatments done from May to July 2010 have participated with self-entry survey method utilizing the Dental Fear Survey questionnaire. The data received was analyzed using the descriptive statistic, t-test, ANOVA and multiple correlation analysis with level of significance as p<0.05. Results : The dental fear factor were significantly high in woman by $2.79{\pm}0.92$ and in 40's age group by $2.82{\pm}0.84$ (p<0.05). Participants with frequent tooth ache, experiencing pain while treating the tooth ache and breaking the dental treatment appointment showed higher fear factor. Thoughts of having poor dental health condition caused bad influence on fear factor. Overall, the factors affecting the fear of the dental treatments were gender, an ache while treating, number of missed appointment, and distrust of the dentist, stimulation factor were the factors affecting the treatment. Conclusions : The fear factors in the dental treatment were higher with gender, related characteristics of the oral health and distrust of the dentist. Therefore accurately recognizing the sensitive patient with dental treatment, proper management of the toothache, effort to increase the creditability of the doctors and separately treating patient customized for each individual patient will reduce the fear of the dental treatment.

• 대한치과보철학회지
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• 제43권5호
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• pp.633-649
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• 2005

Statement of problem: In spite of the progress in techniques and materials in complete denture prosthodontics, patients still complain of discomfort after the insertion of complete dentures. For the last several decades many prosthodontists tried to find factors influencing patient complete denture satisfaction, however the reported results became a controversy. Purpose: The purpose of the present study was to verify the factors influencing patient satisfaction with complete dentures using multiple regression analysis. Materials and methods: 33 patients who visited the department of prosthodontics, dental hospital of Yonsei University, 4 to 6 weeks after the complete denture delivery, were asked to complete the questionnaires on complete denture satisfaction, social variables and psychological variables. The Prosthodontists who treated the patients with complete dentures were also asked to complete the questionnaires on evaluation of patients' oral condition and technical quality of dentures. The factors influencing patients' satisfaction with their complete dentures were analyzed using multiple regression analysis. Results: Among the patients' sociodemographic variables. the variables of relationship with children, economic status, housing condition, other people's opinions of dentures and gender were the influential factors on patients' satisfaction with complete dentures. Patients showing the symptoms of depression, one of the psychological variables, were dissatisfied with their complete dentures. In spite of the good oral condition, patients were dissatisfied with complete dentures, where-as the technical quality of dentures did not influence patients' complete denture satisfaction. Conclusion : According to the results above, patients' sociodemographic and psychological variables rather than clinical variables including oral condition and technical quality of dentures were the influential factors on complete denture satisfaction. The results of this study may not only enable prosthodontists to predict the success and failure of complete denture treatment, but also help both prosthodontists and patients be informed of the essentials of increasing satisfaction with complete dentures.