• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.127-136
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• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• 성인간호학회지
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• 제17권4호
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• pp.548-560
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• 2005

Purpose: High risk women with congenital heart disease decide to get pregnancy is determined by not individual autonomous intention but complex interaction with their physical status and socio-psychological environments. This study tried to the answer to the question. : "What is experience high risk women who have congenital heart disease during transition to parenthood?". Method: A micro-ethnographic research method and oral historic research approach were done at the Grown-Up Congenital Heart Disease Clinic in one Korean metropolitan city from July 2002 to September 2003. Result: It was discovered that high risk women's experience of transitional parenthood is accounted as the process of lonely and fearful self-accomplishment. Their need for self-accomplishment creates them seek more opportunities to increase enduring abilities for their parenthood. Conclusion: We suggest that from the time of beginning of patient's making decisions about becoming pregnant, collaborative efforts must be considered that priority level of patient's needs be reviewed and find appropriate advices for their situation. Special counseling program should be provided to all the prospective parents with understanding their meaning of parenthood.

• 의학교육논단
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• 제22권1호
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• pp.9-15
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• 2020

Currently, accreditation within medical education is a priority on the agenda for many countries worldwide. The World Federation for Medical Education's (WFME) launch of its first trilogy of standards in 2003 was a seminal event in promoting accreditation within basic medical education (BME) globally. Parallel to that, WFME also actively spearheaded a project to recognize the accrediting agencies within individual countries. The introduction of competency-based medical education (CBME) with the two key concepts of "entrusted professional activity" and milestones has enabled researchers to identify the relationship between patient outcomes and medical education. Recent data driven by CBME has been used for the continuous quality improvement of trainees and training programmes as well. The goal of accreditation has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Even though there are a plethora of types of postgraduate medical education (PGME), it may be possible to accredit resident programmes on a global scale by adopting the concept of CBME. In addition, the alignment of the accreditation for BME and PGME, which center on competency, will be achievable. This argument may extend the possibility of measuring the outcomes of the accreditation itself against patient outcomes as well. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available in the near future and quality improvement will be the driving force of the accreditation process.

• 대한간호학회지
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• 제33권1호
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• pp.71-78
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• 2003

Purpose: The study was done to identify the relationship of treatment side effects, family support, and quality of life in patients with cancer, and factors influencing quality of life. Method: A convenience sample of 106 patients who were receiving cancer treatment at W hospital were interviewed using the Side Effects scale by Hur, Family Support scale by Kang, and QOL scale by Ro. Result: Results indicate that women experienced more severe side effects than men. There was a negative relationship between side effects and quality of life, and a positive relationship between family support and quality of life. The most bothersome side effects were changes in taste and appetite, followed by general weakness and fatigue. Side effects such as loss of hair, nausea, dizziness, numbness, pins and needles in fingers and toes, and dry mouth were also experienced. General weakness and family support were analysed as to whether they were factors influencing quality of life. Conclusion: The results revealed that relieving general weakness should be given high priority in nursing interventions for patients undergoing cancer treatment. In addition, nursing programs should be developed that can reinforce family support.

• 한국전자통신학회논문지
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• 제9권5호
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• pp.595-600
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• 2014

요즘 우리 사회는 급속히 고령화 사회로 변화되고 있다. 고령화 사회에서는 치매에 대하여 잘 아는 것이 매우 중요한 일이다. 따라서 본 연구는 기본적으로 치매환자로부터 측정한 EEG 신호의 특성을 파악하는 것을 목표로 한다. 먼저 그것을 위하여 치매환자와 정상인의 EEG 특성을 구분하기 위하여 두 그룹의 자발 EEG 신호를 분석하였다. EEG 신호는 16개의 전극으로 계측하였고, 그 신호들은 주파수대역으로 분류하여 분석하였다. 보다 선명한 EEG 신호로 처리하기 위해서는 2개의 채널 간에 상호상관함수를 적용하였다. 그 결과, 치매환자와 정상인의 EEG 신호의 특성은 분명히 다르다는 사실을 확인할 수 있었다.

• Radiation Oncology Journal
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• 제38권2호
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• pp.93-98
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• 2020

Purpose: Due to COVID 19 pandemic, the treatment of cancer patients has become a dilemma for every oncologist. Cancer patients are at an increased risk of immunosuppression and have a higher risk to acquire any infection. There are individual experiences from some centers regarding the management of cancer patients during such a crisis. So we have developed our institutional strategy to balance between COVID and cancer management. Materials and Methods: Radiation Oncology departmental meeting was held to prepare a consensus document on Radiotherapy schedules and department functioning during this pandemic. Results: Strategies were taken in form of following areas were steps need to be taken to decrease risk of infection, categorise treatment on the basis of priority, radiotherapy schedules modification, academic meetings and management of COVID positive patient/personnel in Radiation Oncology department. Conclusion: We hope to strike the balance in overcoming both the battles and emerge as winners. Stringent long term follow up will be done for assessing the response or any unforeseen treatment related sequelae.

• 대한정형외과학회지
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• 제56권5호
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• pp.433-439
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• 2021

파상풍 감염에 대한 확실하고 효율적인 예방법이 있어 선진국에서의 발병률과 사망률은 현저히 감소하였으나 이로 인해 파상풍 감염에 대한 인지도 저하 및 예방접종 규칙 미준수로 최근 발병률의 증가 추세를 보인다. 파상풍 감염 결과는 치명적일 수 있어 예방이 우선되어야 하며 감염 시 적극적인 수술적 처치와 지지요법을 통해 치료해야 한다. 이에 저자들은 족부 부상으로 인해 발생한 59세 남성 환자의 전신 파상풍 증례를 통해 감염된 족부에 적극적 외과적 변연절제술 및 절단을 시행하였고 2개월간 지지요법을 통해 환자는 성공적으로 회복하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3933-3938
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• 2014

Background: Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. Materials and Methods: A descriptive-correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. Results: Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. Conclusions: The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.

• 대한영양사협회학술지
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• 제22권1호
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• 한국산업보건학회지
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• 제29권3호
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• pp.375-382
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• 2019

Objectives: This study was to examine the features of work and posture analysis outputs in assessment of exposure to musculoskeletal disorder (MSD) risk factors in general hospital nurses. Methods: Work and posture analyses were carried out using observational approaches for nurses at general hospitals across Korea. With development of a taxonomy for assessing exposure to MSD risk factors, nursing tasks were documented in frequency (%time) for 8 hours a day in work analyses. Rapid Entire Body Assessment (REBA) scores were obtained for mode and maximum risk levels, respectively, during posture analyses. Results: A total of 27 nurses were observed while conducting 7 nursing tasks at 6 general hospitals. For both the work analyses and posture analyses, the taxonomy was developed and used. In the work analyses, 'Video display terminal task' and 'Nursing examination/ treatment' were the highest as 25%time for 8 hours a day, followed by 'Patient care' and 'Room rounding' as 13%time in order. In the posture analyses, the mode REBA scores were 2 or less for all nursing tasks while the maximum REBA scores were 7 for upper limbs at 'Room rounding' and 6 for trunk/neck/legs at 'Patient care'. Conclusions: The results showed the study nurses are occasionally at a risk for MSD, a medium level as designated in the REBA risk level, suggesting that it is important to control awkward posture at the nursing tasks such as 'Room rounding' and 'Patient care', in priority, for preventing MSD in the hospital sector including the study general hospitals.