• Title/Summary/Keyword: patient-physician communication

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End of Life Issues in Cancer Cases: Ethical Aspects

  • Taghavi, Afsoon;Hashemi-Bahremani, Mohammad;Hosseini, Leili;Bazmi, Shabnam
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.239-243
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    • 2016
  • This article investigates ethical challenges cancer patients face in the end stages of life including doctors' responsibilities, patients' rights, unexpected desires of patients and their relatives, futile treatments, and communication with patients in end stages of life. These patients are taken care of through palliative rather than curative measures. In many cases, patients in the last days of life ask their physician to terminate their illness via euthanasia which has many ethical considerations. Proponents of such mercy killing (euthanasia) believe that if the patient desires, the physician must end the life, while opponents of this issue, consider it as an act of murder incompatible with the spirit of medical sciences. The related arguments presented in this paper and other ethical issues these patients face and possible solutions for dealing with them have been proposed. It should be mentioned that this paper is more human rational and empirical and the views of the legislator are not included, though in many cases human intellectual and empirical comments are compatible with those of the legislator.

A Study on the Disturbing Factors which Work against Therapeutic Atmosphere & Environment on Hospital Wards as Perceived by Patients and Nurses (환자 및 간호사가 지각하는 치료적인 병실분위기 조성의 저해요인에 대한 조사 연구)

  • 김영혜;한명은
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.178-188
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    • 1997
  • As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means & SD. and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role & economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were' the prognosis of disease', 'the communication trouble with the medical team & interpersonal relationships'. 'The change of daily life' was not a perceved factor by nurses, but ranked third by the patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship. the patient group reported that the worst disturbance was dur to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors. the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded' physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or infavorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information. the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

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Simulation training applying SBAR for the improvement of nursing undergraduate students' interdisciplinary communication skills (SBAR 적용 시뮬레이션 교육이 간호학생의 의료팀간 의사소통능력 향상에 미치는 효과)

  • Ha, Yikyung;Lee, Yoonju;Lee, Yeon Hee
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.2
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    • pp.407-419
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    • 2017
  • In this paper, we aim to evaluate the effect of simulation training with a focus on the application of SBAR for the improvement of communication skills of nursing students with physician. The results of the analysis of 25 videos recorded pre/post-simulation were as follows: In terms of the SBAR score, "the most recently measured vital signs" in stage B increased significantly (Z = -2.448, p =.014); the frequency of step-by-step progress in SBAR did not advance to the SBA or SBAR stage in the pre-simulation stage, but increased to 48% post-simulation. The frequencies of SBAR evaluation items mentioned in the post-simulation were the following order: the name of the patient (96%), nurse's name (80%), most recently measured oxygen saturation (76%), and main symptoms (60%). The results of the nurse's judgment (A), request for additional prescription or request for the doctor's direct patient visit (R) were not mentioned. Therefore, it is necessary to consider the application of SBAR in simulation training, which requires problem solving through cooperation with physicians, because it has a positive effect on education in nurse-physician communication.

An Exploratory Study on the Meaning of 'the Patient Trusts the Doctor' (의사-환자 관계에서 '환자가 의사를 신뢰한다'의 의미 고찰)

  • Kim, Min-Jeong
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.415-423
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    • 2017
  • Patient's trust in their physician is crucial for relationship between patients and their doctors, treatment outcomes such as satisfaction and adherence or revisits. The purpose of this study is to investigate the meaning of trusting the doctor in the doctor - patient relationship and to examine it through the multidimensional measurement tools. Using the convenience sampling method, 328 respondents in their 20s or older who had visited the hospital within 6 months were used as the analysis data. As a result of the research, it is difficult to define the meaning of the patient's trust in the doctor, but it can be summarized as having at least four meanings. First, the doctor should listen carefully to the patient's story and show communication behaviors expressing interest and forming an atmosphere of dialogue. Second, the patient's health should be considered first to understand the patient and empathize with the patient. Third, it should be honest in the examination and procedures related to the treatment as well as the technical ability. Finally, we should try to cooperate with patients.

Work Stress, Turnover Intention and Burnout among Nurses in Neonatal Intensive Care Units (신생아중환자실 간호사의 업무 스트레스, 이직의도 및 소진에 관한 연구)

  • Yu, Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.1
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    • pp.115-126
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    • 2011
  • Purpose: This study was done to identify differences in work environment, work stress, turnover intention and burnout and investigate the relationship among these variables in nurses in Korean Neonatal Intensive Care Units. Method: Participants were 242 nurses working in 13 general hospitals. Burnout was measured by the Maslach Burnout Inventory (MBI), work stress with the instrument by Gu & Kim (1994), and turnover intention with the scale by Kim & Lee (2001). Size of the NICU, nurse to patient ratio, and communication satisfaction were included in work environment. Data were analyzed using Pearson correlation coefficients and multiple regression analysis with SPSS WIN program. Results: The mean score for work stress in NICU nurses was 3.43 points, for burnout, 2.72 points, and for turnover intention, 4.64 points. Burnout and turnover intention level of participants were moderate-high. Work stress, communication dissatisfaction with physician, and clinical career accounted for 33% of variance in burnout. Significant differences were found between size of NICU and staffing related to environmental characteristics in turnover intention and burnout. Conclusions: Results indicate that effective communication with coworkers and institutional support for appropriate staffing according to number of beds will help to prevent work stress, burnout, and ultimately, nurses' resignations.

Improvement Plan of the Korean Electronic Medical Record (우리나라 전자의무기록의 개선방안)

  • Choi, Chan-Ho
    • Journal of Society of Preventive Korean Medicine
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    • v.18 no.3
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    • pp.11-21
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    • 2014
  • The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.

Rehabilization after ACL Reconstruction (전방십자인대 재건술후 재활치료)

  • Shin, Dong-Min
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.86-90
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    • 1997
  • Good stability and complete range of motion should be the ultimate goal of a rehabilitation program after ACL reconstruction. In previous years. the rehabilitation of the ACL reconstructed knee focused on protecting the new ligament by blocking terminal knee extension, hut, despite good stability, this approach led to numerous postoperative complications. Nowadays, most of surgeons agree the accelerated rehabilitation program based on the concept of ligamentization and clinical experience. Accelerated rehabilitation program consists of maintain of full extension of the knee, early weight bearing and prompt recovery of ROM, and closed kinetic chain exercise. Meeting this goal requires effective communication between-members of the health care team-the physician, physical therapist, atheletic trainer, and the patient. We have to know the importance of rehabilitation, knowlege about the physical therapy, and to introduce for special physical therapist and equipment.

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Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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A Personalized Healthcare Analysis System in Ubiquitous Environment

  • Sain, Mangal;Chung, Wan-Young;Lee, Hoon-Jae
    • Journal of information and communication convergence engineering
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    • v.9 no.2
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    • pp.235-243
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    • 2011
  • With the recent trends and the adaptation of further advancement in personal healthcare system leads to develop some application which can work independent and user can operate that application without much interference of physician or any specialist user. To meet these needs, this paper proposes and implements a progressive architecture for the personal healthcare information system. This new architecture will not only play the role of middleware but also provide a analysis tool to process that different sensor data which is collected from different sensors implemented on patient body and environment. After collecting that data, with the help of various developed applications this data can be convert into useful information which will be stored in application server for further use and research. These features can be enabled by simple and effortless interactions of normal users and act autonomously to support their activities. This proposed personal healthcare architecture will also provide analysis report to the doctors and patient or various users for further instructions. The analysis report consists of healthcare data analysis results and history of patients. We are considering healthcare data like ECG, which is an important aspect for basic healthcare need.

Doctors' Images Represented in the Korean Press: From a Perspective of the Korean Doctor's Role 2014

  • Kim, Kyong-Jee;Yoo, Kyung-Eun;Hwang, Jee-Young
    • Korean Medical Education Review
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    • v.20 no.3
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    • pp.141-149
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    • 2018
  • This study examined doctors' images represented in the Korean press to identify overall public perceptions of doctors and to suggest areas for improvement to enhance their image. All news reports published in the two major Korean daily newspapers between years 2011 and 2015 related to doctors and the practice of medicine were searched and collected. The news reports were categorized into the five competency domains in the Korean doctor's role (i.e., patient care, communication and cooperation, social accountability, professionalism, and education and research). Each news item was coded as being either positive or negative and was given a score regarding the extent to which positive or negative image that it represents of doctors using the Doctor Image Scale (DIS) score. A total of 314 news reports were collected, a majority of which were on patient care (36%), professionalism (33%), and social accountability (23%). Positive stories slightly outnumbered negative ones (56% vs. 44%). The largest number of positive news reports was in patient care (n=82); negative news reports most frequently appeared in professionalism (n=99) and patient care (n=32). The total DIS score was also positive (+28): the highest positive DIS score was in social accountability (+164); the highest negative DIS score was obtained in professionalism (-226). This study revealed overall positive portrayals of doctors in the Korean press, yet doctors need to better comply with regulations and ethical guidelines and enhance their medical knowledge and clinical skills and to improve their image.