Kim, Min-Ji;Shin, Eui-Chul;Park, Seong-Hi;Kim, Jee-Yoon
Quality Improvement in Health Care
/
v.19
no.2
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pp.36-46
/
2013
Objectives: The purpose of this study is to find a way to effectively introduce accreditation for ambulatory health care organization by identifying the physicians' attitude for accreditation and characteristics that affect thei r attitude. Methods: A web survey was conducted from February 15 to March 4, 2011 for 183 physicians who work in ambulatory health care organizations throughout the nation. Self-reported questionnaire was used for this study. SPSS WIN(version 12.0) was utilized for statistical analysis. Results: Physician's attitude towards accreditation for ambulatory health care organization was positive(25.7%), moderate(39.3%), and negative(35.0%). Clinics that practice as a group or which treat more patients per day showed more positive attitude(p<0.05). The result of ordinal regression analysis indicates the groups with daily patients over 100 showed 36.3 times more positive attitude than the one under 75(p<0.05). Conclusion: The accreditation for ambulatory health care organization has not been throughly discussed yet. Many physicians did not have knowledge about accreditation. Clinics that see more patients per day had more positive attitude for accreditation. It indicates the cost may play important role in voluntary participation in accreditation.
Park Tae Won is one of the physicians that participated in the treatment of King Injo in "承政院日記(Seungjeongwonilgi, official records of incidents during the Joseon Dynasty)". The purpose of this study is to look into the forms of actual medical treatment, social status and activities of the physicians at that time by organizing Park Tae Won's records as a physician and his other works. Park Tae Won was originally an acupuncturist for the royal medical department but he performed other activities such as actual diagnosis and drug prescriptions. More concretely it seems that he used methods mentioned in "鍼灸經驗方(Chimgugyungjeonbang)". Park Tae Won held concurrent positions as royal physician as well as provincial governor. It is suspected that physicians were named provincial governors of metropolitan areas so that they could be brought in immediately when in need and so that the capital centered medical service could be distributed to other provinces. We can also presume that the appointment of physicians as provincial governors was part of the government policy to efficiently distribute aid to the common people. From this study we can conclude that the physicians of that time did not commit solely to their jobs but also held important social positions that led the Joseon society.
The aim of this study was to analyze the correlation between professional autonomy and ideology among Korean physicians and to investigate how these factors affect job satisfaction like social status satisfaction and economic reward satisfaction. This study utilized a self-administered questionnaire survey and collected data nationwide between July and August, 2003. 211 responses were used for final analysis. SPSS 12.0 was used for a chi-square test, one-way ANOVA, Pearson correlation analysis, independent t-test and hierarchical multiple regression analysis. The results of this study were as follows. First, many variables of ideological factor were related to job satisfaction. Second, physicians expecting the change of political influence has patient-centered attitude. Third, there were many relationships between professional autonomy and ideology variables. Fourth, physicians expecting the change of political influence and customer-centered healthcare system showed more job satisfaction. In conclusion, professional autonomy is related to ideology, and in order to enhance job satisfaction, ideological factor needs more development. In addition, market-oriented healthcare system would contribute to enhance the job satisfaction of physicians expecting the change of political influence and customer-centered healthcare system.
Though the attending system was first implemented in 2003 to facilitate the efficient utilization of medical resources and specialties, only a few hospitals and physicians are participated in that system. The purpose of this study was to investigate the actual facts which related to operation of attending system and propose a basic information to revitalized of the attending system in Korea. The data were collected between August 1 and October 30, 2005 from 25 hospitals and 42 attending physicians who were in part of the attending system. Medical institutions were unwilling to participate despite the advantages of the attending system with respect to the utilization of medical resources and improvement in the quality of medical services. The primary reason for this was the lack of understanding among physicians about the attending system and the difficulty(lack of time) encountered by the attending physicians in administering care to patients hospitalized in the attending hospitals. Moreover insufficient reimbursement for rendered medical services constituted another important reason. In conclusion, we can state that the establishment of a committee is required to discuss the issues surrounding the attending system and to control the growing disparity between the viewpoints of hospitals and physicians. Regardless, there is a need to develop economical incentives for medical institutes. The attending system served as a useful policy in promoting the medical service system and bringing about an improvement in the management of medical institutes.
Objectives : The objectives of this study are to provide the education of communication skills in the class of theories of Korean medical famous physicians and to survey students' perception of the effect. Methods : The class of theories of Korean medical famous physicians was newly designed and was given to students. The results from the questionnaire survey with second year students at department of Korean medicine were applied to the evaluation of study issues. The scale used for this study was the modified version of 'Beyer-Fetzer's Essential Elements of Communication Skills Assessment Sheet', which was developed by researchers in line with the education of Korean medicine. Results : In six (except for 'opening a conversation') out of seven categories, post-test results were more improved than pretest results. In the category of communication skills (a total of 25 questions), post-test results were higher than pretest results in all items. Among them, 13 items were statistically significant. With regard to the question as to how important the class of communication skills is to raise their professionalism as Korean medicine doctor, post-test result was higher than pretest result. Regarding an appropriate education point of time, there were various points in the entire period of curriculum. The appropriateness of teaching-learning method was positively evaluated. In terms of the content helpful for learning, learner-oriented activities was preferred over teacher-oriented lecturing. Conclusions : The communication skills learned in the class of theories of Korean medical famous physicians were effective. Communications skills should be taught constantly in the entire curriculum in order to raise students' professionalism as Korean medicine doctor. In terms of education method, it is desirable to design a class based on students' various activities, rather than lecturing.
C-arm fluoroscopy is a useful tool for interventional pain management. However, with the increasing use of C-arm fluoroscopy, the risk of accumulated radiation exposure is a significant concern for pain physicians. Therefore, efforts are needed to reduce radiation exposure. There are three types of radiation exposure sources: (1) the primary X-ray beam, (2) scattered radiation, and (3) leakage from the X-ray tube. The major radiation exposure risk for most medical staff members is scattered radiation, the amount of which is affected by many factors. Pain physicians can reduce their radiation exposure by use of several effective methods, which utilize the following main principles: reducing the exposure time, increasing the distance from the radiation source, and radiation shielding. Some methods reduce not only the pain physician's but also the patient's radiation exposure. Taking images with collimation and minimal use of magnification are ways to reduce the intensity of the primary X-ray beam and the amount of scattered radiation. It is also important to carefully select the C-arm fluoroscopy mode, such as pulsed mode or low-dose mode, for ensuring the physician's and patient's radiation safety. Pain physicians should practice these principles and also be aware of the annual permissible radiation dose as well as checking their radiation exposure. This article aimed to review the literature on radiation safety in relation to C-arm fluoroscopy and provide recommendations to pain physicians during C-arm fluoroscopy-guided interventional pain management.
Objectives This study aims to assess the status quo of depression among Korean physicians and identify stressors and psychiatric assets related to it. Methods The questionnaire was designed to assess depression, stressors, burnout and psychiatric assets. 343 physicians were included in the analyses. Results Physician depression in Korea was found to be related to several daily life stressors and occupational stressors. It was also related to higher burnout and lower psychological assets. Physicians who reported workplace problems, familial problems, and mannerism were at higher risk of depression while who reported passion (in psychiatric assets) were at lower risk of depression. Conclusions This study identified factors affecting physician depression in Korea. Further research would benefit physicians and their patients by identifying and testing various, including personal and organizational, intervention methods.
Purpose: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. Methods: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. Results: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under-developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imiprarnin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. Conclusion: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.
The rate of human milk feeding has been decreasing despite the diverse efforts of many physicians and nurses, as well as numerous professional organizations and various international health institutions. The number of physicians and nurses who can provide proper guidance for human milk feeding and offer appropriate knowledge and techniques to allow the most beneficial and convenient manner of breastfeeding is quite deficient. It is suggested that physicians and nurses be trained to teach and educate about the medical importance of human milk feeding to lactating mothers. This can be accomplished through systemic changes in medical education and clinical practice. However, the curricula of medical schools in Korea do not provide enough education and training to effect an increase in human milk feeding. The author strongly recommends that the educational objectives for medical schools and resident training offer more education and training concerning so that they are well aware of breastfeeding basics and techniques, and have ability to solve lactation-associated clinical problems.
Objective: To determine STAT3, P-STAT3, and VEGF-C expression levels in small cell lung cancers (SCLCs), and discuss their role and clinical significance in SCLC development. Method: Immunohistochemical methods were applied to 128 cases of SCLC and 40 cases of adjacent normal tissue. Results: The expression levels of STAT3, P-STAT3, and VEGF-C were higher in SCLC than in normal tissue (P<0.05). Pairwise comparisons showed positive correlations with lymph node metastasis, clinical stage, and tumor size (P<0.05). The expression levels were also related with the overall survival rates. Conclusion: STAT3 and VEGF-C play important roles in the development of SCLC, and might be expected to become new targets for SCLC treatment.
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