• Title/Summary/Keyword: physicians

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Study on image quality improvement using Non-Linear Look-Up Table (비선형 Look-Up Table을 통한 영상 화질 개선에 관한 연구)

  • Kim, Sun-Chil;Lee, Jun-Il
    • Korean Journal of Digital Imaging in Medicine
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    • v.5 no.1
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    • pp.32-44
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    • 2002
  • The role of radiology department has been greatly increased in the past few years as the technology in the medical imaging devices improved and the introduction of PACS (Picture Archiving and Communications System) to the conventional film-based diagnostic structure is a truly remarkable factor to the medical history. In addition, the value of using digital information in medical imaging is highly expected to grow as the technology over the computer and the network improves. However, the current medical practice, using PACS is somewhat limited compared to the film-based conventional one due to a poor image quality. The image quality is the most important and inevitable factor in the PACS environment and it is one of the most necessary steps to more wide practice of digital imaging. The existing image quality control tools are limited in controlling images produced from the medical modalities, because they cannot display the real image changing status. Thus, the image quality is distorted and the ability to diagnosis becomes hindered compared to the one of the film-based practice. In addition, the workflow of the radiologist greatly increases; as every doctor has to perform his or her own image quality control every time they view images produced from the medical modalities. To resolve these kinds of problems and enhance current medical practice under the PACS environment, we have developed a program to display a better image quality by using the ROI optical density of the existing gray level values. When the LUT is used properly, small detailed regions, which cannot be seen by using the existing image quality controls are easily displayed and thus, greatly improves digital medical practice. The purpose of this study is to provide an easier medical practice to physicians, by applying the technology of converting the H-D curves of the analog film screen to the digital imaging technology and to preset image quality control values to each exposed body part, modality and group of physicians for a better and easier medical practice. We have asked to 5 well known professional physicians to compare image quality of the same set of exam by using the two different methods: existing image quality control and the LUT technology. As the result, the LUT technology was enormously favored over the existing image quality control method. All the physicians have pointed out the far more superiority of the LUT over the existing image quality control method and highly praised its ability to display small detailed regions, which cannot be displayed by existing image quality control tools. Two physicians expressed the necessity of presetting the LUT values for each exposed body part. Overall, the LUT technology yielded a great interest among the physicians and highly praised for its ability to overcome currently embedded problems of PACS. We strongly believe that the LUT technology can enhance the current medical practice and open a new beginning in the future medical imaging.

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Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies

  • Kim, Semi;Ham, Eun Hye;Kim, Dong Yeon;Jang, Seung Nam;Kim, Min kyeong;Choi, Hyun Ah;Cho, Yun A;Lee, Seung A;Yun, Min Jeong
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.12-24
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    • 2022
  • Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.

Diagnosis and Management of Acute Otitis Media and Otitis Media With Effusion (급성 중이염과 삼출성 중이염의 진단과 치료)

  • Jang, Seong Hee
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1283-1294
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    • 2005
  • The American Academy of Pediatrics and American Academy of Family Physicians developed the clinical practice guideline on the management of acute otitis media. The American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery developed the clinical practice guideline on the diagnosis and management of otitis media with effusion. These two guidelines provide evidence-based recommendations.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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A Study on the Development of Verbal Abuse Scale for Operating Room Nurses (수술실 간호사가 경험하는 언어폭력 측정도구의 개발)

  • Yoon, Ke-Sook;Chung, Hye Seon;Park, Soon-Ae;Jang, Boo-Young;Kim, Hye-Ran;Ohm, Hyun-Sin;Sung, Young-Hee;Nam, Kyung-Dong
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.2
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    • pp.159-172
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    • 2005
  • Purpose: The Purpose of this study was to development a verbal abuse scale for operating room nurses in Korea. Method: To achieve the purpose of the study, a questionnaire was developed to interview 30 nurses and distributed to 761 nurses who working at 28 general hospital in Korea from september 7 to November 25, 2004. Item analysis and factor analysis were carried out to validate violence predicting scale. Cronbach's Alpha coefficient was used to test reliability of the scale. The data were analyzed by using SPSS/WIN 11.5 program. Result: As a result of the item analysis and factor analysis, 17 items were selected from the total of 30 items, and four factors were labeled as 'self esteem abuse by nurses(7 items)', 'self esteem abuse by physicians(6 items)', 'sexual abuse by physicians(2 items)', 'colleague abuse by physicians(2 items)'. Four factors were explained by 60.8% out of the total variance. The first factor explained 35.456%, second factor explained 12.401% and third factor explained 6.637%. And fourth factor explained 6.304%. Reliability of the factors were tested by Cronbach's Alpha coefficient and result was 0.885. Conclusion: The scale was identified to be a tool with a high degree of reliability and validity. Therefore, this scale can be effectively utilized for assessment of verbal abuse for operating room nurses by nurses and physicians in Korea.

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The Degree and Related Factors of the Depression and Burnout among Private Practice Physicians (일부 개업의의 우울 및 Burnout 정도의 관련요인)

  • Shin, Jun-Ho;Kim, Gun-Su;Park, Yo-Sub;Na, Bek-Ju;Sohn, Seok-Joon;Kim, Byong-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.3 s.51
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    • pp.563-575
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    • 1995
  • In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBI(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and Chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBI data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality, duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.

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Analysis of influencing factors on self-employed physician's income (개원 전문의 소득에 영향을 미치는 요인분석)

  • Park, Woong-Sub;Kim, Han-Joong;Sohn, Myong-Sei;Park, Eun-Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.770-785
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    • 1998
  • This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 persons responded to the mail survey, through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study, and the unit of analysis is a physician. To examine the change of average income per month, multiple regression was used to test the change according to physician's characteristics, demographic characteristics, scale of clinic, average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was mcreased \4,850,000, but the difference was \6,020,000 under the control of control variables. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.

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Probability of Early Retirement Among Emergency Physicians

  • Shin, Jaemyeong;Kim, Yun Jeong;Kim, Jong Kun;Lee, Dong Eun;Moon, Sungbae;Choe, Jae Young;Lee, Won Kee;Lee, Hyung Min;Cho, Kwang Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.3
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    • pp.154-162
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    • 2018
  • Objectives: Early retirement occurs when one's job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction. Methods: A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram. Results: Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors. Conclusions: To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.

An Analysis of Physicians' Online Information Search Process at the Point of Care (의사의 임상질문 해결을 위한 온라인 정보검색과정 연구)

  • Kim, Soon;Chung, EunKyung
    • Journal of the Korean Society for information Management
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    • v.33 no.3
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    • pp.177-193
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    • 2016
  • This study aims to analyze physicians' online information search process to solve the clinical questions at the point of care. To achieve this purpose, ten university hospital-based physicians participated in-depth interviews and observation studies. Based on Wilson's problem solving process, this study analyzed the characteristics of each information search stage and efficiency of online searching. The results showed that participants tend to relatively immediately formulate their clinical questions. However, basic searching strategies were only used and a few preferred information sources were chosen. However, average satisfaction degree of online searching appeared high with 5.7 (7 Likert-scale) and problem-solving index increased after searching. As physicians are likely to use well organized and evidenced-based credible information easily, it implies the needs for an integrated search system within the electronic medical record (EMR). In addition, as other online resources' awareness is lower comparing Google and PubMed, active promotions and training of other resources are needed.