• 제목/요약/키워드: primary care physicians

검색결과 89건 처리시간 0.026초

External Validation of a Clinical Scoring System for Hematuria

  • Lee, Seung Bae;Kim, Hyung Suk;Kim, Myong;Ku, Ja Hyeon
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권16호
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    • pp.6819-6822
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    • 2014
  • Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (${\geq}50$ = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

수술을 시행한 잠복 고환 91예의 임상적 고찰 (Cryptorchidism: Experience with 91 Surgically Corrected Cases)

  • 강진구;김인수;김상윤
    • Advances in pediatric surgery
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    • 제14권1호
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    • pp.58-66
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    • 2008
  • Untreated cryptorchidism contributes to infertility and may play a role in increasing the risk of malignancy. The appropriate time of operation was considered before school age in 1970s, 2 years of age in 1980s, and between 1 and 2 years of age from 1990s to present time. Orchiopexy is the most common operation for congenital urological problem of children. We analyze our experience of orchiopexies to evaluate the results and to identify the role of the pediatric surgeon. We reviewed the medical records of 91 patients who underwent orchiopexy from January 1996 to December 2007. The patient age at orchiopexy were as follows: 48 cases (52.7 %) under 2 years of age, 24 cases (26.4 %) between 3 and 5 years, 16 cases (17.6 %) between 6 and 10 years, and 3 cases (3.3 %) over 11 years. Location of testes was preperitoneum in all 91 cases. There were 84 unilateral and 7 bilateral cases. Among the unilateral cases, the undescended testes were on right side in 54 cases and on the left side in 30 cases. The surgical procedure employed in all cases was trans-inguinal orchiopexies. Seventy-nine patients had excellent results. There were 12 complications; 5 cases of wound infection and 7 cases of temporary incomplete descent. Seven cases of incomplete descent have become normal from 3 to 6 months after orchiopexy. According to our results, 43 cases (47.3 %) underwent orchiopexies over 2 years of age. In conclusion, orchiopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. We suggest that pediatric surgeons should educate their primary care physicians and parents concerning the potential complications of cryptorchidism and the appropriate time of operation.

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기도 및 식도 이물에 대한 임상적 고찰 (Clinical Analysis of Upper Aerodigestive Tract Foreign Body)

  • 이민영;정성도;김영훈;정필상;이상준
    • 대한기관식도과학회지
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    • 제15권1호
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    • pp.28-34
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    • 2009
  • Background and Objectives: Foreign bodies of upper aerodigestive tract are common problem for primary care physicians. Delayed diagnosis or failure of removal might cause fatal problemsand complications. Therefore proper diagnosis and management is imperative. In this study, we described clinical features of upper aerodigestive tract foreign body, and analyzed efficacy of different management modality. Materials and Methods: 250 cases of foreign bodies in the esophagus and trachea, between Jan. 1998 through Jan. 2009 has been retrospectively analyzed. A total of 24 cases and 226 cases had been found each as airway foreign bodies and esophageal foreign bodies. The clinical features are described and treatment outcomes, prognosis, and rate of complications of each management modality have been compared. Results: In airway foreign bodies, ventilating bronchoscopy yielded better results, 19 success out of 19 trials than fiberoptic bronchoscopy, 3 success out of 5 trials. Hospitalization days after removal of foreign body didn't show difference between two treatment modalities, although patients who had ventilating bronchoscopy had gone through general anesthesia. And there was no complication after removal of foreign body. In esophageal foreign bodies, rigid esophagoscope yielded better results, 99% of successful removal rate, compared to the EGD, only 78% of successful removal rate. There was no difference of hospitalization days between two modalities. And complication rate was even low in patients who had done rigid esophagoscopic foreign body removal. Conclusion: In upper aerodigestivetract foreign body. Rapid diagnosis and successful foreign body removal is important. Removal by rigid scope(ventilating bronchoscope, rigid esophagoscope) revealed less failure in both airway and esophageal foreign bodies.

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원격진료 실시에 수반되는 법적 쟁점들에 대한 고찰 (Legal Issues To Be Considered Before Implementing Telehealth in South Korea)

  • 이원복
    • 의료법학
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    • 제22권1호
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    • pp.57-90
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    • 2021
  • 의료인이 직접 환자를 진료하는 형태의 원격진료가 현행 의료법에서 허용이 되는지 여부와 의료법상 허용을 떠나 정책적으로 허용하는 것이 바람직한지의 문제가 오랫동안 논란이 되어 왔다. 그러다가 코비드19라는 인류가 드물게 겪는 팬데믹 상황으로 인하여 우리나라에서 한시적으로 허용이 되었고 외국에서도 이용이 폭발적으로 증가하면서 다시 관심을 받고 있다. 원격진료의 허용 여부에 관하여는 이미 많은 논문이 존재하지만, 막상 원격진료가 실시될 경우 그에 수반되어 발생할 수 있는 부수적인 법적 쟁점들에 관하여는 논의가 부족했던 부분이 있어 이 글에서 다루었다. 필자는 국민건강보험의 수가정책, 환자 본인 확인, 의약품 비대면 구매, 진료장면 녹화에 관하여는 입법적으로 미리 정비를 하는 것이 바람직하다고 보았고, 원격진료에 필요한 시설 기준은 오히려 법제화를 하면 현실에 뒤떨어지거나 변화에 대응하는 탄력성이 떨어지므로 법제화를 하지 않고 대신 의료인이 의료기기법상 승인을 받은 원격진료용 기기를 사용하는 것으로 충분하다고 판단하였으며, 끝으로 원격진료의 맥락에서 발생한 의료사고의 책임이라든가 개인정보 보호는 기존의 민사법이나 개인정보 보호법으로 이미 충분한 대응이 되므로 별도의 특칙을 제정할 필요는 없다는 결론을 내렸다.

Factors Affecting Adherence to Antihypertensive Medication

  • Choi, Hyo Yoon;Oh, Im Jung;Lee, Jung Ah;Lim, Jisun;Kim, Young Sik;Jeon, Tae-Hee;Cheong, Yoo-Seock;Kim, Dae-Hyun;Kim, Moon-Chan;Lee, Sang Yeoup
    • 가정의학회지
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    • 제39권6호
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    • pp.325-332
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    • 2018
  • Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.

Management of the Most Common Functional Gastrointestinal Disorders in Infancy: The Middle East Expert Consensus

  • Indrio, Flavia;Enninger, Axel;Aldekhail, Wajeeh;Al-Ghanem, Ghanem;Al-Hussaini, Abdulrahman;Al-Hussaini, Bakr;Al-Refaee, Fawaz;Al-Said, Khoula;Eid, Bassam;Faysal, Wafaa;Hijazeen, Ruwaida;Isa, Hasan M.A.;Onkarappa, Dinesh;Rawashdeh, Mohammad;Rohani, Pejman;Sokhn, Maroun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권4호
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    • pp.325-336
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    • 2021
  • The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs. This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

Statins and Clinical Outcomes in Patients With Low to Moderate Risk but With Non-obstructive Carotid Plaques: The SCOPE-CP Study

  • Minjae Yoon;Chan Joo Lee;Sungha Park;Sang-Hak Lee
    • Korean Circulation Journal
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    • 제52권12호
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    • pp.890-900
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    • 2022
  • Background and Objectives: Some individuals exhibit discrepancies between risk classifications assessed using clinical factors and those obtained by vascular imaging. We aimed to evaluate whether statins provide clinical outcome benefits in patients classified as having low to moderate cardiovascular risk but with carotid plaque. Methods: This was a retrospective propensity score matching study. A total of 12,158 consecutive patients undergoing carotid ultrasound between January 2012 to February 2020 were screened. Individuals with low to moderate cardiovascular risk who were not currently recommended for statin therapy but had carotid plaques were included. Among 1,611 enrolled individuals, 806 (statin group: 403, control group: 403) were analyzed. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCEs: cardiovascular death, myocardial infarction, coronary revascularization, and ischemic stroke or transient ischemic attack) and all-cause mortality. Results: During the median follow-up of 6.0 years, the incidence of MACCEs did not differ between the groups (6.1 and 5.7/1,000 person-years in the control and statin groups, respectively; adjusted hazard ratio [HR], 0.95; p=0.90). The incidence of all-cause mortality did not differ (3.9 and 3.9/1,000 person-years, respectively; adjusted HR, 1.02; p=0.97). Kaplan-Meier curves revealed similar rates of MACCEs (log-rank p=0.72) and all-cause mortality (log-rank p=0.99) in the 2 groups. Age and smoking were independent predictors of MACCEs. Subgroups exhibited no differences in clinical outcomes with statin use. Conclusions: Benefit of statin therapy was likely to be limited in low to moderate risk patients with carotid plaques. These results could guide physicians in clinical decision-making regarding cardiovascular prevention.

우리나라 일차 진료의사의 만성폐쇄성폐질환(COPD) 진료실태조사 (Survey of COPD Management among the Primary Care Physicians in Korea)

  • 박명재;최천웅;김승준;김영균;이승룡;강경호;신경철;이관호;이진화;김유일;임성철;박용범;정기석;김태형;신동호;유지홍
    • Tuberculosis and Respiratory Diseases
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    • 제64권2호
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    • pp.109-124
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    • 2008
  • 연구배경: COPD는 전세계적으로 유병률, 이환율 및 사망률이 급격히 증가하는 질환으로 환자의 삶의 질을 호전 시키고 사회, 경제적인 질병부담을 줄이기 위해 경증 COPD 환자를 조기에 진단하여 적절히 치료하는데 일차진료의사의 역할이 중요하다. 근거중심을 바탕으로 개발된 GOLD와 같은 COPD 진료지침은 이 목적을 위해 유용하나 우리나라의 진료실태가 반영되지 않은 문제점이 있다. 근거중심을 바탕으로 우리나라 진료실정이 반영된 진료지침을 개발하기 위해 우리나라 일차진료의사들의 진료 실태를 조사하여 보고한다. 방법: 진료실태는 웹을 기반으로 COPD의 진단, 치료, 위험인자, 교육, 진료지침에 대한 25개의 설문을 포함 제작하였고 총 217명의 일차진료의사가 설문조사에 동의하고 참여하였다. 참여자의 의사경력은 평균 17.7년이며 76.5%가 내과를 전공하였고 지역적으로는 63.6%가 서울, 경기지역에서 진료를 하고 있었다. 결과: 비교적 높은 비율(61.8%)로 폐기능검사기를 보유하고 있지만 실제 진료 시 활용도는 낮은(35.8%) 편임을 알 수 있었다. 안정 시, 급성악화 시 COPD의 치료에서 경구제제의 처방빈도가 흡입제제에 비해서 모두 높았다. COPD의 주요 위험인자인 흡연에 대해서는 흡연여부 확인율, 금연권유율 등이 90% 이상으로 높았으나 금연을 위한 처방에서 금연 성공률이 높은 니코친대체제와 부프로피온의 병용 처방률이 4.3%로 낮았다. COPD 진료지침에 대한 인지도는 56.7%였고 그대로 따르는 경우는 7.3%로 국내 진료실태를 반영한 진료지침의 개발이 요구되며 진료지침의 보급과 확산을 위해서는 진료지침책자를 포함한 인쇄자료의 보급이 효과적임을 알 수 있었다. 결론: 우리나라 일차진료의사들의 COPD 진료실태는 진단에서 폐기능검사의 보유율에 비해 사용률이 낮고 치료에서 흡입제에 비해 경구제제의 처방을 선호하는 경향을 보였다. GOLD 진료지침에 대한 인지도는 높으나 그대로 따르는 일차진료의사는 적으므로 이번 진료실태조사 결과를 바탕으로 근거중심이지만 국내실정을 반영한 COPD 진료지침의 개발 및 보급이 필요하리라 생각된다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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말기 암환자와 가족을 위한 집단상담 프로그램 - 서울대학교병원 경험의 분석- (The Group Counseling Program for Terminal Cancer Patients and their Family Members in the Seoul National University Hospital)

  • 이영숙;허대석;윤영호;김현숙;최경숙;윤여정
    • Journal of Hospice and Palliative Care
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    • 제1권1호
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    • pp.56-64
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    • 1998
  • 목적 : 본 연구는 서울대학교병원의 말기암환자와 가족을 위한 집단상담 프로그램을 소개하고, 현황 및 문제점을 파악하고자 하였다. 방법 : 1996년 한 해동안 상담에 참석한 말기암환자 및 가족들의 상담기록지를 중심으로 연구자들이 상담한 내용을 분석하였다. 결과 : 참석자 312명은 가족(84%)이 환자(16%)의 4배 이상 참석했고, 대부분 1회만 참석하고 있음을 보여주었다. 참석한 환자 또는 가족이 돌보는 환자의 현황은 나이별로 60대, 50대, 40대가 많았고, 암의 종류는 폐암, 위암, 간암 순으로 많았다. 가족의 특성은 261명으로 배우자, 자녀, 며느리, 형제자매, 부모순으로 많았다. 프로그램에 오게된 경로는 의사의 권유(69%), 병원 포스터(26%), 기타 순이었다. 이것은 의사가 환자와 가족을 집단에 참여시키는데 중요한 역할을 담당하고 있음을 보여준다. 질문은 우선적으로 의료적인 정보에 대한 욕구가 많았다. 이것은 환자나 가족이 의료진으로부터 정보를 제대로 전달받지 못하고 있음을 보여준다. 또한 가족은 환자를 돌보는데 있어서 정보의 제공만으로 해결될 수 없는 여러가지 실제적인 어려움을 주고 있었다. 그 결과 계속적인 24시간 전화상담 서비스 호스피스 시설 가정간호 서비스의 확대, 3차 의료기관과 1,2차 의료기관과의 의뢰 체계 등을 필요로하고 있었다. 따라서 병원에서 제공될 수 있는 프로그램과 지역사회에서 제공될 수 있는 자원, 호스피스 시설과의 연계가 필요하며 이를 관리해줄 수 있는 환자 관리 전담 인력이 필요하다. 결론 : 본 프로그램은 1회(single-session)적인 성격이 강하지만 환자와 가족이 궁금해하는 점들을 만족시켜주므로서 암에 대한 인식이 증가하고 대처능력이 향상되고 있음을 볼 수 있다. 이것은 이 프로그램이 위기에 처한 말기암환자와 가족을 지지하는 프로그램으로서 활용가치가 높다고 볼 수 있다. 추후 연구는 프로그램의 효용성에 대한 평가가 검토되어야 할 것이며, 다른 병원에서도 각 병원의 특성과 참석자들의 특성을 고려하여 보다 발전된 프로그램이 나오기를 바란다.

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