• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.128-144
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• 2023

Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators' attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

• Korean Journal of Community Nutrition
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• v.27 no.4
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• pp.321-340
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• 2022

Objectives: This study established a practical direction for the prevention and management of metabolic syndrome by evaluating the health status, nutrition intake level, and diet quality according to metabolic syndrome and related drug treatment in Korean adults. Methods: The data from the 2017 KNHANES (Korea National Health and Nutrition Examination Survey) was analyzed. The analysis included 2,978 adults, classified into the normal, metabolic syndrome (MetS), metabolic syndrome with medicines (MetS-M), and without medicines (MetS-noM) groups. The nutrient intake, NAR (nutrient adequacy ratio), INQ (index of nutritional quality), and DDS (dietary diversity score) were analyzed. Results: The mean BMI was significantly higher in the MetS group than in the normal group for all subjects. Subjects of the MetS group tended to consume less energy and major nutrients, while males aged 50 ~ 64 and all females showed less intake of nutrients in the MetS-M group. The energy intake ratio was within 55 ~ 65 : 7~ 20 : 15 ~ 30 of KDRI (Korean Dietary Recommended Intake), but the carbohydrate energy ratio of all subjects aged 50 to 64 was over 65%. The NAR of the major nutrients was lower in the MetS-M group, the average INQ was around 0.8, especially the INQ of calcium and vitamin A was less than 1, and the total DDS score was less than 4 points. Conclusions: This study confirmed that the nutrient intake and diet quality differed among subjects diagnosed with metabolic syndrome and managed with medical care. The intakes of energy and many nutrients, the quality of diets, and the diversity of food groups in the MetS-M group were lower than in the normal group. Therefore, these will be an important basis for establishing a specific direction of diet education for preventing and managing metabolic syndrome according to gender, age, metabolic syndrome, and drug treatment.

• Journal of Korean Medical classics
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• v.30 no.4
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• pp.123-153
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• 2017

Objective : This paper attempts to analyze the curriculum of the modern Korean Medicine's higher education institutions and study their significance. Rather than conducting an in-depth pedagogical research, the paper attempts to summarize and provide a simple analysis on the subject matter due to the lack of the historical evidence of modern Korean Medicine. Method : General theses and academic papers along with daily publications before the Japanese colonial era, materials owned by Kyunghee University Korean Medicine History Museum, and history databases owned by the National Institute of Korean History and Kyujanggak were investigated Result : Upon studying the curriculum of Korean Medicine's higher education institutions, it could be concluded that the efforts to maintain the independence and professionalism of Korean Medicine in its relationship with the Western Medicine. It could also be discovered that the curriculum was improved through policy measures in order to raise the status of the practitioners and expand the scope of their practices. These higher education institutions has been continuously working to develop the Korean Medicine and raise the quality of curriculum, and their efforts were vital in the establishment of the Korean Medicine Doctor system. Conclusion : Systematic academic researches should be done on the curriculum of Korean Medicine's high education institutions in order to fulfill the objective of normalizing the Korean Medicine education and contributing to the growth of Korean Medicine.

• International Journal of Knowledge Content Development & Technology
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• v.7 no.2
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• pp.21-40
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• 2017

Considering the need for quality health information and resultant health care services in any society, this study was carried out to look into the status of library and information resources and services provided by medical libraries in Enugu State, Nigeria. The main objective of the study was to find out the information resources and services available for medical library users towards quality health care provision. Five (5) medical libraries of major teaching hospitals were used for the study with 980 registered users as the study population from where 245 users were sampled. Observation checklist was used to collect data on resources while questionnaire was used to collect data from the respondents on the services provided. The Medical Library Association Standard guided the analysis of data from observation while frequency counts and mean scores were used to analyze data from the questionnaire. Major findings showed that even though some of the required resources and services are available and provided the medical libraries, most of the required resources and services are not adequately provided by these libraries.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.1
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• pp.52-59
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• 2006

Purpose: The study was attempted to provide basic materials for development of nursing-intervention programs by examining effects of growth hormone therapy on the quality of life, depression and self-esteem. Method: A survey was conducted for 31 adult outpatients as experimental group who have received growth hormone therapy more than 6 months and for 29 adults as control group who have not. A scale developed by Hilditch was used to measure their quality of life and also, the Zung's Self-rating Depression Scale and the Rosenberg's Self-esteem Scale were adopted to measure their depression and self-esteem each. Data were analyzed using one-way and two-way ANOVA Result: 1) there were differences between the two groups in the overall measurement of the quality of life. the growth hormone therapy group was higher in sub-factors 2) There were clear-cut differences between the two groups in depression, so that the control group marked higher score in the measurement of depression. 3) Self-esteem was not identical across the two groups, so that it was more higher for the growth hormone treatment group. Conclusion: Those findings suggest that development of education programs related to growth hormone and nursing-intervention is promising.

• Korean Medical Education Review
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• v.21 no.1
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.296-310
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• 1998

Background : Performance evaluation of medical care providers has become more important than before in Korea. Especially in university hospitals, job contents of medical staffs are so complicated that evaluation is not easily performed. In addition, in order that the feedback of evaluation be successful, acceptance of staffs to be evaluated is essential. This study is aimed at the development of items for evaluation and weighting of each item in one university hospital, and clustering departments by different weight given by medical staffs. Methods : Through resource group meeting. performance items were listed up by categories of education, research, medical services, and other activities in and out of the hospital. For each item, all the medical staffs were asked how important they thought, compared with publishing one original article. By factor analysis, the items in each category were grouped into a few subgroups. In turn, cluster analysis was done for the purpose of grouping departments by priority the medical staffs gave. Results and Conclusion : Among five major categories, medical staffs regard education, research, and medical services more important than other activities in and out of the hospital. Five categories consisted of two or three components. Departments in hospital were grouped into three. However, characteristics of each group was not clearly delineated. This result suggests that more comprehensive tool should be developed and applied in the process of performance evaluation in university hospitals.

• The Korean Journal of Emergency Medical Services
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• v.23 no.3
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• pp.83-96
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• 2019

Purpose: This study was conducted to provide fundamental resource in improving the quality of life and stress by understanding the influence of egoresilience and social support by paramedic students during field practice. Methods: The measurement instrument consisted of 100 questions on the general characteristics, egoresilience, social support, stress, and quality of life of the participants. Frequency and descriptive analysis, t-test, ANOVA, correlation analysis, and multiple regression analysis were performed. Results: The average scores for egoresilience, social support, and stress were 3.00, 3.14, and 1.68 out of 4.00, respectively. The degree of stress was high enough to be statistically significant in the case of women compared to men, and if unsatisfied with one's major. The average quality of life score was 4.50. The degree of quality of life was high enough to be statistically significant in the case of men compared to women, smokers, drinkers, and if content with one's major. Conclusion: It is suggested that colleges develop programs to increase the satisfaction rate of the students and improve their egoresilience and social support. Such programs would improve the quality of life and address the stress experienced by emergency medical technology students.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.2
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• pp.40-49
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• 2021

The purpose of this study was to examine the influence of self-help education on job competence, job satisfaction, and quality of life in 119 paramedics, and to prepare basic data for the improvement of the quality of emergency medical services. A survey was conducted from May 12 to August 23, 2019, on 205 male and female fire officers in the Gangwon and Daegu Provinces. The collected data was analyzed using the SPSS 20.0 version, and frequency analysis, correlation analysis, and multiple regression analysis were carried out. The multiple regression analysis showed that the participants had a static correlation between self-help education, job competence, job satisfaction, and quality of life. Also, the self-help education had a significant correlation with job competence (personal area), job satisfaction (personal area, organizational area, professional area) and quality of life (personal area, professional area) (p<.01, p<.001). The job competence and job satisfaction of the paramedics had a significant impact on their quality of life. Given the findings of the study, specific systems need to be developed to improve the quality of life through the invigoration of self-help education for paramedics.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3619-3623
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• 2014

Background: The aim of the study was to evaluate the vaginal dose and toxicity in patients of cervical cancer treated with image guided brachytherapy at our institute. Materials and Methods: Thirty-five patients treated with image based brachytherapy for cervical cancer were included. Vaginal contouring was done on MRI at brachytherapy and with CT scans of subsequent brachytherapy fractions. Dose volume parameters (DVH) were reported in accordance with the GEC-ESTRO guidelines. These were correlated with vaginal toxicity (assessed by CTCAE version 3) and quality of sexual life assessed at one year of completion of treatment. Results: Vaginal shortness was observed in 22 out of 30 (62.8%) patients, Nine (25.7%) had vaginal dryness and in 10 (28.5%) patients, there was contact bleeding. No association could be demonstrated between the dose volume parameters and vaginal toxicity in the present study. Conclusions: The lack of association between dose volume parameters of vagina with vaginal morbidity may be due to uncertainties involved in the delineation of vaginal wall and dosimetry. Future research is required to accurately define vaginal dose distribution to study its correlation with vaginal morbidity. Vaginal morbidity needs to be documented in order to improve the sexual outcome in these patients.