• 대한한의학회지
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• 제43권4호
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• pp.102-130
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• 2022

Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.85-97
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• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• 한국의료질향상학회지
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• 제7권1호
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• Nutrition Research and Practice
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• 제11권3호
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• pp.240-246
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• 2017

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea. SUBJECTS/METHODS: A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers. RESULTS: Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%). CONCLUSIONS: Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.81-91
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• 2018

Purpose: This study aimed to suggest strategies for advancing local-government-based accreditation systems and surveyor training in long-term care facilities in Korea. Methods: A comprehensive review of the literature including research papers and official reports issued by governments from the United States, Australia, and Japan was conducted to explore domestic and international policies related to long-term care facility certification and accreditation systems. Results: The USA has two types of care quality assurance systems including mandatory certification (5-star rating system) by the Centers for Medicare and Medicaid Services and voluntary accreditation by the Joint Commission on Accreditation of Healthcare Organizations. Australia operates a government-based mandatory accreditation system for all long-term care facilities through the Australian Aged Care Quality Agency. Japan, particularly the Tokyo district, operates a third-party evaluation system that involves the voluntary participation of long-term care facilities. Conclusion: This study provides several strategies to enhance accreditation processes and surveyors'expertise. For instance, motivating facilities to voluntarily participate in accreditation is necessary by 1) providing sufficient and continuous consultations and feedback about how to improve care quality, 2) differentiating accreditation domains and indicators from the national health insurance certification system, and 3) actively utilizing accreditation results and providing incentives.

• 산경연구논집
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• 제10권7호
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• pp.71-82
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• 2019

Purpose - This study aims to identify the priorities of medical service quality improvement by customer satisfaction characteristics and potential customer satisfaction improvement (PCSI) index based on the dualistic quality classification of Kano Model (1984) for Comprehensive Health Screeening Center in General Hospitals and Centers only for Comprehensive Health Screening and suggest a direction for future improvement. Research design, data, and methodology - Through advanced research on health screening medical service quality, this study set four service quality factors, including tangible, human, process and supportive factors, and 39 measurement items. Based on these items, the study used 117 questions, which consist of dualistic quality factors, customer satisfaction coefficients, positive and negative questions for PCSI index and questions for current satisfaction. 300 effective samples were collected for adults in their 20s who experienced health screening service in Seoul, Gyeonggi-do and Incheon within the past two years. Collected data were input in the quality evaluation duality table to categorize quality factors and calculate customer satisfaction coefficients by Timko(1993). The study also analyzed PCSI index in comparison with current satisfaction and identified priorities in quality improvement. Results - It was found that the most urgent factors to improve the quality in both groups were adequate waiting hours and emergency response for complications, which are process factors classified as unitary quality. It is urgently needed to improve the quality as the PCSI index was high in supportive factors (complaint response team) as attractive quality in Comprehensive Health Screening Center in General Hospitals and in process factors (prevention of infection) as unitary quality in Centers only for Comprehensive Health Screening. As the PCSI index was low in space use as a tangible factor, it was found that the current level can be maintained instead of improvement. Conclusions - To improve the health screening medical service quality, it is required to focus on process factors (adequate waiting hours, emergency response for complications, prevention of infection) and supportive factors (complaint response team) among service qualities perceived by users. It is proposed to ensure continuous efforts to manage and reinforce priorities as a direction for future improvement in health screening service.

• Healthcare Informatics Research
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• 제24권4호
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• pp.359-370
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• 2018

Objectives: We assessed the public acceptance of a health information exchange (HIE) and examined factors that influenced the acceptance and associations among constructs of the Technology Acceptance Model (TAM). Methods: We collected data from a survey of 1,000 individuals in Korea, which was administered through a structured questionnaire. We assessed the validity and reliability of the survey instrument with exploratory factor analysis and Cronbach's alpha coefficients. We computed descriptive statistics to assess the acceptance and performed regression analyses with a structural equation model to estimate the magnitude and significance of influences among constructs of TAM. Results: Eighty-seven percent of the respondents were willing to use the technology, and the average level of agreement with the need for the technology was 4.16 on a 5-point Likert scale. The perception of ease of use of the technology significantly influenced perceptions of usefulness and attitudes about the need for HIE. Perceptions of usefulness influenced attitude and behavioral intention to use HIE, and attitude influenced intention. Age showed a wide range of influences throughout the model, and experience with offline-based information exchange and health status also showed noteworthy influences. Conclusions: The public acceptance of HIE was high, and influences posited by TAM were mostly confirmed by the study results. The study findings indicated a need for an education and communication strategy tailored by population age, health status, and prior experience with offline-based exchange to gain public buy-in for a successful introduction of the technology.

• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 대한예방한의학회지
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• 제28권1호
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• pp.31-42
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• 2024

Objective : In order to understand the changes in domestic approval regulations applicable to traditional Korean medical device companies, this article will explain the major amendments 「Regulation on Medical Device Approval Report Review, etc.」 from 2005 to the present on a year-by-year basis, and provide a counter plan to the recent changes in approval regulations. Methods : We analysed the changes in approval regulatory amendments related to the traditional Korean medical devices from 2005 to the present. Results : The Ministry of Food and Drug Safety is continuously improving medical device approval regulations to ensure the global competitiveness of domestic medical devices and contribute to the improvement of public health. Recent major approval regulatory amendments include the establishment of a review system for software medical devices and digital therapeutics, the recognition of real world evidence materials, the introduction of a biological evaluation of medical devices within a risk management process and a medical device approval licence renewal system. Conclusions : It is expected that the range of medical devices available to Korean medicine doctors will continue to expand in the future through the provision of non-face-to-face medical services and the development of advanced and new medical devices, as well as wearable medical devices and digital therapeutics. In order to increase the market entry potential of traditional Korean medical devices that incorporate advanced technologies such as digital technology and AI-based diagnosis and prediction technology, it is urgent that the government provide significant support to traditional Korean medical device companies to improve approval regulatory compliance.

• 한국항해항만학회지
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• 제39권3호
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• pp.193-198
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• 2015

이 연구는 선내의료 및 선원 건강관리 여건 개선 방안을 마련하기 위하여 선원 건강관리 정책에 영향을 미치는 정부를 비롯한 선원 유관단체 종사자 139명을 대상으로 선원들의 건강과 질병관리에 대한 보건의료실태에 대한 인식도 조사를 실시하였다. 조사결과 선원들의 건강관리여건(p<0.01)과 건강관리 능력(p<0.01), 현행의 무선응급의료 정책(p<0.01), 선내 의료함 및 의료장비의 도움(p<0.05) 및 선박 의료관리자 제도에 대해 유관기관 간에 인식도 차이는 있었으나 대체적으로 부정적인 응답률이 높았으며, 선원 건강관리를 위한 선내의료 지원제도 개선을 위해서는 간이 건강측정장비 비치, 정기적 건강검진 강화, 원격의료 및 건강관리를 위한 선원건강증진센터의 설치(p<0.01)가 시급히 필요하다고 조사되었다.