• Title/Summary/Keyword: 기피 환자

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DSS of Discharging from Military Service using the Analysis of Mental Patient's Prescription (정신과 환자 처방분석을 통한 의병전역 결정지원 시스템)

  • Jeon, Young-Hee;Park, Gun-Woo;Lee, Sang-Hoon
    • Journal of the military operations research society of Korea
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    • v.34 no.3
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    • pp.93-105
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    • 2008
  • Recently, mental patients are increasing by secondary gain, that is, purpose for avoiding a military service as the social prejudice about mental disease decreases. In particular, it is unique diagnostic tool to a patient's subjective symptoms complaint and a doctor's special judgment, in occasion of psychiatry problem that an objective diagnostic tool does not exist. In this paper, we provide an objective basis to help in a quick decision-making of discharging from military service using the datamining, that analyzes mental patient's prescription to find a special rule. Therefore, we propose the decision support system of discharging from service using the analysis of mental patient's prescription.

Analysis of dental avoidance factors of dental patients (치과환자의 치과기피요인에 대한 분석)

  • Jung, Su-Jin;Lee, Da-Won;Park, Bo-Mi;Park, Ji-Sun;Son, Min-Ah;Lee, You-Mi;Lee, Ha-Eun
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.6
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    • pp.937-947
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    • 2020
  • Objectives: This study was conducted to investigate the factors that prevent dental patients from visiting the dental clinic. Methods: From June 22, 2020 to July 17, 2020, among patients 10 years or older who had visited the dental clinic, 314 individuals who agreed to the study were asked to fill out a self-administered questionnaire. The data were analyzed using the SPSS Statistics 22.0 program, and the significance level was set at 0.05. Results: The dental avoidance factors according to the general characteristics were high in women and housewives, and among the dental-related characteristics, the most common reason for visiting the dental clinic was experiencing pain. The factors influencing anxiety were fear, environment, stimulus, age, and exercise, and the factors influencing the fear were anxiety, stimulus, subjective oral health status, education, and exercise. The factors influencing the stimulus were environmental factors, fear, anxiety, and age, and the factors that influenced environmental factors were stimulus and anxiety. Conclusions: There is a need to develop measures and policies to overcome fear of dental procedures, such as developing a dental experience program and allowing patients to experience dental fear and anxiety in advance.

Assessment and Treatment of Somatization (신체화의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.149-164
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    • 2000
  • Somatization is regarded as a process rather than a diagnostic entity. It should be emphasized to identify psychopathology rather than to make a choice regarding diagnosis in assessing somatizing patients. Psychiatrists should be aware of the psychosocial cues underlying the patients' physical symptoms. Special skills and strategies are required by nonpsychiatric physicians to facilitate the patients' acceptance of psychiatric treatment. The goal of treatment for somatization is management but not cure. The approach should be flexible, depending on the patients' responses and need. The difficulty in diagnosing and treating somatization is likely to be related to abnormal illness behavior such as the patients' denial of their psychosocial problems and resistance to psychiatric approach. In conclusion, biopsychosocial approach is needed to treat these patients effectively. Psychiatrists should also teach other physicians the interview skill that they could identify these patients as early as possible and facilitate their acceptance of psychiatric treatment.

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A Study on the Characteristics of Patients Affecting the Behavior of Students Majoring in Dental Hygiene Avoiding Patients (치위생과 학생의 환자 기피에 영향하는 환자 특성에 관한 연구)

  • Kim, Young-Nam
    • Journal of Korean society of Dental Hygiene
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    • v.2 no.1
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    • pp.21-41
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    • 2002
  • This study is designed to offer basic materials necessary for the instruction of effective clinical practices and the establishment of relationship with patients by means of making an analysis of the characteristics of patients affecting the behavior of students majoring in dental hygiene avoiding patients and countermeasures. With this in mind, the researcher worked with sophomores and juniors exposed to clinical practices during the period ranging from October 22, 2001 to November 9, 2001. The researcher came to the following conclusions on the basis of the findings of this survey. 1. The characteristics of patients influencing the behavior of avoiding them were categorized into appearance characteristics, personality characteristics, treatment-cooperative characteristics, and speech and behavior characteristics. Speech and behavior characteristics(4.26) turned out to be the most influential factor of all, which was followed by treatment-cooperative characteristics(3.68), personality characteristics(3.62) and appearance characteristics(3.42) in the right order. 2. The survey shows that foul breath and obnoxious oral(3.94) cavity were the worst factors of appearance characteristics and that using abusive language and being too aggressive(4.41) were the worst factors of personality characteristics. The study reveals that not putting faith in trainees(4.02) was the highest factor of treatment-cooperative characteristics and that using abusive language(4.50) was the highest factor of speech and behavior characteristics. 3. There was a significant positive relation between the domains of the characteristics of avoiding patients. The study indicates that the more subjects avoided the characteristics of patients, the more they avoided appearance characteristics(r =.444, p<.001) and that the more subjects avoided treatment-cooperative characteristics, the more they avoided appearance characteristics(r=.324, P<.001) and personality characteristics(r=.691, p<.001), and that the more they avoided speech and behavior characteristics, the more they avoided appearance characteristics(r=.265, p<.001) and personality characteristics (r=.531, p<.001). 4. The study shows that there was a significant difference between appearance characteristics and the growth areas of the subjects(p<.05) and that there was a significant difference between the satisfaction of clinical practices(p<.05) and health status(p<.05) in terms of personality characteristics. 5. The subjects avoided preschoolers, whose age ranged from 4 to 6(33.5%), most and avoided boys(71.4%) more than girls. They avoided those who were bereft of jobs(62.9%). And they avoided handicapped persons most in terms of special patients and avoided infant patients(31.0%). 6. The subjects turned out to have negative and passive countermeasures against those patients that had ever been avoided. So the researcher would like to suggest that theoretic education and training programs should be conducted in this respect by incorporating this mailer into the hygiene curriculum.

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An Oriental Psychotherapy of a Patient Classified with Social Phobia (한방정신치료를 이용한 사회공포증 환자 치험 1례)

  • Park, Se-Jin;Park, Sang-Dong;Park, Young-Yup;Lee, Jeong-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.207-212
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    • 2003
  • Social phobia is a symptom that is characterized as a feeling anxiety and fear in front of others in social situations. The patient of our hospital is 34-years-old man who has symptoms such as avoiding other people, being flushed of his face and trembling of his hands when he meets other person. Thus, he has been treated by applying acupuncture treatment, taking herb medicine, and Giungoroen & Kyungjapyungji of the oriental psychotherapy. In 3 months, his condition of this disease got improved. This case suggested one approach for the treatment of this disease and we consider that the oriental psychotherapy such as Giungoroen and Kyungjapyungji is useful in treatment of this disease.

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Research on the Development of Automated Multifunction-Integrated Motion Bed (자동화된 다기능 통합 전동 침대 개발에 대한 연구)

  • Lee, Youngdae;Choi, Moonsoo;Jang, Ilhwan;Kim, Chang-Young;Choi, Dong-Soo;Kim, Minsung;Kim, Wonjoon;Kim, Dong-Hwan
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.18 no.5
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    • pp.215-222
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    • 2018
  • Recently, various motion beds have been actively developed and popularized. The motion bed has the functions of height adjustment, back plate rising, knee lifting, tilt function and left / right rotation, and the remote control can conveniently be used by the patient himself or the caregiver to move the patient. However, since the medical bed for use does not have a function of preventing pressure ulcers, exchanging sheets, and transferring patients, it is necessary to disperse body pressure by using a pressure ulcer prevention matrix to prevent pressure ulcers. However, it is accompanied by muscle strength and hard work, and nurses are avoiding difficult nursing care. In this study, we developed the first prototype in the world and confirmed that the system works normally with the goal of developing multifunctional beds that automatically perform the prevention of bed sores, the exchange of sheets and the transfer of patients in order to facilitate such nursing work. It is anticipated that the proposed multifunctional motorized bed in the future will be a model of a medical robot for smart healthcare.

Clinical Analysis of Chemonucleolysis for Treatment of Lumbar Disc Herniation (요추간판 탈출증치료에서 화학적 수핵용해술의 임상적 고찰)

  • Ihm, Jowa-Hyuk;Baek, Seung-Chan;Ko, Sam-Kyu;Chi, Yong-Chul;Choi, Byung-Yeran;Moon, Choong-Bae;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.171-177
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    • 1986
  • During last 48 months, in our department 51 patients with single or multiple herniated lumbar discs have received chemonucleolysis. Forty-one of 51 cases have single level herniation and remaining cases have multiple level. Age distribution were from 19 to 59 years old. Over 4 months(longest case: 18 months) follow up revealed as follows: 40 cases(78%) revealed excellent results: 4 cases(7.8%) received discectomy 3-6 months after chemonucleolysis because of recurred symtoms : no anaphylaxis and no major complications were noted.

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RETROSPECTIVE STUDY OF TRACHEOTOMY IN CHILDREN (유소아 기관 절개술의 후향적 고찰)

  • 정명현;홍원표;장미숙;이정환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.26-26
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    • 1991
  • 기관 절개술은 절대적으로 필요한 수술 방법임에도 불구하고 경우에 따라서는 매우 심각한 합병증이나 후유증을 유발하고 있어 가능한 피하는 것이 좋으며 부득이하여 시술을 하더라도 그 적절한 시기를 정하기 어려운 경우가 많다. 특히 유소아에서는 최근에 개량된 삽관튜브의 출현으로 비교적 장기간의 기관삽관이 가능해지자 기관절개술의 적용예가 많이 감소하기는 하였으나 합병증이나 후유증을 너무 우려한 나머지 기관절개술을 기피하거나 적절한 수술시기를 놓쳐 더욱 어려운 입장에 처하게 되기도 한다. 저자들은 1977년도부터 1990년까지 세브란스 병원에서 기관절개술을 시행받은 15세이하의 유소아 환자 94례에서 기관절개술의 원인 질환과 적용시기 및 합병증을 알아보고 기관삽관과의 관계를 후향적으로 조사하여 다음의 결과를 얻었다. 1. 유소아 기관 절개술의 원인 질환은 두부외상이 28례(29.8%)로 가장 많았고, 신경계 질환 17례(18%), 기도 감염 10례(10.6%)의 순이었고 그 외 선천적 기형 종양, 외상, 감염 등으로 다양한 분포를 보였다. 2.기관 절개술전에 기관삽관을 시행하지 않았던 예는 18례(19.1%)이고 기관삽관을 시행했던 예는 76례(80.9%)이며, 38례(40.4%)는 일주이내에 기관절개술을 시행하였고 12례(12.8%)는 2주이내에, 8례(8.5%)는 3주이내, 6례(6.4%)는 4주이내에 시행하였으며 12례(12.8%)는 기관 삽관후 4주이후에 기관절개술을 시행하였다. 3.기관 절개술후, 합병증은 26례(27.7%)에서 있었고 육아조직 형성이 14례(14.9%) 였고 기관 협착이 12례(12.8%)의 순이었다. 4.인공 호흡기률 사용하였던 46례(48.9%)중 14례(14.9%)에서 합병증이 있었고, 인공 호흡기를 사용치 않았던 48례(51.5%)에서는 12례(12.8%)에서 합병증이 발생하였다. 5.삽관 발거를 시행할 수 있었던 예는 47례(50%)였으며, 기관 절개술후 1개월이내에 시행한 예가 21례(16%), 6개월이내 시행한 예가 16례(17%), 2년이내에 시행한 예가 6?(6.4%)였으며 2년 이후 시행할 수 있었던 예도 4례(4.3%) 있었다. 6.기관 절개술 환자중 26례(27.7%)는 원인 질환으로 결국은 사망하였으며, 21례(22.3%)는 삽관 발거를 하지 않은 상태에서 퇴원하여 추적이 불가능하였다.

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Informed Consent and Refusal of Treatment in Emergency Medical Situation (응급의료에서의 설명·동의 원칙과 응급의료거부죄)

  • Lee, Jung-eun
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.37-80
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    • 2022
  • By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

Clinical Study of 80 Cases of Mitral Valve Operations Via Extended Transseptal Approach (확장시킨 경중격 절개방식을 통한 승모판 수술의 80례 임상 분석)

  • 김학제;황재준;최영호;손영상;김욱진;김태식;김현구
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1037-1042
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    • 1998
  • Background: Among the various techniques for the adequate exposure of the mitral valve, the extended transseptal approach is the essential prerequisite for accurate repair or replacement of the mitral apparatus. But the efficacy and safty of the extended transseptal approach has not determined in Korea yet. Materials and methods: Retrospective data of 80 consecutive patients, operated from September 1992 to July 1997 were reviewed. Seventy- eight patients underwent mitral valve replacement and 2 patients underwent excision of left atrial myxoma. Thirty-eight of 78 patients had other concomitant procedures such as aortic valve replacement(n=22), tricuspid annulopasty(n=14), coronary artery bypass graft(n=1) and closure of ventricular septal defect(n=1). Mean follow up was 23.3±15.0 months and total follow up was 1792 patient-months. Results: The hospital mortality rate was 3.8%(3 patients). Two deaths were due to low cardiac output and one due to postoperative bleeding of coagulopathy. Among the 46 patients who had atrial fibrillation preoperatively, 45 had atrial fibrillation postoperatively and 1 converted to sinus rhythm. All 34 patients who were in normal sinus rhythm preoperatively remained in sinus rhythm after the operation. Mean aortic cross clamping time was 62 minutes for isolated mitral procedure and 90 minutes for concomitant procedures. There were no specific complications related to this approach. Conclusions: We suggest that the extended transseptal approach is an easy and good method for mitral valve surgery, especially in patients with small sized left atrium.

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