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Doctor's Perception and Referral Barriers toward Palliative Care for Advanced Cancer Patients (말기암환자의 완화의료에 대한 의사들의 인식과 완화의료 의뢰 시 장애요인)

  • Lee, Jae-Ri;Lee, Jung-Kwon;Hwang, Sun-Jin;Kim, Ji-Eun;Chung, Ji-In;Kim, Si-Young
    • Journal of Hospice and Palliative Care
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    • v.15 no.1
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    • pp.10-17
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    • 2012
  • Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.

Attitude and Participation Status on District Health Planning in Officials of Health Centers (보건소 공무원의 지역보건의료계획 수립 참여실태 및 태도)

  • Jeong, Han-Ho;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.135-154
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    • 2003
  • Objectives: This study was performed to investigate attitude and participation status on district health planning of officials in Health Centers. Methods: The data collected by self-administered questionnaire survey of 674 officials of Health Centers and the data on district health planning of 28 Health Centers in Gyeongsangbuk-do and Daegu metropolitan city were analyzed. Results: Only 13.6% of officials of Health Centers responded that they had read 'the second district health planning paper' thoroughly and 12.5% of officials of Health Centers replied that they had known contents of 'the second district health planning paper' fully. 56.9% of officials of Health Centers didn't have 'the second district health planning paper'. Thirty five point four percent(35.4%) of health center officials replied that the mayor's or county executive's concern about the district health planning was high, 22.4% in councilors, 77.8% in Health Center chiefs, 44.9% in Health Center officials, 43.9% in him or her. Among respondents, 58.6% of Health Center officials replied that district health planning was necessary and 38.0% of subjects replied that the degree of utilization of district health planning was high. About thirty seven percent(36.9%) of respondents participated in making out 'the second district health planning paper' and 49.6% in 'the third district health planning paper'. Health Center officials replied that the most serious problem of district health planning was 'lack of budget and personnels'(39.8%), 'lack of concern for district health planning'(21.4%) and the most important thing to improve district health planning was 'establishing department for health planning', 'adjustment of establishment time for district health planning'. Conclusions: In order to establish effective district health planning, it would be necessary to secure budget and personnels, to promote the county executive's concern and Health Center officials' concern about the district health planning, to establish department for health planning, and to adjust establishment time for district health planning.

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수당오대(隋唐五代)의 의정사(醫政史)에 관한 연구

  • Park, Hyeon-Guk;Kim, Gi-Uk;Jeong, Seong-Chae
    • Journal of Korean Medical classics
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    • v.19 no.4
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    • pp.27-61
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    • 2006
  • 수당오대적대근의학발전유소적정책(隨唐五代적代근의學발展有소的政策), 기구(기구), 제도등축점완비료(制度等逐漸完비了). 저시기유정부발전의학교육적정책치득의정적공적(저時期由政府발展의學교育的政策値得의政的功적). 정규의학교육적방면상몰치전과의(定規의學교育的方面上몰置전科의), 안배교육과정(安排교育과程), 임용고시등구비구비료의학교적규모(任用考시等具비具비了의學교的規模), 영외발전료지방의학교육화의학보급(영外발展了地方의學보育和의學普及). 방포의방화지방요로상다착처방적조시백성의료제공방변(방布의方和地方要路上다着처方的조百姓의료提供方便), 야영향료의학화신적보급(也影향了의學和신的普及). 저시기의정상최현저적성과시제고본초학적지위적(저時期의政上最현著的成果是提高本草學的地位的). 태의서내설치료의학교육동시설치료전문약학교육(太의署內設置了의學교育同時설置了전문葯學교育). 이차정부이편수본초학적병반포전국위최초적약전(而且政府以編수本草學籍幷반布全국위最初的葯典). 저시기유정부법제화료의약관리방면적야시대대수획(저時期由政府法制化了의葯管理方面的也是大大收획). 수당이전몰형성의약관리화유소제도(隨唐以前沒形成의葯管理和有소制度), 규모(規模). 의생근거일정적법률근환자관계병엄가구관자기(의生根据一定的法律근患者관系幷엄可拘管自己). 수당오대의정흔다방면상탁유성효(隨唐五代의政흔多方面上卓有成效), 단시궁정의약기구적규모흔방대(但是宮廷의葯기구的規模흔방大), 인원과잉(人員과剩), 역궁정의관수공제(亦宮廷의官受控制), 불능발휘자기적능력(不能발揮自己的能力). 야불능발전위백성적의약기구(也不能발展위百姓的의葯기구). 인위정부불태중시의학(因위政府不太重시의學), 소이의생적지위잉시불고(所以의生的地位仍是不高). 나취시저시기의정적결점(那就是저시期의政的缺点).

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A integrated study on the current status and improvement direction of physician assistant (전담간호사 제도 개선방안에 대한 통합적 연구)

  • Moon, Heakyung
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.3
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    • pp.159-165
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    • 2020
  • This study was attempted to identify the status of the work of the PA and provide the direction and evidence of policy making on the PA scheme. A convergence study was conducted to analyze a total of 23 articles of papers and Internet news through systematic review methodology. A literature search was performed using KISS, NDSL, RISS, National assembly library, and 11 major domestic daily newspapers and Youth Medical Newspaper. The analysis of eight papers showed that the PA's work-related exhaustion, job stress, unclear scope of work and lack of regulations reduced job satisfaction. Through 15 press articles, it was understood that it was urgent to establish a legal system and education system for qualifications and work as professional medical personnel amid a conflict of positive and negative opinions of related agencies. In order to increase the utilization of PA in the future, it is necessary to secure institutional devices suitable for Korean affairs and prepare educational programs.

A Review on the Clinical Laboratory Personnel in North Korea (북한 임상검사인력에 대한 고찰)

  • Koo, Bon-Kyeong;Joo, Sei Ick;Kim, Dai-Joong;Jang, In-Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.1
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    • pp.83-89
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    • 2020
  • There is a noticeable gap in the personnel structures of clinical laboratories between North Korea and South Korea. In North Korea, 'Laboratory Doctor' is similar to the workforce of 'Medical Technologist (commonly known as Clinical Laboratory Technologist or Medical Laboratory Scientist)' in South Korea. Considering preceding research based on the verbal evidence of North Korean healthcare personnel defectors, it is estimated that the status of laboratory doctor in North Korea generally corresponds to physician and feldsher (such as physician assistant in Western countries). Physicians and feldshers are trained and fostered for five and a half years in medical universities and for three years in medical vocational schools (so-called junior college of medicine). Unlike South Korea, the North Korea's healthcare personnel system does not subdivide the tasks, education, qualifications and law regarding the specialties of health experts. It is thought that the Korean Association of Medical Technologists needs to collaboratively search and present the milestones for establishment of a professional system on clinical laboratory personnel in North Korea through cooperative research on policies with the related organizations for better preparation of the unification of the Korean Peninsula.

Effects of Thoracic Mobility Exercise on Cervicothoracic Function, Posture and Pain in Individuals With Mechanical Neck Pain (등뼈 가동성 운동이 기계적 목통증 환자의 목등뼈부 기능 수준과 자세, 통증 수준에 미치는 영향)

  • Lee, Hwa-jeong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.42-56
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    • 2019
  • Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

Effects of Active Craniocervical Movement Training Using a Cognitive Game on Stroke Patients' Balance (인지적 게임을 이용한 능동적 두경부 움직임 훈련이 뇌졸중 환자의 균형에 미치는 영향)

  • Kim, Mi-sun;Choi, Woo-sung;Choi, Jong-Duk
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.47-52
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    • 2021
  • Background: Compared with normal people, stroke patients have decreased voluntary craniocervical motion, which affects their balance. Objects: This study was conducted in order to examine the effects of active craniocervical movement training using a cognitive game on stroke patient's cervical movement control ability, balance, and functional mobility. Methods: The subject of this study were 29chronic stroke patients who were randomly allocated to either an experimental, cognitive game group (n = 15), or control group (n = 14), to which only neuro-developmental treatment (NDT) was applied. The intervention was conducted 5 times per week, 30 minutes per each time, for a total of 4 weeks. Active angle reproduction test, static stability test, limits of stability test, and Time up and Go (TUG) test, respectively, were carried out in order to evaluate cervical movement control ability, static balance, dynamic balance, and functional mobility. Paired t-test was used in order to compare differences between prior to after the intervention, along with an independent-test in order to compare prior to and after-intervention differences between the two groups. Results: After the craniocervical training with a body-driven cognitive game, the experimental group showed significant differences in flexion, extension, and lateral flexion on the affected side, and rotation on the affected side in the active angle reproduction test. The experimental group indicated significant differences in sway length both with eyes-open and with eyesclosed in the static stability test and in limits of stability test and TUG test. The control group to which NDT was applied had significant differences in flexion in the active angle reproduction test and in limits of stability test and TUG test. Conclusion: The above results mean that craniocervical training using a body-driven cognitive game positively influences stroke patient's cervical movement control ability and as a result their balance and functional mobility.

Effects of Cervical Sensorimotor Control Training on Pain, Function and Psychosocial Status in Patients With Chronic Neck Pain (목뼈 부위 감각운동 조절 훈련이 만성 목 통증 환자의 통증과 기능, 심리사회적 수준에 미치는 영향)

  • Min, In-gi;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.36-46
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    • 2021
  • Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

The Determinants and Behavioral Intentions of Korean Medicine Utilization in Youth Aged 19-39 Years : Based on the microdata of national survey on Korean Medicine Utilization and Herbal Medicine Consumption, 2017 (청년층(만19~39세)의 한의의료이용 결정요인 및 행동의도 - 『2017년 한방의료이용 및 한약소비실태조사』 마이크로데이터를 중심으로 -)

  • Yoon, Lyang Sook;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.25 no.2
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    • pp.85-98
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    • 2021
  • Objectives : This study aimed to analyze characteristics of the Korean Medicine users aged 19-39 years, the determinants of Korean Medicine use and effects of Korean Medicine use experience on behavioral intentions among youths. Methods : We studied Korean Medicine Utilization and Herbal Medicine Consumption Survey(2017) data set by complex-sample survey data analysis. In order to derive the characteristics of younger users, Rao-scott χ2 test and t-test were conducted. Through multiple logistic regression model adjusted by general characteristic variables, the determinants and behavioral intentions of the Korean Medicine utilization among youths were derived. Results : Fist of all, young users and non-users have significant differences in socio-demographic characteristics and perception on Korean Medicine. Among the general characteristic variables, region, age, marital status, occupation, chronic disease, and private health insurance plans had an effect on the Korean Medicine use in young people(Model II). And adjusted by general characteristic variables as control variables, awareness of Korean Medicine and perception of safety of herbal medicine were deduced as determinants of Korean Medicine use(Model III). Secondly, Korean Medicine use experience increased intentions to use and recommend Korean Medicine services(Model IV-1, 3). Conclusions : In order to increase the use of Korean Medicine among young people, Korean Medicine institutions should strive to increase users' satisfaction, and public health insurance coverage for Korean Medicine services needs to be expanded.

The Image of Nurses in Newspaper Articles during COVID-19 Era (코로나19 상황 속 간호사의 이미지 : 국내 주요 일간지 분석)

  • Choi, Hannah;Oh, Eui Geum;Lee, Ji Yea
    • The Journal of the Korea Contents Association
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    • v.21 no.11
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    • pp.626-637
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    • 2021
  • This study was conducted to describe the image of nurses in the context of COVID-19 pandemic by reviewing newspaper articles (n=451) from 11 major domestic daily newspapers. Analysis of monthly prevalence, favorability towards nurses, proportion of nurse coverage, and thematic analysis was conducted. Five themes and 9 sub-themes were derived from thematic analysis, and major themes are as follows: "Poor work environment"; "Nursing, 'The job of calling'"; "Prominent as a medical profession"; "Strict standards"; and "Expanding the realm of nursing" in order of frequency. In conclusion, media is still reporting a limited role of nurses. Therefore, in order to widen public perspective towards nurses, further academic activities that highlight various roles and positive aspects of nursing profession are needed.