• Title/Summary/Keyword: 환자평가

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The Effects of Hospital Accreditation Program to the Organizational Culture, Job Satisfaction, Financial Performances and Patient Safety at Geriatric Hospital : About Busan Metrocity (의료기관 인증제도가 요양병원의 조직문화, 직무만족, 경영성과 및 환자안전에 미치는 영향 -부산지역을 중심으로-)

  • Shin, Moon-Ju
    • Journal of Digital Convergence
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    • v.12 no.10
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    • pp.455-466
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    • 2014
  • This study has been implemented to improve the quality in geriatric hospital through the Hospital Accreditation. So research a change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the Hospital Accreditation. For this, a survay was conducted from April 1 to July 20, 2014 to targeting staffs of eight geriatric hospital in the Busan city. Thus, a total of 283 questionnaires were used in the study. Firstly, It was found that change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the the Hospital Accreditation. Secondly, It was found that a statistical correlation among variables such as Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance. Thirdly, Organizational Culture, Job Satisfaction, Financial Performance had a positive effect on Patient Safety. Therefore, we should develop the Hospital Accreditation program with the internal assessment to implement health care quality and patient safety to ensure a complete job satisfaction of hospital staffs in the Hospital Accreditation program further improve the evaluation process of hospital care.

Dimensional Structure of Emotion in Schizophrenic Patients (정신분열병 환자의 정서구조 분석: 2차원 모형을 중심으로)

  • 오경자;문혜신;김영아;박수경;김진관
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 1999.11a
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    • pp.362-367
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    • 1999
  • 본 연구에서는 정신분열증 환자들이 정서상태를 개념화하고 얼굴표정을 통하여 타인의 정서 상태를 판단하는 과정을 정상인과 비교하였다. 연구1에서는 만 19세-46세의 정신분열병 환자 19명에게 정서 관련 형용사 15개로 구성된 105개의 형용사 쌍에 대하여 유사성을 평정하도록 하여 MDS로 분석한 결과, 쾌/불쾌와 각성의 두 차원이 일관되게 보고되고 있는 정상집단과는 달리 정신분열병 집단의 자료에서는 쾌/불쾌 차원만이 뚜렷하게 나타나고 각성 차원은 얻어지지 않았다. 연구 2에서는 다양한 정서를 표현한 얼굴 사진 28개를 정신분열병 환자 30명과 대학생 31명에게 제시하고 각 사진의 인물이 경험하고 있는 내적 상태를 쾌/불쾌와 각성의 두 차원에 대하여 각각 7점 척도로 평정하도록 한 결과 정신분열병 집단은 대학생 집단에 비하여 쾌/불쾌 차원에서는 보다 긍정적으로 평정하는 경향이, 각성 차원에서는 상대적으로 낮게 평가하는 경향을 나타냈다. 특히 부정적이고 각성 수준이 높은 내적 상태를 표현하는 사진 자극에 대하여 정신분열병 환자 집단이 각성수준을 과소평가하는 경향이 두드러지게 나타났다. 이와 같은 결과를 종합하여 볼 때, 정신분열병 환자들은 정서상태의 개념화 과정에서 각성 차원에 대하여 상대적으로 낮은 민감도를 보이고 있으며, 특히 부정적인 정서상태를 표현하는 얼굴들에 대란 판단에서는 각성 차원을 과소평가하여 높은 각성수준을 나타내는 표정과 낮은 각성수준을 변별하는데 어려움을 보이는 것으로 해석될 수 있다. 본 연구의 결과는 정신분열병 환자들은 자율신경계의 높은 각성 수준으로 인하여 각성 수준을 더 높일 가능성이 있는 자극을 회피하는 경향이 있다는 Mednick의 가설과 일관되는 결과로 이들의 각성 수준에 대한 낮은 민감도는 방어적인 회피성향의 지속에 따른 둔감화의 결과로 해석될 수 있다. 효과는 GSR를 비롯한 자율신경계지표에서 잘 반영되었다.^2$=.792가 되었다. 설명되는 누적분산값은 67.18%였다.주관적 평가의 결과와 객관적 평가 결과를 이용해 마직물의 태를 평가하는 산출식을 제시하였다. 태 평가치의 경우 16가지 특성치를 모두 넣는 방법과 stepwise 방법, 또 Kawabatark 사용한 순차적 군 회귀법의 세가지 방법의 회귀식 중 16가지 특성치를 모두 넣는 방법의 결정계수가 가장 높았다.tosterone농도는 107.7$\pm$12.0 pmol/l이었고, 남성의 타액내 농도는 274.2$\pm$22.1 pmol/l이었다. 이상의 결과로 보아 본 연구에서 정립된 EIA 방법은 RIA를 대신하여 소규모의 실험실에서도 활용할 수 있을 것으로 사려된다.또한 상실기 이후 배아에서 합성되며, 발생시기에 따라 그 영향이 다르고 팽창과 부화에 관여하는 것으로 사료된다. 더욱이, 조선의 ${\ulcorner}$구성교육${\lrcorner}$이 조선총독부의 관리하에서 실행되었다는 것을, 당시의 사범학교를 중심으로 한 교육조직을 기술한 문헌에 의해 규명시켰다.nd of letter design which represents -natural objects and was popular at the time of Yukjo Dynasty, and there are some documents of that period left both in Japan and Korea. "Hyojedo" in Korea is supposed to have been influenced by the letter design. Asite- is also considered to have been "Japanese Lett

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Comparison of CT Volumetry and RECIST to Predict the Treatment Response and Overall Survival in Gastric Cancer Liver Metastases (위암 간전이 환자의 반응평가와 생존율 예측을 위한 종양 부피 측정과 RECIST 기준의 비교 연구)

  • Sung Hyun Yu;Seung Joon Choi;HeeYeon Noh;In seon Lee;So Hyun Park; Se Jong Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.876-888
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    • 2021
  • Purpose The aim of this study was to compare the diameter and volume of liver metastases on CT images in relation to overall survival and tumor response in patients with gastric cancer liver metastases (GCLM) treated with chemotherapy. Materials and Methods We recruited 43 patients with GCLM who underwent chemotherapy as a first-line treatment. We performed a three-dimensional quantification of the metastases for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors (RECIST) was performed and compared to volumetric measurements. Overall survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios following univariate analyses. Results When patients were classified as responders or non-responders based on volumetric criteria, the median overall survival was 23.6 months [95% confidence interval (CI), 8.63-38.57] and 7.6 months (95% CI, 3.78-11.42), respectively (p = 0.039). The volumetric analysis and RECIST of the non-progressing and progressing groups showed similar results based on the Kaplan-Meier method (p = 0.006) and the Cox proportional hazard model (p = 0.008). Conclusion Volumetric assessment of liver metastases could be an alternative predictor of overall survival for patients with GCLM treated with chemotherapy.

Evaluation of the Adequacy of Pain Management in the Admitted Cancer Patients (입원중인 암환자에 대한 통증관리의 적절성평가 - 한 3차 의료기관 내과 전공의를 대상으로 -)

  • Kim, Kuk-Hyoe;Jang, Won-Il;Joh, Yo-Han;Choi, In-Sil;Park, Sook-Ryun;Lee, Sang-Yoon;Kim, Jee-Hyun;Kim, Do-Yeun;Lee, Se-Hoon;Kim, Tae-You;Bang, Yung-Jue;Kim, Noe-Kyeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.137-144
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    • 2001
  • Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

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Relationships between Respiratory Diseases and Safety of Pediatric Dental Sedation (소아의 호흡기 질환과 안전한 치과진정법의 연관성)

  • Chung, Woojin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.327-330
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    • 2015
  • The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

Effect of Acupuncture Treatment in Patients with Bronchial Asthma (기관지천식에 대한 침치료의 임상적 효과 검토)

  • Masao, Suzuki;Kenji, Namura;Masato, Egawa;Tadashi, Yano
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.185-195
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    • 2007
  • 목적 : 부신피질 스테로이드약을 포함한 약물치료에도 조절되지 않았던 기관지천식 환자 6 증례에 대하여 침구치료를 행하여,연구방법의 하나인 조건반전법(N-of-1)을 이용하여 침치료의 효과를 검토하였다. 방법 : 연구디자인 : 조건반전법으로 침치료 기간(A기간)과 침치료 휴지기간(B기간)을 서로 반복하였다. A기간은 10주간으로 하고 1주간에 1회의 침치료를행하였다. 실시장소 : 메이지 침구대학부속병원 내과와 부속침구센터 대상 : 기관지천식의 표준적인 약물치료를 행하여도 천식발작이 충분히 개선되지 않았던 중등증에서 중증의 천식환자 6 증례를 대상으로 하였다. 평가 기관치천식에 대한 침치료의 효과를 아래의 항목을 이용하여 평가하였다. (1) 발작상태를 천식일지에 의해 평가 (2) 호흡곤란감을 VAS(Visual Analogue Scale)에 의해 평가 (3) 호흡기능검사 (4) 말초혈호산구수 (5) 스테로이드약의 투여량 (6) 중증도 효과 : A기간에 동시적으로 모든 예에서 천식발작과 호흡곤란감의 개선이 인정되었다. 한편 B기간에서는 6례 중 5례에서 천식발작의 재연이 확인되었다. 또한 천식발작의 개선에 수반하여 모든 예에서 중증도의 개선도 인정되었으며,6례 중 4례에서 스테로이드약의 감량이 가능하게 되었다. 결론 : 약물치료로 조절되지 않았던 기관지천식 환자에 대하여 침치료를 행한 결과, 환자의 천식발작, 자각증상, 호흡기능의 개선에 유효하였다고 생각된다.

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Evaluate the implementation of Volumetric Modulated Arc Therapy QA in the radiation therapy treatment according to Various factors by using the Portal Dosimetry (용적변조회전 방사선치료에서 Portal Dosimetry를 이용한 선량평가의 재현성 분석)

  • Kim, Se Hyeon;Bae, Sun Myung;Seo, Dong Rin;Kang, Tae Young;Baek, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.167-174
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    • 2015
  • Purpose : The pre-treatment QA using Portal dosimetry for Volumetric Arc Therapy To analyze whether maintaining the reproducibility depending on various factors. Materials and Methods : Test was used for TrueBeam STx$^{TM}$ (Ver.1.5, Varian, USA). Varian Eclipse Treatment planning system(TPS) was used for planning with total of seven patients include head and neck cancer, lung cancer, prostate cancer, and cervical cancer was established for a Portal dosimetry QA plan. In order to measure these plans, Portal Dosimetry application (Ver.10) (Varian) and Portal Vision aS1000 Imager was used. Each Points of QA was determined by dividing, before and after morning treatment, and the after afternoon treatment ended (after 4 hours). Calibration of EPID(Dark field correction, Flood field correction, Dose normalization) was implemented before Every QA measure points. MLC initialize was implemented after each QA points and QA was retried. Also before QA measurements, Beam Ouput at the each of QA points was measured using the Water Phantom and Ionization chamber(IBA dosimetry, Germany). Results : The mean values of the Gamma pass rate(GPR, 3%, 3mm) for every patients between morning, afternoon and evening was 97.3%, 96.1%, 95.4% and the patient's showing maximum difference was 95.7%, 94.2% 93.7%. The mean value of GPR before and after EPID calibration were 95.94%, 96.01%. The mean value of Beam Output were 100.45%, 100.46%, 100.59% at each QA points. The mean value of GPR before and after MLC initialization were 95.83%, 96.40%. Conclusion : Maintain the reproducibility of the Portal Dosimetry as a VMAT QA tool required management of the various factors that can affect the dosimetry.

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Utility Comparison of Chest Lateral Decubitus Projection with AP and PA Position (흉부 측와위 촬영 시 전후방향과 후전방향 검사의 유용성 비교)

  • Choi, Guirack
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.233-238
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    • 2013
  • Chest lateral decubitus radiation exposure PA be carried out in general, but emergency patient or the patient's discomfort in the body examination had a lot of inconvenience. In this study, we compared AP and PA image quality, patient safety, and analysis of the examination effectiveness between the two tests was to evaluate the usefulness. Pleurisy or pneumothorax in patients with suspected or diagnosed chest lateral decubitus radiation exposure 30 consecutive patients (male 20 patients, 10 females) were included in the study. Image quality evaluation method microstructure of lung, wide areas of diagnosis, a clear air-fluid interface, the patient rotate, cardiac shadow and sharp diaphragmatic was based on Department of Radiology specialist, division of pulmonology resident blind test was evaluated by four people. Chest decubitus by radiation exposure the AP and PA position examination the usefulness of comparative analysis Image quality in the AP and PA, whereas there was no significant difference in attitude, Stability of the patient and Radiation's examination efficiency AP position compared to the position of PA scores were higher. PA position does not require a examination may be of AP position in a position to suggest that.

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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Measurement of Patient Dose from Computed Tomography Using Physical Anthropomorphic Phantom (물리적 팬텀을 이용한 CT 촬영 환자의 피폭 선량 측정 및 평가)

  • Jang, Ki-Won;Lee, Choon-Sik;Kwon, Jung-Wan;Lee, Jai-Ki
    • Journal of Radiation Protection and Research
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    • v.30 no.3
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    • pp.113-119
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    • 2005
  • The computed tomogrpahy(CT) provides a high quality in images of human body but contributes to the relatively high patient dose. The frequency of CT examination is increasing and, therefore, the concerns about the patient dose are also increasing. In this study the experimental determination of patient dose was performed by using a physical anthropomorphic phantom and thermoluminescent dosimeter(TLD). The measurements were done for the both axial and spiral scan mode. As a result the effective doses for each scan mode were 17.78mSv and 10.01 mSv respectively and the fact that the degree of the reduction in the patient dose depends on the pitch scan parameter was confirmed. The measurement methods suggested in this study can be applied for the reassessment of the patient dose when the technique in CT equipment is developed or the protocol for CT scanning is changed.