• Title/Summary/Keyword: 환자 가족의 의료 서비스 요구도

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Strategies for Improving Pre-hospital Emergency Medical Service (병원전단계 응급의료서비스 고도화 전략)

  • Chai, Seung-Gi;Jang, Dai-Hyun;Lee, Hyun-Woo;Han, Woo-Chul
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2011.01a
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    • pp.127-130
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    • 2011
  • 사회가 고령화, 초핵가족화 및 재난취약계층이 늘어나면서 요구호자에 대한 고품질 맞춤형서비스가 필요하게 되었고, 급성진환, 심뇌혈관 고위험 환자 및 자살 등 예방가능 사망률이 선진국에 비해 높음에 따라 신속하고 전문적인 구조 구급서비스가 요구된다. 따라서 본 논문에서는 응급환자가 발생하였을 때 병원 도착 전 환자의 정보를 이용하여 응급처치가 가능하도록 하고, 응급의료기관에서는 환자 진료준비를 사전에 할 수 갖출 수 있도록 하여 응급환자 진료의 효율성을 극대화하였다. 또한 사회적 인지도가 높은 119번호를 이용한 다양한 복합 응급신고 접수 시 유관기관과 통합적 대응체계를 구축하는 효율적 응급의료서비스 고도화 전략을 제시하고자 한다.

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Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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Need Assessment of Home-based Cancer Patients (재가암환자 요구도 조사)

  • Kim, Tae-Sook;Yang, Byung-Guk;Jeong, Eun-Kyeong;Park, No-Rai;Lee, Young-Sook;Lee, Young-Sung;Lee, Sok-Goo;Kim, Young-Taek;Yun, Young-Ho;Huh, Gil-Ja
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.36-45
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    • 1999
  • Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

A Comparison of Needs for Hospice Care between Families of Children and Adult with Cancer (암 환아 및 암 환자 가족의 호스피스 요구도 비교)

  • Kang, Kyung-Ah;Kim, Shin-Jeong
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.216-223
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    • 2005
  • Purpose: The purpose of this study was to compare the need for hospice care between families of children and adults with cancer. Methods: The data was collected from 190 families of children and adult with cancer using self-rating questionnaires from December, 2004 to February, 2005. Data was analyzed using SPSS/Win program by Mean, SD and t-test. Results: The mean score of the need for hospice care in families of children with cancer was greater significantly than in families of adults with cancer (t=-2.126, P=.035). The scores of two factors among the five factors evaluated for the need for hospice care were different significantly. The mean score of control of major terminal physical symptoms' in families of children with cancer was greater significantly than the mean score of adults with cancer (t=-2.165, P=.032). The mean score of 'spiritual care to prepare for death' in families of adults with cancer was greater significantly than the mean score of children with cancer (t=-2.380, P=.018). Conclusion: For improving the quality of life for both patients and families, the hospice service program needs to consider the life cycle of patients.

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Information Needs and Satisfaction among Family Members of Terminal Cancer Patients through Phone Cancer Information Services (말기 암 환자 가족의 전화상담을 통한 정보요구와 만족도 조사)

  • Kwon, Kyeung-Eun;Kim, Boon-Han;Chang, Yoon-Jung;Kim, Hee-Jung;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.5-13
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    • 2009
  • Purpose: This exploratory study was undertaken to analyze the information needs of family members of terminal cancer patients, collected through the telephone counselling service by National Cancer Information Center. Methods: The study included 113 family members of terminal cancer patients who had enrolled at the National Cancer Information Center for the period from June, 2007 through March, 2008 and had agreed to the survey. Results: The subjects (n=113) consisted of grown-up children (n=82) and spouses (n=8) of patients'. Those in their 40's (n=40) and 30's (n=36) accounted for the majority of the sample. The questions raised most were about the information on treatment methods (n=117), management of terminal cancer patients (n=46), terminal cancer patients' life (n=27), deathbed and prediction of remaining life (n=18), hospitalization (n=16), and financial support (n=15). Most of the subjects were satisfied with the telephone counseling services, and 69% of the subjects had come to know about the telephone counseling service via Internet, and 10.6% of them stated that the PR for the service was poor. Conclusion: It is deemed essential for the government to use the mass media for PR of the hospice services, since family members of terminal cancer patients' are less aware of the hospice conducive to enhancement of patients' remaining quality of life, being involued too deeply in their treatment.

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Qualitative Analysis of Medical Usage Patterns of Medical Aid Patients (의료급여환자의 의료이용행태에 관한 질적 분석)

  • Park, Young-Hee;Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.17 no.9
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    • pp.39-49
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    • 2017
  • This was a qualitative study on medical aid patients to understand the cause and process of statistical difference of health service utilization between medical aid and health insurance patients. The main results were the following; 1) There was few overuse of health service in medical aid patients. The reason of heavy utilization was mainly due to the complicated disease. Some of them were considered to overuse physical therapy and oriental acupuncture. 2) In case of medical aid patients, medical cost was paid by their welfare benefit of government or by the support of family or neighbors. They usually could not adequately use the services of uninsured benefit or large hospitals due to the cost. Some patients just endured the pain. There was still discrimination for medical aid patients in some medical institutions. 3) The health officials and institutions did not provide sufficient information to medical aid patients about the policy of medical cost support. 4) Health policies, such as selective clinic system, medial aid case management, approval of extended care, were considered to contribute in preventing unnecessary use of health service. However, this might limit adequate use of medical aid service. In conclusion, there is little evidence of overuse of health service for medical aid patients, which is different from the previous studies. A new plan is necessary, because medical aid patients thought that the necessary health service was not accessible to them.

Strategy for Advancement of Current Pre-hospital Emergency Medical Service (현 병원 전 단계 응급의료서비스의 선진화 전략)

  • Shin, Seong-Yoon;Chai, Seung-Ki;Jang, Dai-Hyunl;Park, Sang-Joon;Choi, Byeong-Seok
    • Journal of the Korea Society of Computer and Information
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    • v.16 no.12
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    • pp.265-271
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    • 2011
  • High-quality customized services demand was growing due to the increase of aging, extremely nuclear family, disaster vulnerable of society. Ambulance service is required of fast and professional rescue and emergency service because of preventable death rate such as acute diseases, cerebral and cardiovascular diseases, suicides, etc. was higher than in developed countries. First aid will be available using patients information when emergency occurs, before arriving at the hospital. And emergency department is equipped with that patient care can be prepared in advance, increase the efficiency of emergency care. We received a variety of complex emergency call using high social awareness of 119 number and propose an efficient emergency medical service advancement strategy building an integrated response system with relevant organization.

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

The Last Phase of Life.Life Completion.Palliative Care Model (생의 마지막 단계.삶의 완결.완화간호 모델)

  • Kim, Dal-Sook
    • Journal of Hospice and Palliative Care
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    • v.12 no.3
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    • pp.115-121
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    • 2009
  • Despite a recent increased nation's attention given to improving end-life care, we professionals need to be more critical and reflective on our realities surrounding hospice palliative care. The aim of this paper is to suggest that palliative care models can be used for patients/families in the last phase of life and examine whether they are appropriate for caring them in congruence with philosophy of hospice. The hospice experience model (HEM) of Eagan & Labyak and the developmental model of Byock are introduced and examined for their congruence with philosophy of hospice in applying to clinical practice. The HEM as a patient/family value-directed end of life care model emphasizes three principles; unique experience of patient/family, interactions/relationships among multiple dimensions of personhood and between family, and personal growth and development in the face of suffering through a life-completion. The developmental model stipulates dying as the last stage of living, a stage of life cycle in which patients/family may have growth through life-completion in multidimensional relationships of personhood. The model includes the developmental landmarks and tasks for life-completion as the framework to guide a means of professionals' to recognize their opportunity to grow. The landmarks and tasks include worldly and social affair, individual relationships, intrapersonal, and transcendent dimension. The models could work as appropriate palliative care models for patients/families in the last stage of living. The professionals need to be encouraged to apply the models to end of life care setting.

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