• Title/Summary/Keyword: Health self-determination

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A study on Empowerment of the Clinical Dental Hygienists (임상치과위생사의 임파워먼트에 관한 연구)

  • Shin, Seon-haeng
    • Journal of dental hygiene science
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    • v.10 no.3
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    • pp.185-190
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    • 2010
  • This study was conducted to collect the basic data to provide for the purpose of the development of dental field. This research is to find the relationship between the level of recognized empowerment of hygienists working in dental clinics and the factors influencing on work achievement in the system of dental clinics. The population of the research is some randomely chosen dental clinics located in Seoul City during the period from March 22 to April 30, 2010, and the sample of 256 female dental hygienists working in the field were recruited as the analysis object group. The data on general characteristics and empowerment were collected by a questionnaire survey. The collected data were analyzed with the SPSS WIN 12.0 program. The following shows the results of this study. 1. The empowerment level of the analysis subject group was 3.63. It is significant statistically that the longer working career or higher annual salary, the higher empowerment level (p<0.05). 2. It shows the high level of empowerment in the group of hygienists who are in education counsel (p<0.01), and who have a permanent job (p<0.05) than others. 3. There is a significant correlation among capability, age, career, annual salary (p<0.01). 4. There is a significant correlation among self determination, age(p<0.05), career (p<0.01), annual salary (p<0.05). 5. In regression analysis, career is proved as one of the significant factors that is related to the empowerment in dental hygienists (p<0.05). This finding shows high level of empowerment in dental hygienists who hold high level of career, annual salary, education counsel jobs, or permanent jobs. Therefore, I suggest with the result of the study that the organization of dental clinic needs to improve its capability and efficiency with the efficient manpower management. Particularly, there need to be various kinds of leadership-trainning and education-program development to enhance empowerment in hygienists as professionals through independent self-decision making experiences and role do experiences.

Standardization of the Method of Measuring Average Glandular Dose (AGD) and Evaluation of the Breast Composition and Thickness for AGD (평균 유선선량 측정방법의 표준화 및 유방 두께, 실질양상과의 상관관계 분석)

  • Park, Hye-Suk;Kim, Hee-Joung;Lee, Chang-Lae;Cho, Hyo-Min;Yu, A-Ram
    • Progress in Medical Physics
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    • v.20 no.1
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    • pp.21-29
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    • 2009
  • Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

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Fusion of the Guardianship System and Mental Health Law Based on Mental Capacity - Focusing on the Enactment and the Application of the Mental Capacity Act (Northern Ireland) 2016 - (의사능력에 기반한 후견제도와 정신건강복지법의 융합 - 북아일랜드 정신능력법[Mental Capacity Act (Northern Ireland) 2016]의 제정 과정과 그 의의를 중심으로 -)

  • Kihoon You
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.155-206
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    • 2023
  • When a person with diminished mental capacity refuses necessary medical care, normative judgments about when paternalistic intervention can be justified come into question. A typical example is involuntary hospitalization for people with mental disabilities, traditionally governed by mental health law. However, Korean civil law reform in 2011 introduced a new form of involuntary hospitalization through guardianship legislation, leading to a dualized system to involuntary hospitalization. Consequently, a conflict has arisen between the 'best interest and surrogate decision-making' paradigm of civil law and the 'social defense and preventive detention' paradigm of mental health law. Many countries have criticized this dualized system as not only inefficient but also unfair. Moreover, the requirement for the presence of 'mental illness' for involuntary hospitalization under mental health law has faced criticism for unfairly discriminating against people with mental disabilities. In response, attempts have been made to integrate guardianship legislation and mental health law based on mental capacity. This study examines the legislative process and framework of the Mental Capacity Act (Northern Ireland) 2016, which reorganized the mental health care system by fusing guardianship legislation with mental health law based on mental capacity. By analyzing the case of Northern Ireland, which has grappled with conflicts between guardianship legislation and mental health law since the 1990s and recently proposed mental capacity as a single, non-discriminatory standard, we aimed to offer insights for the Korean guardianship and mental health systems.

Changes in the Concept of Disability and its Implications for Social Work Practice (장애개념의 변화와 사회복지실천 현장 함의)

  • Kim, Yong-Deug
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.157-182
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    • 2002
  • This study attempts to identify the changes in social reactions to disabilities in general, and to research the contextual implication of these changes in social work practice in Korea. In the early years after the Industrial Revolution, disability was conceived as social unfitness and it was assumed that the cause and responsibility could be attributed to people with disabilities. But, in the midst and late 20th century, social responsibility for people with disabilities was argued and generally accepted. As the results of these changes, conceptual models explaining disabilities have changed gradually; there has been a transition, so called, from individual model to social model. In a similar vein, WHO has refined the definition and classification of disability. Related to these changes, social welfare service paradigm for people with disabilities has shifted. This paradigm shift can be explained with the perspective of strength approach, empowerment approach, case management and independent living model. In Korea, 1998 Act on welfare for people with disabilities meant that social service for the disabled were categorized with, namely, residential service, community rehabilitation service and vocational rehabilitation service. Recently, the extent of these services has been rapidly broadened. In these situation, this study researched to identify the implications on social work practice in the context of changes in social response, conceptual model, definition and also service paradigm. Such as the followings are enumerated for the implications: disabled person's participation in assessment process, development of assessment tools focusing on social and environmental perspectives, reinforcement of information service helping self-determination, supporting on formal and informal helping network, expanding self-help programs and, finally, a shift from displacement model to support model.

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A Study on Empowerment Perception Level and Job Satisfaction of Dental Hygienists (치과위생사의 임파워먼트 지각수준과 직무만족에 관한 연구)

  • Shin, Seon-haeng
    • Journal of dental hygiene science
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    • v.11 no.5
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    • pp.437-444
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    • 2011
  • This study was conducted to collect the basic data to provide for the purpose of the development of dental field. This research is to find the relationship between the empowerment perception level and job satisfaction of dental hygienists working in dental clinics and the factors influencing on work achievement in the system of dental clinics. The subjects of the research is some randomly chosen at dental clinics located in Seoul City during the period from March 22 to April 30, 2010, and the sample of 256 female dental hygienists working in the field were recruited as the analysis object group. The following shows the results of this study. 1. The empowerment level of the subjects was 3.63. It is significant statistically that the longer working career or higher annual salary, the higher empowerment level (p<0.05). 2. Dental hygienists who are in charge of education counsel(p<0.01) and who have a permanent job(p<0.05) have higher empowerment level than others. 3. The job satisfaction of the subjects was 3.18. It was significant statistically that the increaser age(p<0.05) or in the journal subscription group, the higher job satisfaction (p<0.001). 4. In regression analysis, meaningfulness, self-determination were proved as a significant factors that is related to the job satisfaction in dental hygienists (p<0.05). This finding shows high job satisfaction in dental hygienists who hold high level of empowerment perception. Therefore, I suggest that the organization of dental clinic needs to improve its capability and efficiency with the efficient manpower management. Particularly, in order to increase job satisfaction, A need exists to develop various kinds of leadership training and educational programs to enhance the empowerment of dental hygienists as professionals through independent decision making and role executions.

The Relationship Between Knowledge of Patient Safety, Nursing Professionalism and Patient Safety Management Activities in Nursing Students (간호대학생의 환자안전에 대한 지식, 간호전문직관과 환자안전관리활동의 관련성)

  • Kim, Chul-Gyu;Yu, Ha-Min;Kim, Hye-Won;Nam, A-Yeon;Roh, Hee-Sung;Bang, Da-Sol;Sin, Jin-Ui;Lee, A-Hyun;Lee, Eun-Gyeong;Jeon, Han-yong;Jeong, Se-Lim;Jung, You-Jung
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.26-40
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    • 2018
  • Purpose: The objective of this study was to identify the relationship between knowledge of patient safety, nursing professionalism and patient safety management activities of nursing students with clinical practical experience. Methods: Self-administered questionnaires survey on knowledge of patient safety, nursing professionalism, and patient safety management activities were conducted for the $3^{rd}-year$ and $3^{th}-year$ nursing students. 139 questionnaires were distributed, of which, 131 were used for data analysis. Results: The scores of nursing students' knowledge of patient safety, nursing professionalism and patient safety management activities were $6.76{\pm}1.26$, $65.11{\pm}7.97$ and $67.99{\pm}7.26$, respectively. Knowledge of patient safety differed significantly according to the grade. Nursing professionalism had a difference with major satisfaction, clinical practical satisfaction, and experience of patient safety accident. Patient safety management activities were positively correlated (p<.01) with knowledge of patient safety and nursing professionalism. Patient safety management activities increased significantly with increase in the scores of knowledge of patient safety and nursing professionals. The factors that were related to patient safety management activities of nursing students were knowledge of patient safety and nursing professionalism. Knowledge of patient safety and nursing professionalism were selected as significant variables for explaining the patient safety management activities of nursing students, of which the coefficient of determination was 9.8%. Conclusion: To promote patient safety management activities of nursing students, training programs for patient safety management activities are required. Also, there is the need to increase the knowledge of patient safety and nursing professionalism of nursing students using various educational method.

Review of 2022 Major Medicla Decisions (2022년 주요 의료판결 분석)

  • Lee Jeongmin;Yoo Hyunjung;Park Taeshin;Jeong Heyseung;Cho Woosun;Park Nohmin
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.79-117
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    • 2023
  • Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.

The Relationship of Organizational and Job Characteristics, Empowerment, Job Satisfaction and Organizational Commitment Perceived by Hospital Administrative Staffs (병원 행정인력이 인지하는 조지.직무특성, 임파워먼트, 직무만족 및 조직몰입간의 관련성)

  • 박재산
    • Health Policy and Management
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    • v.14 no.1
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    • pp.65-88
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    • 2004
  • In general, empowerment is defined as the motivational concept of autonomy and self-efficacy. Recently, the concept of empowerment is applied to improve organizational staff's job satisfaction and organizational commitment in many organizations. Empower-ment in service organizations, i.e., hospitals, has certainly generated more publicity than any other organizations. The objectives of this study are, first, to measure the degree of hospital employees' empowerment using Spreitzer(1995)'s empowerment theory, second, to analyze the causal relationship of organizational and job characteristics, a degree of empowerment, and organizational performance(job satisfaction and organizational commitment), and third, to offer the strategy for the improvement of job satisfaction and organizational commitment. Spreitzer insists that the empowerment is composed of 4 dimensions(meaning, competence, self-determination, and impact). And he argues that various work-related characteristics is a direct cause of empowerment and the indirect cause of job satisfaction and organizational commitment, mediated by the empowerment latent variable. In order to perform this study, data were collected by self-administered questionnaires from hospital employees working in administrative department of 3 university hospitals in Inchon and Kyunggi-Do region. The number of cases is 181(response rate; 86%). The Collected data were analyzed with SPSS Ver. 10.0 and AMOSV Ver. 4.0. First, to test validity of variables, the factor analysis was used. Second, to test reliability, Cronbach's alpha coefficients was calculated. Cronbach's alpha of empowerment variable is 0.8323 showing that there's no problem in regard to the internal consistency. Also the Cronbach's alpha of other variables are 0.8301 of the degree of perceived control, 0.6705 of job characteristics, O.8787 of compensation, 0.9254 of job satisfaction, and 0.8389 of organizational commitment, respectively. Among the questions of job characteristics, two survey questions are deleted due to lowering the reliability. Third, to test multicollinearity and correlation of variables, the correlation analysis was performed. There was no problem of multicollinearity. Finally structural equation modelling (SEM) analysis was conducted to find the causal relationship of organizational and job Characteristics, empowerment, job satisfaction and organizational commitment. The 16 variables are included for the SEM analysis. The major results of this study are as follows: First, in the case of model fitness, the condition of x$^2$ statistic(92.187) is not fully satisfied, but the indices of GFI(0.912), AGFI(0.863), NFI(0.917) and CFI(0.928) are partially satisfied, which needs to upper 0.90. Second, in the result of hypotheses testing, all hypotheses are accepted and have a positive effect in 95% or 99% confidence interval(P<0.05 or P<0.001) except the effect of compensation variable on empowerment(P=0.082). Third, in regard to the direct, indirect, and total effect of variables, the direct effect of perceived control, task characteristics, and compensation on job satisfaction are 0.728, 2.264, 0.328 and on organizational commitment are 0.094, 1.411, 0.418, respectively. Also the indirect effect of perceived control, task characteristics, and compensation on job satisfaction are 0.311, 0.196, 0.028 and on organizational commitment are 0.210, 0.132, 0.019, respectively. Thus, these findings imply that various work-related factors are direct effect of empowerment and indirect effect of result variables, job satisfaction and organizational commitment. Also These results showed that the workplace empowerment is significant mediating factor of employee's job satisfaction and organizational commitment.

A Study on the Effective Guarantee of the Right to Portability of Personal Health Information (개인건강정보 이동권의 실효적 보장에 관한 연구)

  • Kim, Kang Han;Lee, Jung Hyun
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.35-77
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    • 2023
  • As the amendment to the Personal Information Protection Act, which newly established the basis for the right to request transmission of personal information, was promulgated through the plenary session of the National Assembly, MyData, which was previously applied only to the financial sector, could spread to all fields. The right to request transmission of personal information is the right of the information subject to be guaranteed for the realization of MyData. However, since the right to request transmission of personal information stipulated in the Personal Information Protection Act is designed to be applied to all fields, not a special field such as the medical field, it has many shortcomings to act as a core basis for implementing MyData in Medicine. Based on this awareness of the problem, this paper compares and analyzes major legal trends related to the right to portability of personal health information at home and abroad, and examines the limitations of Korea's Personal Information Protection Act and Medical Act in realizing Medical MyData. Under the Personal Information Protection Act, the right to request transmission of personal information is insufficient to apply to the medical field, such as the scope of information to be transmitted, the transmission method, and the scope of the person obligated to perform the transmission, etc.. Regulations on the right to access medical information and transmission of medical records under the Medical Act also have limitations in implementing the full function of Medical My Data in that the target information and the leading institution are very limited. In order to overcome these limitations, this paper prepared a separate and independent special law to regulate matters related to the use and protection of personal health information as a measure to improve the legal system that can effectively guarantee the right to portability of personal health information, taking into account the specificity of the medical field. It was proposed to specifically regulate the contents of the movement and transmission system of personal health information.

A Study on the Perception Changes of Physicians toward Duty to Inform - Focusing on the Influence of the Revised Medical Law - (설명의무에 대한 의사의 인식 변화 조사 연구 -의료법 개정의 영향을 중심으로-)

  • Kim, Rosa
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.235-261
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    • 2018
  • The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.