• 디지털융복합연구
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• 제18권11호
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• pp.409-415
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• 2020

본 연구는 고혈압 노인의 자기역량강화 프로그램 개발을 위해 IPA(Important-Performance- Analysis)기법을 적용하여 자기역량강화 교육 요구를 파악하기 위한 서술적 조사연구이다. 연구대상은 A와 B지역의 65세 이상 고혈압 노인 128명이었으며' 2020년 5월 11일부터 6월 26일까지 연구자와 연구보조원 총 6인을 통해 자료를 수집하였다. 수집된 자료는 빈도분석' 기술통계' t-test로 분석하였다. 분석결과 교육요구도가 가장 높은 문항은 '나는 의료인에게 나의 질환관리와 관련된 사항을 적극적으로 이야기 한다' 문항이며' 중요도와 수행도의 차이가 가장 큰 문항은 '나는 질환관리와 관련된 약속을 지킨다' 문항으로 나타났다. 본 연구를 토대로 고혈압 노인의 자기역량강화 프로그램 개발 시 교육 요구가 높은 문항을 반영하는 전략이 필요하다고 사료된다.

• 한국임상약학회지
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• 제24권3호
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• pp.183-192
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• 2014

Purpose: This study was aimed to identify the status of utilization of healthcare services and self-care behaviors, knowledge level and influencing choice factors of non-prescription drugs (OTCs) on consumers since sales of OTCs at the outside of pharmacy in Korea, and to confirm the changes in perception of consumers for OTCs policy through check of perception level for current OTCs policy. Methods: Data was collected from April 2014 to May 2014 from questionnaires by 418 adults who are in university located in Seoul or live in Seoul Metropolitan area but not health science major and healthcare providers. Results: The female gender was 56.6% and University students were 73.9%. The ratio by age was as follows: below 25 (60.9%), 26-30 (18.2%), 30-40s (14.9%) and 50-60s (6.0%). The knowledge level of OTCs for use of medicine, dose and side effects was generally low and especially they knew little how to deal with side effects after taking OTCs on sale at the outside of pharmacy, even though over one year has passed since the policy. The proportion of those who thought the current OTCs policy has problems regarding safety issues since the policy was very high and it was also high that the study group thought there are problems with the current way to sale OTCs and educate employees. Conclusion: After selling OTCs at the outside of pharmacy, the consumers still lacked knowledge of OTCs and did not get correct information properly. Especially, they had little information about the way to deal with side effects after taking OTCs. Public policy should be based on the health of the people and the public health is a national health priority. When all these things are taken into consideration, the government has to strengthen the OTCs policy and provide a safer environment with the accurate drug information for people than developing OTCs policy in the future.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.4961-4964
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• 2013

Greater use of mobile phone devices seems inevitable because the health industry and cancer care are facing challenges such as resource constraints, rising care costs, the need for immediate access to healthcare data of types such as audio video texts for early detection and treatment of patients and increasing remote aids in telemedicine. Physicians, in order to study the causes of cancer, detect cancer earlier, act in prevention measures, determine the effectiveness of treatment and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive and timely cancer data. Mobile devices provide opportunities and can play an important role in consulting, diagnosis, treatment, and quick access to health information. There easy carriage make them perfect tools for healthcare providers in cancer care management. Key factors in cancer care management systems through a mobile phone health approach must be considered such as human resources, confidentiality and privacy, legal and ethical issues, appropriate ICT and provider infrastructure and costs in general aspects and interoperability, human relationships, types of mobile devices and telecommunication related points in specific aspects. The successful implementation of mobile-based systems in cancer care management will constantly face many challenges. Hence, in applying mobile cancer care, involvement of users and considering their needs in all phases of project, providing adequate bandwidth, preparation of standard tools that provide maximum mobility and flexibility for users, decreasing obstacles to interrupt network communications, and using suitable communication protocols are essential. It is obvious that identifying and reducing barriers and strengthening the positive points will have a significant role in appropriate planning and promoting the achievements of mobile cancer care systems. The aim of this article is to explain key points which should be considered in designing appropriate mobile health systems in cancer care as an approach for improving cancer care management.

• 한국인터넷방송통신학회논문지
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• 제15권6호
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• pp.163-171
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• 2015

개인건강기록 서비스는 환자에게 건강기록 관리와 중요한 의료파일 관리 그리고 응급상황 연락과 같이 편리하고 사용하기 쉬운 해결책을 제시해준다. 이러한 중요한 장점에도 불구하고 개인건강기록 서비스는 데이터의 보안에 관련된 소비자 입장에서는 피할 수 없는 중요한 도전을 제기하고 있다. 개인건강기록 기술이 헬스케어와 융합되면서 사용자 개인정보 침해가 발생하고 사용자의 민감한 의료정보가 유출되는 문제가 증가되고 있다. 본 논문에서는 개인건강기록 서비스의 취약점과 반드시 해결해야할 다양한 보안 측면을 분석한다. 또한, 개인건강기록 사용자와 애플리케이션 서비스 제공자 관점에서 보안 요구사항을 기술하였으며, 개인건강기록 보안 요구사항을 만족하고 보안위협을 대응할 수 있는 보안 메커니즘에 대해 연구하였다.

• Nutrition Research and Practice
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• 제15권6호
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• pp.789-797
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• 2021

BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m². Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.

• 대한예방한의학회지
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• 제23권1호
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• pp.15-26
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• 2019

Background and Aim : Health care and cosmetics as well as quality of life is now a matter of concern and many categories of complementary and alternative medicine fall into the territory of the medical practice of Korean medicine. Accordingly, penalties are being taken for unlicensed medical practices of Korean medicine in so called complementary and alternative medicine area. There is a possibility of violating the law for the public part because it is not clearly stipulated in the law as to what is a licensed medical practice. Materials and Method : The significance of the Medical Service Act and the Act on Special Measures for the Control of Public Health Crimes were reviewed, and the related supreme court cases were discussed upon the legal aspect of processing the unlicensed medical practice of Korean medicine. The legal information was provided from the National Law Information Center of the Ministry of Government Legislation, and the information websites of the Supreme Court and the Constitutional Court. Results : The concept of medical practice, which is essential in judging the case of unlicensed medical practice, is 'prevention and treatment of diseases through diagnosis, examination, prescribing, medication, or surgical procedures based on medical expertise', and the 'acts that may result in harm and injury of health unless performed by a medical person'. With respect to the medical practice of Korean medicine, the concept includes 'prevention and treatment of diseases using the principle of traditional Korean Medicine'. Conclusions : The concept of medical practice should be clearly stipulated in the law for the control over the unlicensed medical practices of Korean medicine. And it is important to move from the current concept of medical person-oriented medical practice emerging from the national system of healthcare control, to a concept that can accept the era of health managing-oriented medical environment and the co-governance of the healthcare providers and consumers for the future.

• 보건행정학회지
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• 제31권2호
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• pp.148-157
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• 2021

Background: Based on that the key function of health technology is improving the quality of healthcare services, our study purports to explore the process of medical device development in detail and to discuss its policy implications. Methods: A total of 12 in-depth interviews were conducted with four groups of industry, hospital, academia, and civil society. All of the interviewees except those from civil society were involved in the new medical device development between 2009 and 2018. We performed a text network analysis and content analysis of the interview data. Results: The frequency and the degree centrality rankings suggested a close association between the utilization issue and the technology development. Similarly, the results of the content analysis showed that the appropriate intervention in the utilization of technology has a direct impact on the progress of development. Under the continuous industrial effort to boost profits by developing new technology, service providers and citizens should be knowledgeable of and make good use of the new technology for the provision of better services. Conclusion: As the development itself would not guarantee the improvement of service quality and better health outcomes, health technology policies should take a more comprehensive view to serve the unmet needs and even to facilitate the technology development.

• 한국병원경영학회지
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• 제28권2호
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• pp.21-31
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• 2023

Purposes: Patient experience is a tool to evaluate the process and results of medical services provided by medical institutions from the patient's point of view. Patient satisfaction surveys are a meaningful and essential source of information for improving quality in healthcare organizations. This study aims to provide basic data for improving the quality of medical service that patients can feel by analyzing the recommendation intention and satisfaction of inpatients in specialty hospitals. Methodology: The subjects of this study were 879 inpatients in 28 specialty hospitals in 14 designated fields. We conducted a telephone survey with a structured questionnaire on the satisfaction and recommendation intention for specialty hospitals. Findings: In inpatients, hospital satisfaction was higher in nursing care services and hospital satisfaction was low in physicians care services. The overall patient satisfaction score was 91.4(SD=11.9) out of 100, and the intention of recommendation was 92.0(SD=14.1) out of 100. The factors affecting patient experience were designated fields, sex, age, residential area, monthly household income, and perceived health status. Practical Implications: This study confirmed the high level of patient satisfaction and recommendation intention among inpatients of specialty hospitals. Patient satisfaction can be of great value to healthcare providers in recognizing and improving the quality of care, as well as predicting patients' willingness to revisit medical institutions. This study can be used to improve the quality of hospital care services in specialty hospitals rather than general and tertiary general hospitals.

• Journal of Chest Surgery
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• 제56권2호
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• pp.128-135
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• 2023

Background: Pneumonia caused by severe acute respiratory syndrome coronavirus 2 can cause acute respiratory distress syndrome, often requiring prolonged mechanical ventilation and eventually tracheostomy. Both procedures occur in isolation units where personal protective equipment is needed. Additionally, the high bleeding risk in patients with extracorporeal membrane oxygenation (ECMO) places a great strain on surgeons. We investigated the clinical characteristics and outcomes of percutaneous dilatational tracheostomy (PDT) in patients with coronavirus disease 2019 (COVID-19) supported by ECMO, and compared the outcomes of patients with and without ECMO. Methods: This retrospective, single-center, observational study included patients with severe COVID-19 who underwent elective PDT (n=29) from April 1, 2020, to October 31, 2021. The patients were divided into ECMO and non-ECMO groups. Data were collected from electronic medical records at Ajou University Hospital in Suwon, Korea. Results: Twenty-nine COVID-19 patients underwent PDT (24 men [82.8%] and 5 women [17.2%]; median age, 61 years; range, 26-87 years; interquartile range, 54-71 years). The mean procedure time was 17±10.07 minutes. No clinically or statistically significant difference in procedure time was noted between the ECMO and non-ECMO groups (16.35±7.34 vs. 18.25±13.32, p=0.661). Overall, 12 patients (41.4%) had minor complications; 10 had mild subdermal bleeding from the skin incision, which was resolved with local gauze packing, and 2 (6.9%) had dislodgement. No healthcare provider infection was reported. Conclusion: Our PDT approach is safe for patients and healthcare providers. With bronchoscopy assistance, PDT can be performed quickly and easily even in isolation units and with acceptable risk, regardless of the hypo-coagulable condition of patients on ECMO.

• 한국의사학회지
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• 제36권1호
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• pp.99-112
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• 2023

This paper analyzes the historical context, the author, and the organization of contents of Dongseo uihak youi (Essentials of Eastern and Western Medicines), which was written by Do Jinwoo. In the colonial situation of the early twentieth century, the tradition of Korean medicine faced crises and challenges in many ways. Members of the Korean medicine community were simultaneously faced with continuing the tradition of Korean medicine and becoming healthcare providers with a specific role within the healthcare system of the time. Dongseo uihak youi is the result of the collective and official efforts of the Association of Korean Medicine of the time to maintain its tradition where only Western medicine was officially allowed to be taught and tested after the promulgation of the Rules of the Medical Student (ŭisaeng). Dongseo uihak youi was the first Korean medicine book to precisely describe and compare the names of diseases in Eastern and Western medicines. Dongseo uihak youi contained not only medical theories and prescriptions but also laws and forms, in that the purpose of the book was not simply to cultivate clinical skills but also to demarcate the boundary of medical knowledge and activities required of a practitioner of Korean medicine in the modern colonial health care system of the time.