• 제목/요약/키워드: Hospital physicians

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의사의 진료비 심사기준 준수행동 분석 (Analysis of Physician's Observance Behavior of Health Insurance Review Standards)

  • 이은실;윤경일
    • 한국병원경영학회지
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    • 제20권2호
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    • pp.28-38
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    • 2015
  • This study was conducted by extending Ajzen's Theory of Planned Behavior(TPB) model in analyzing physician's observance behavior of National Health Insurance review standards. An extended TPB model was proposed by including 'background knowledge'and 'dorganizational commitment'in original model to predict physician's review standards observance behavior. Surveys for data collection were carried out on the physicians who were working in a general hospital, clinics, specialized hospitals, local medical centers and long term care hospitals located in Daegu and Kyoung-Buk province in Korea. Two hundreds twenty copies of questionnaires were distributed and 166 physicians responded. Data were analyzed using a structural equation model. The results show that an affirmative attitude and subjective norms have significant positive effects on physicians' behavior of observing review standards. However, the effect of perceived behavioral control on intention to behavior is not significant. The organizational commitment and background knowledge have a positive effect on the intention of observance of review standards. In conclusion, because physician's observance behaviors are affected by background knowledge and organizational commitment as well as attitudes, subjective norms, hospital managements should establish a communication system to share information on the review standards among physicians and provide appropriate measures to increase physician's organizational commitment.

Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies

  • Kim, Semi;Ham, Eun Hye;Kim, Dong Yeon;Jang, Seung Nam;Kim, Min kyeong;Choi, Hyun Ah;Cho, Yun A;Lee, Seung A;Yun, Min Jeong
    • Journal of Hospice and Palliative Care
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    • 제25권1호
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    • pp.12-24
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    • 2022
  • Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.

응급실 서비스 만족도에 대한 환자 가족의 평가와 의료진의 인식 차이 (Satisfaction Gaps among Physicians, Nurses, and Patient Family in the Emergency Department)

  • 강경희
    • 보건행정학회지
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    • 제23권2호
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    • pp.145-151
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    • 2013
  • Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

침습적 시술 시 가족입회에 대한 의사와 간호사의 인식 (Perception of Physicians and Nurses on Presence of Family during Invasive Procedures)

  • 심상희;이은남
    • 대한간호학회지
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    • 제40권3호
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    • pp.326-335
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    • 2010
  • Purpose: The purpose of this descriptive study was to determine the perception of physicians and nurses on family presence during invasive procedures. Methods: The study population consisted of 100 physicians and 100 nurses from five hospitals which have more than 500 beds in B city. Data collection was done from August 20 to September 19, 2007. The Family Presence During Resuscitation (FPDR) Inventory developed by Fulbrook, Albarran and Latour (2005) was used as the study instrument. The collected data was analyzed by t-test, ANOVA and Duncan's multiple range test using SPSS/WIN 14.0 version. Results: Nurses had more positive attitudes to allowing family members to be present during invasive procedures than physicians did. However, compared to physicians, nurses had more concern about problems of confidentiality, arguing with medical team, and increased rate of legal action if family members were present during invasive procedure. Conclusion: The results of this study indicate that educational programs and policy for family presence be required within the hospital to enhance the perception of physicians and nurses to the family presence.

Radiation Safety and Education in the Applicants of the Final Test for the Expert of Pain Medicine

  • Park, Pyong-Eun;Park, Jung-Min;Kang, Joo-Eun;Cho, Jae-Hun;Cho, Suk-Ju;Kim, Jae-Hun;Sim, Woo-Seog;Kim, Yong-Chul
    • The Korean Journal of Pain
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    • 제25권1호
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    • pp.16-21
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    • 2012
  • Background: The C-arm fluoroscope is known as the most important equipment in pain interventions. This study was conducted to investigate the completion rate of education on radiation safety, the knowledge of radiation exposure, the use of radiation protection, and so on. Methods: Unsigned questionnaires were collected from the 27 pain physicians who applied for the final test to become an expert in pain medicine in 2011. The survey was composed of 12 questions about the position of the hospital, the kind of hospital, the use of C-arm fluoroscopy, radiation safety education, knowledge of annual permissible radiation dose, use of radiation protection, and efforts to reduce radiation exposure. Results: In this study, although most respondents (93%) had used C-arm fluoroscopy, only 33% of the physicians completed radiation safety education. Even though nine (33%) had received education on radiation safety, none of the physicians knew the annual permissible radiation dose. In comparing the radiation safety education group and the no-education group, the rate of wearing radiation-protective glasses or goggles and the use of radiation badges or dosimeters were significantly higher in the education group. However, in the use of other protective equipment, knowledge of radiation safety, and efforts to reduce radiation exposure, there were no statistical differences between the two groups. Conclusions: The respondents knew very little about radiation safety and had low interest in their radiation exposure. To make the use of fluoroscopy safer, additional education, as well as attention to and knowledge of practices of radiation safety are required for pain physicians.

의료정보 전산화를 위한 치과차트의 표준안 제시 (Standardization of the Dental Chart for Comtuterization of The Medical Information)

  • 김경태;안시훈;김무성;천무철;김성식;전계록
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1998년도 추계학술대회
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    • pp.253-254
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    • 1998
  • The standardization of the dental chart proposed to computerization of the dental hospital information. To objective standardization, we gathered the dental chart from four university hospital(seoul, yonsei, kyunghee, pusan) and held a conference with dental physicians. From gathered charts, we classified the common and non-common items. We proposed the standardization to choose the most of the common items and necessary non-common things. The proposed chart include those items and the new things which the dental physicians want. After this paper, we will hold a conference with more dental physicians about more data to make more useful proposal.

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Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • 제15권2호
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

일부 대학병원 의사의 조직애착과 직업애착에 관한 연구 (Organizational and Occupational Commitment Among Physicians Working in University Hospitals)

  • 고종욱;서영준
    • 보건행정학회지
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    • 제9권1호
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    • pp.178-200
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    • 1999
  • The present study purports to examine the relationship between organizational and occupational commitment and to find the determinats of occupational commitment for salaried physicians working in hospitals. For the purpose of comparison, those of hospital administrative and clerical employees were also investigated for the purpose of comparison. The sample for jthis study consists of 77 salaried physicicas and 185 administrative and clerical employees (comparison group) from two university hospitals in Seoul and its surburbs. Data were collected by questionnaires and analyzed using ANOVA, ANCOVA, and multiple regression. The main findings of the study are as follows : 1) organizational and occupational commitment were positively correlated for both salaried physicans and clerical employees; 2) the variable of job variety had a positive impact on occupational commitment for salaried physicians; and 3) three variables of fairness of rewards, autonomy, and job variety had positive impacts for clerical employees. These findings were discussed and implications for organizational analysts and hospital administrators were suggested.

Physician's Attitude toward Treating Breakthrough Cancer Pain in Korea

  • Seo, Min Seok;Shim, Jae Yong;Choi, Youn Seon;Kim, Do Yeun;Hwang, In Gyu;Baek, Sun Kyung;Shin, Jin Young;Lee, Juneyoung;Lee, Chang Geol
    • Journal of Hospice and Palliative Care
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    • 제20권1호
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    • pp.18-25
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    • 2017
  • 목적: 돌발성 통증을 적절히 조절하는 것은 암환자에서 필수적이다. 돌발성 통증을 조절하는 것은 의료진이 돌발성 통증에 대해 잘 이해하고 적절한 구제 진통제를 사용하는 것에 달려있다. 본 연구는 한국 완화의료 전문의들의 돌발성 통증에 대한 견해와 진료 형태에 대해 알아보고자 하였다. 방법: 본 연구는 한국호스피스 완화의료학회에서 시행된 2014년 돌발성 통증 설문조사를 바탕으로 진행하였다. 100명의 의사가 온라인 설문조사에 참여하였다. 총 33개의 자가 기입식 설문 문항 중에서 12개의 항목이 분석에 사용되었다. 결과: 빠른 작용 발현은 구제 진통제를 선택함에 있어 가장 중요한 요소였다. 경구 옥시코돈(65%)과 모르핀 주사제(27%)는 흔히 사용되는 구제진통제였다. 소수의 의사들(3%)만이 점막 흡수형 펜타닐을 선호하였다. 빠른 작용 발현 때문에 경구 옥시코돈을 선택한다고 답변한 의사들은 21.5%였으며, 반면에 빠른 작용 발현 때문에 모르핀 주사제를 처방한 의사들은 81.5%였다. 전체 응답자의 약 66%는 돌발성 통증이 구제 진통제로 잘 조절되지 않는다고 답변했다. 결론: 돌발성 통증 조절에 의료진들은 어려움을 느끼고 있었고, 의료진들이 구제진통제를 선택함에 있어서 필요로 하는 중요한 요소와 실제 처방의 형태에는 차이가 있었다.

Expression and Clinical Significance of STAT3, P-STAT3, and VEGF-C in Small Cell Lung Cancer

  • Zhao, Xue;Sun, Xian;Li, Xiao-Li
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권6호
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    • pp.2873-2877
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    • 2012
  • Objective: To determine STAT3, P-STAT3, and VEGF-C expression levels in small cell lung cancers (SCLCs), and discuss their role and clinical significance in SCLC development. Method: Immunohistochemical methods were applied to 128 cases of SCLC and 40 cases of adjacent normal tissue. Results: The expression levels of STAT3, P-STAT3, and VEGF-C were higher in SCLC than in normal tissue (P<0.05). Pairwise comparisons showed positive correlations with lymph node metastasis, clinical stage, and tumor size (P<0.05). The expression levels were also related with the overall survival rates. Conclusion: STAT3 and VEGF-C play important roles in the development of SCLC, and might be expected to become new targets for SCLC treatment.