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Awareness of Doctors' Shared Decision-Making in Life-Sustaining Care Decisions

  • Kim, Dalyong;Lee, Hyun Jung;Yu, Soo-Young;Kwon, Jung Hye;Ahn, Hee Kyung;Kim, Jee Hyun;Seo, Seyoung;Maeng, Chi Hoon;Lim, Seungtaek;Kim, Do Yeun;Shin, Sung Joon
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.204-213
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    • 2021
  • Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

High Performance Work System for Entertainment Business : An Analytic Network Process Approach (엔터테인먼트업의 고성과작업조직 : ANP 기법을 중심으로)

  • Kwon, Jung-Eon
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.2
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    • pp.1-10
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    • 2021
  • The purpose of this study is to explore a significant HPWS(High Performance Work System) model for the entertainment industry. HPWS is one of the most studied themes for managing human resources as well as a set of practices to elicit employees' commitment to an organization. Recently, the entertainment industry is growing rapidly, but it is difficult for entertainment firms to retain a stable profit unlike the manufacturing industry. This is because the performance of entertainment business tends to rely heavily on the capabilities and synergy of human resources. In order to suggest a systematic way to manage these, this research identified an effective HPWS model for entertainment business and provides a competitive advantage to entertainment firms, using ANP(Analytic Network Process). ANP is a multicriteria decision making technique that allows dependences and feedbacks among decision elements in the hierarchical or network structures in a holistic manner. The pairwise comparison data that prioritized the criteria of HPWS was collected from 28 team leaders in entertainment firms. According to our results, the most critical factor for HPWS in entertainment business is "employee involvement in decision-making." The sub-factors such as "open communication," "distributive decision-making," and "performance-driven reward" have a greater effect. These findings could provide implications for entertainment firms to determine which practices should be taken into account to accomplish HPWS.

A Study on Digital Humanities Research Guides of Academic Libraries in the U.S. (대학도서관의 디지털 인문학 연구지원 가이드에 관한 연구 - 미국 대학도서관 사례를 중심으로 -)

  • Lee, Jisu
    • Journal of the Korean Society for Library and Information Science
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    • v.56 no.1
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    • pp.297-320
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    • 2022
  • In this study, the current status of digital humanities(DH) research support guide service, which is increasing recently in research-oriented academic libraries in the United States, was analyzed by comparing the contents provided by each institution's Website. Based on the ranking of research-focused academic libraries with the largest volume of books in North America as of 2018-19 in Association of Research Libraries(ARL) statistics, the service contents of 30 institutions providing DH research support guide service were analyzed. The criteria for analysis are 8 components of services presented in previous studies: (1) tools and technology, (2) funding, (3) community, (4) pedagogy, (5) projects, (6) resources, (7) publications and consultations, and (8) workshops and training. As a result of the analysis, it was found that most of the institutions operating the DH research support guide service provided 'DH resources', and more than half of the institutions were providing 'DH tools and technology' and 'DH community' information. In addition, most institutions are operating the DH research support guide service in cooperation with the library itself, on-campus research institutes and centers, or other departments for DH publication and project consultation, so they focused on research support information services through consulting. In the future, discussions on the DH research support guide service operation plan of domestic academic libraries and the competency of service personnel should be continued.

The Phenomenological Study on Self-actualization of Middle-aged Single Mothers - Application of Guided Imagery and Music (GIM) - (한 부모 중년 여성가장의 자기실현과정에 관한 현상학적 연구 -심상유도 음악치료(GIM) 적용-)

  • Lim, Jae-Young;Shin, Dong-yeol;Lee, Ju-Young
    • Industry Promotion Research
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    • v.6 no.2
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    • pp.55-62
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    • 2021
  • The number of single-parent families in South Korea increased since 2000, related to a sharp rise in the divorce rate of 50s and an increase in male mortality rates among those aged 40s-50s. Middle-aged single mothers experience a critical period realizing self-actualization needs, while being in the middle adulthood from the lifespan developmental perspective. In this respect, it is significant to study self-actualization of middle-aged single mothers through guided imagery and music (GIM) in order to provide them with psychological support. This study was conducted from September 2018 to June 2020, and the GIM sessions were conducted at least 10 times. Four participants were selected among the middle-aged single mothers. The imagery experiences of participants in the GIM sessions were classified into four sub-elements: physicalness, emotion, memory, and sense. Within those sub-elements, eight semantic units were categorized into 46 elements. Finally, 152 semantic units were derived. Moreover, the self-actualization which participants experienced through GIM presented three archetypal images: shadow, persona, and the self. In the GIM sessions, experiences of putting their negative emotions associated with family into words and changing passive self-imagery into active one enabled participants to bring the shadow into their consciousness, there by recognizing their positive and bright internal self. Furthermore, participants could map that their current status as people marginalized by siblings and parents, enraged and holding double standards for others, was suppressed by their 'good daughter' and 'religious' personas. This realization lead them to realize and restore their persona. The use of GIM in the study allowed participants to elicit re-experiences of the negative events, while experiencing various imagery and music. This process helped participants achieve self-actualization.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

The Effects of Information Sources on Trust, WOM Intention, and eWOM Intention in the Restaurant Sector (외식기업의 정보원천이 신뢰, 구전의도, 그리고 온라인 구전의도에 미치는 영향)

  • CHAO, Meiyu;YOU, YenYoo;KIM Eun-Jung
    • The Korean Journal of Franchise Management
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    • v.13 no.3
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    • pp.1-15
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    • 2022
  • Purpose: In the restaurant sector, it has been known that consumers' positive perception of brands influences their positive WOM intention, and information sources play an important role in increasing credibility by enhancing consumer awareness and developing differentiated brands. This study examines the effects of information sources (e.g., advertisement, WOM, SNS) on trust (cognitive and affective) and, WOM and eWOM intention in the restaurant context. In the model, cognitive and affective trust play mediating roles in the relationships between information sources (e.g., advertisement, WOM, SNS) WOM and eWOM intention. Research design, data, and methodology: Research models and hypotheses were developed according to the research direction. The survey questionnaire items were developed and used appropriately according to the contents of this paper based on prior studies. All constructs were measured with multiple items developed and validated in prior studies. A total of 502 responses were collected from an online survey. The research model was evaluated using SmartPLS 4.0. Frequency analysis was performed to understand the demographic characteristics of the survey respondents. The reliability, convergent validity, and discriminant validity were assessed using measurement model analysis. The proposed model was verified using the structural equation model. Results: Advertisement, WOM, and SNS information sources all had a positive effect on affective trust, whereas only WOM had a significant effect on cognitive trust. In addition, affective trust had a positive effect on cognitive trust and eWOM intention but did not affect WOM intention. Finally, cognitive trust was found to have a positive effect on both WOM intention and eWOM intention. Conclusions: This study redefines the concept of where restaurant service companies should focus when providing consumers with information about their products and services. As a result, the conceptual framework of positive word of mouth intention to increase new customer visits to the restaurant brand has been expanded. In addition, this study not only presents an information source management strategy for restaurant brands, but also presents practical implications for resource allocation guidelines for customer management in the restaurant sector.

Deriving Key Risk Sub-Clauses for EPC/Turnkey Contract Conditions for Overseas Construction Projects - Based on FIDIC Conditions of Contract for EPC/Turnkey Projects, second edition 2017 - (해외건설공사 EPC/Turnkey 계약조건 핵심 리스크 세부조항 도출 - FIDIC Silver Book 2017년 개정판 기준으로 -)

  • Hong, Seong Yeoll;Jei, Jae Yong;Seo, Sung Chul;Park, Hyung Keun
    • Korean Journal of Construction Engineering and Management
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    • v.23 no.6
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    • pp.101-110
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    • 2022
  • Recently, the global construction market is expected to grow at an annual average of 4.8% by 2025 and the risk of overseas construction is also expected to increase accordingly. In particular, domestic construction companies intensively participated in the EPC(Engineering, Procurement, Construction)/Turnkey project, but as a result of failing to respond to contractual risks, they have suffered losses of trillions of won in overseas business since 2013. Nevertheless, there have been not many studies on the derivation of EPC/Turnkey's contractual key risk sub-clauses. Therefore, in this study, the key risk sub-clauses were studied for the conditions of the 2017 Silver Book contract issued by the International Consulting Engineering Federation(FIDIC). To this end, 30 experts with more than 10 years of experience in international construction contracts were formed as a panel to conduct a Delphi survey on 170 sub-clauses of 21 clauses of FIDIC Silver Book to derive 62 main risk sub-clauses. In addition, the RPN(Risk Priority Number) was finally calculated using the FMEA(Failure Mode and Effect Analysis) technique, and 25 key risk sub-clauses within the Critical Risk range were derived. Through the results of this study, the practical point of view is able to refer to the contract provisions to be carefully reviewed at the bidding and contract signing stage in overseas construction projects. From an academic point of view, it provides direction and basic knowledge of how to study the contract fields used in overseas construction EPC/Turnkey projects.

A Phenomenological Study on the Burnout of Specialized Counselors in the 117 Report Center - Application of the Integrated Working System of Government Departments- (117 신고센터 전문상담 요원의 소진에 관한 현상학적 연구 -정부 부처 통합근무 체제 적용-)

  • Youn, Yang-suk;Kim, Eun-hye
    • Industry Promotion Research
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    • v.7 no.3
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    • pp.85-91
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    • 2022
  • In modern society, the field of life is expanding to complex and diverse fields according to changes in lifestyle. As people's consciousness also changes, various social problems are involved, and countermeasures are being taken in various ways. In particular, as the issue of school violence has become a subject of interest, government-related ministries have jointly set up a reporting center and professional counselors are receiving and consulting on damage reports. Counselors experience mental and physical exhaustion in the course of their work. Therefore, the need to contribute to effective counseling work is raised by studying the factors that cause burnout. This study collected the experiences of 10 counselors working at 117 reporting centers from February 2019 to May 2020 through interviews and analyzed them with Colaizzi's phenomenological research method. The exhaustion factors derived from the results of the study were first experiences such as conflict between counselors during the period of institutional integration in the "117 reporting center experience", and secondly, professional counselors experienced emotional exhaustion, inhumanization, and lack of achievement. In order to prevent and overcome the exhaustion factors of counseling agents, it was necessary to prepare measures to promote fraud. This is expected to be useful data for improving the working environment of special job counselors in the era of industrialization and informatization in which various anonymous counseling methods are used.

The Effect of Support Quality of Chatbot Services on User Satisfaction, Loyalty and Continued Use Intention: Focusing on the Moderating Effect of Social Presence (챗봇서비스의 지원품질이 사용자 만족, 충성도 및 지속사용의도에 미치는 영향에 관한 연구 : 사회적 실재감의 조절효과를 중심으로)

  • Kim Jung Tae;Choi Do Young
    • Journal of Service Research and Studies
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    • v.12 no.4
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    • pp.106-124
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    • 2022
  • This study examined whether the social support (emotional support, information support) provided by customers through chatbot service affects the satisfaction of chatbot service felt by customers and whether the satisfaction of chatbot service affects loyalty and intention to continue using chatbot service. In order to confirm the moderating effect of social presence of chatbot service, a total of 300 effective data were obtained by conducting an online survey divided into a group that recognizes social presence highly and a group that recognizes low. As a result of the analysis, the path from emotional support to satisfaction of chatbot service was supported in the group that recognized social presence highly, and the path from emotional support to satisfaction of chatbot service was not supported in the group that recognized social presence low, and the difference was confirmed in the hypothesis path coefficient. This is interpreted as the social presence affecting human emotional response.This study can provide implications for the function of social presence of chatbot service in that it applied information support and emotional support, which are two factors of social support, to chatbot service, and demonstrated the relationship between satisfaction, loyalty, and continuous use according to the degree of social presence of chatbot users.

Non-linear Finite Strain Consolidation of Ultra-soft Soil Formation Considering Radial Drainage (방사방향 배수를 고려한 초연약 지반의 비선형 유한변형 자중압밀 거동 분석)

  • An, Yong-Hoon;Kwak, Tae-Hoon;Lee, Chul-Ho;Choi, Hang-Seok;Choi, Eun-Seok
    • Journal of the Korean Geotechnical Society
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    • v.26 no.11
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    • pp.17-28
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    • 2010
  • Vertical drains are commonly used to accelerate the consolidation process of soft soils, such as dredged materials, because they additionally provide a radial drainage path in a deep soil deposit. In practice, vertical drains are commonly installed in the process of self-weight consolidation of a dredged soil deposit. The absence of an appropriate analysis tool for this situation makes it substantially difficult to estimate self-weight consolidation behavior considering both vertical and radial drainage. In this paper, a new method has been proposed to take into account both vertical and radial drainage conditions during nonlinear finite strain self-weight consolidation of dredged soil deposits. For 1-D nonlinear finite strain consolidation in the vertical direction, the Morris (2002) theory and the PSDDF analysis are adopted, respectively. On the other hand, to consider the radial drainage, Barron's vertical drain theory (1948) is used. The overall average degree of self-weight consolidation of the dredged soil is estimated using the Carillo formula (1942), in which both vertical and radial drainage are assembled together. A series of large-scale self-weight consolidation experiments being equipped with a vertical drain have been carried out to verify the analysis method proposed in this paper. The results of the new analysis method were generally in agreement with those of the experiments.