• Title/Summary/Keyword: Institutional care

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Predictors of Outcome in Management of Paediatric Head Trauma in a Tertiary Healthcare Institution in North-Central Nigeria

  • Gyang Markus Bot; Danaan J. Shilong; Jerry A. Philip; Ezekiel Dido Dung; Andrew H. Shitta; Nanpan Isa Kyesmen;Jeneral D. Alfin; Lena Mary Houlihan; Mark C. Preul; Kenneth N. Ozoilo; Peter O. Binitie
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.582-590
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    • 2023
  • Objective : Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality. Methods : We examined our institutional Trauma Registry over a 2 year period. Results : A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries. Conclusion : Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

A Study on the Leisure Activation Policy Plan for Social Integration on Married Immigrant Women (결혼이주여성의 사회통합을 위한 여가 활성화 정책 방안)

  • Kim, Young-Mee;Kim, Ill-Gwang;Park, Su-Sun;Lee, Jong-Kil;Yang, Jae-Sik
    • 한국체육학회지인문사회과학편
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    • v.54 no.5
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    • pp.77-87
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    • 2015
  • This study aimed to make the leisure activation policy plan on married immigrant women for social integration of multicultural families as a social problem. For that, this study selected total 25 professional experts who can suggest leisure activation policy plans on married immigrant women with convenience quota sampling, and, they were chiefs and instructors in multicultural family support centers, professors of social welfare and leisure, and married immigrant women who had passed Test of Proficiency in Korean and been doing leisure activities. As the results, there were classified into 6 main category like established policy direction, engage, awareness, and program improvement, operations and facility improvements, administrative support, 13 middle categories, and 37 small categories. Through above process, this study suggested 6 steps of policy plan: 1st, making systematic policy direction on the base of married immigrant women's real demand, 2nd, making administrative·institutional support system for effective policy enhancement, 3rd, improving recognitions on immigrant women's leisure activity from surrounders, 4th, improving programs by efficient management and qualitative diversification, 5th, improving management of concerned facilities, and 6th, attracting participations of married immigrant women through economical support·connection and child care service.

A Comparative Law Study on the Professional Work of Nurses: Focusing on Legal Basis and Standardization (간호사의 전문적 업무에 대한 국가 간 비교법적 연구: 법적 근거와 업무 범위 표준화를 중심으로)

  • Jayoung You;Jiyong Park
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.117-148
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    • 2024
  • This study attempted to examine the ambiguity of work from the legal, social perspective, and actual performance differences in domestic nursing work compared to foreign countries. We compared the historical background of nurses' expanded work through overseas situations, compare and analyze the legal basis for nurses' qualifications and work in each country, and what changes they have undergone to clarify their work. Through this, we would like to consider the current status of the absence of a legal basis for professional work of domestic nurses and seek a direction for the development of domestic medical care. This study applied the case study method as one of the comparative institutional research methods. Among OECD countries, developed countries such as the United States, Australia, and Japan were selected and compared among developed countries that are solving medical gaps using nurses. In the United States, Australia, Japan, and Korea, nurses' professional work has been created by changes in the medical environment due to an aging society, chronic diseases, and lack of doctors. We looked at the start of their professional work, the establishment of legal grounds, the timing of qualification recognition, the development of the credential system and scope of work. Foreign countries have legal grounds for their roles and tasks, but domestic countries are before legislation. The country still has not narrowed the gap between the position of the legislative and judicial branches and actual work, and the current status of the domestic healthcare system has been measured through overseas development cases.

Developing Measurement Items for the Service Quality of Clinical Trials based on the Brady & Cronin Model (Brady & Cronin의 모델에 기반한 임상시험 서비스 질 측정 문항 개발)

  • Go-Eun Lee;Sanghee Kim;Sue Kim;Sang Hui Chu;Jeong-Ho Seok;So Yoon Kim
    • The Journal of KAIRB
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    • v.6 no.1
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    • pp.17-31
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    • 2024
  • Purpose: This study aims to develop preliminary items for measuring the perceived service quality of clinical trials among participants and to verify content validity. Methods: This study was designed as a methodological study. A conceptual framework was established based on Brady and Cronin's hierarchical model, and preliminary items were prepared through translation-back-translation, a review of existing instruments, and in-depth interviews with clinical trial participants and clinical research coordinators. The final items were completed through content validity testing by experts and a review of items by clinical trial participants for the prepared preliminary items. Results: Through this study, a set of 58 items across four domains (quality of interaction with researchers, the physical environment, performance procedures, and performance results) and 9 components (information·education·communication, trust, respect for participant preferences, securing facilities and space, accessibility, comfortability, informed consent, coordination of care, subjective understanding of clinical trials) on the service quality of clinical trials were completed. The scale content validity index of all preliminary items was 0.96, meeting the recommended standards. The individual-item content validity index also meets the recommended criteria for most items, excluding four items. Conclusion: This study holds significance in developing items to measure the quality of clinical trial execution from the perspective of participants. By verifying the reliability and validity of these items through subsequent research, it is expected that they can be utilized as a valuable instrument to devise strategies for improving the quality of clinical trials.

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The Effects of Job Stress and Nursing Problem-solving Ability according to MBTI Type of Nurses on Nursing Work Performance (간호사의 MBTI 유형에 따른 직무스트레스, 간호문제해결능력이 간호업무성과에 미치는 영향)

  • Gyeong Ok Lee;Sue Won Lee;So Eun Choi;Seong Ri Kim;Nam Joo Je
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.4
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    • pp.121-132
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    • 2024
  • This study attempted to determine the effects of job stress, nursing problem-solving ability, nursing work performance, and job stress and nursing problem-solving ability on nursing work performance according to the MBTI type of nurses. The study subjects were 141 nurses working at a medical institution in G Province, and data collection was conducted from March 01 to March 31, 2024. The collected data were analyzed using correlation and multiple regression analysis. Among the psychological function types of MBTI, the SF type (sympathetic and friendly type) was the most common, and among the psychological temperament types, the SP type (sensuous and open type) was the most common. Nursing work performance had a negative correlation with job resource stress, a positive correlation with nursing problem-solving ability, and a positive correlation with problem recognition, information collection, planning ability, and evaluation. The variable that had a significant impact on nursing work performance was job resources, and problem recognition, a subfactor of nursing problem-solving ability, was found to be the best predictor of nursing work performance, followed by planning ability. The explanatory power was 17.8%. The results of this study are expected to be used as basic data to develop efficient nursing management guidelines by not only improving understanding of the personality of nurses but also investigating factors related to nurses' work performance. Through the development of programs and measures to improve nursing performance, it is necessary to revitalize programs, provide educational opportunities, and provide institutional support from hospital organizations to enable high-quality nursing care through skilled nursing work.

A Study on e-Healthcare Business Model: Focusing on Business Ecosystem Approach (e헬스케어 비즈니스모델에 관한 연구: 비즈니스생태계 접근 중심으로)

  • Kim, Youngsoo;Jung, Jai-Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.1
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    • pp.167-185
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    • 2019
  • As most G-20 countries expect medical spending to grow rapidly over the next few decades, the burden of healthcare costs continues to grow globally due to an increase in the elderly population and chronic illnesses, and the ongoing quality improvement of health care services. However, under the rapidly changing technological environment of healthcare and IT convergence, the problem may become even bigger if not properly recognized and not properly prepared. In the context of the paradigm shift and the increasing problem of the medical field, complex responses in technical, institutional and business aspects are urgently needed. The key is to derive a business model that is appropriate for businesses that integrate IT in the medical field. With the arrival of the era of the 4th industrial revolution, new technologies such as Internet of Things have been applied to eHealthcare, and the need for new business models has emerged.In the e-healthcare of the Internet era, it became a traditional firm-based business model. However, due to the characteristics of dynamics and complexity of things Internet in the Internet of things, A business ecosystem-based approach is needed. In this paper, we present and analyze the major success factors of the ecosystem based on the 3 - layer structure of the e - healthcare business ecosystem as a result of research on e - healthcare business ecosystem based on emerging technology such as Internet of things. The three-layer business ecosystem was defined as (1) Infrastructure Layer, (2) Character Layer, and (3) Stakeholder Layer. As the key success factors for the eHealthCare business ecosystem, the following four factors are suggested: (1) introduction of the iHealthcare concept, (2) expansion of the business ecosystem, (3) business ecosystem change process innovation, and (4) business ecosystem leadership innovation.

Legal Issues on the Collection and Utilization of Infectious Disease Data in the Infectious Disease Crisis (감염병 위기 상황에서 감염병 데이터의 수집 및 활용에 관한 법적 쟁점 -미국 감염병 데이터 수집 및 활용 절차를 참조 사례로 하여-)

  • Kim, Jae Sun
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.29-74
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    • 2022
  • As social disasters occur under the Disaster Management Act, which can damage the people's "life, body, and property" due to the rapid spread and spread of unexpected COVID-19 infectious diseases in 2020, information collected through inspection and reporting of infectious disease pathogens (Article 11), epidemiological investigation (Article 18), epidemiological investigation for vaccination (Article 29), artificial technology, and prevention policy Decision), (3) It was used as an important basis for decision-making in the context of an infectious disease crisis, such as promoting vaccination and understanding the current status of damage. In addition, medical policy decisions using infectious disease data contribute to quarantine policy decisions, information provision, drug development, and research technology development, and interest in the legal scope and limitations of using infectious disease data has increased worldwide. The use of infectious disease data can be classified for the purpose of spreading and blocking infectious diseases, prevention, management, and treatment of infectious diseases, and the use of information will be more widely made in the context of an infectious disease crisis. In particular, as the serious stage of the Disaster Management Act continues, the processing of personal identification information and sensitive information becomes an important issue. Information on "medical records, vaccination drugs, vaccination, underlying diseases, health rankings, long-term care recognition grades, pregnancy, etc." needs to be interpreted. In the case of "prevention, management, and treatment of infectious diseases", it is difficult to clearly define the concept of medical practicesThe types of actions are judged based on "legislative purposes, academic principles, expertise, and social norms," but the balance of legal interests should be based on the need for data use in quarantine policies and urgent judgment in public health crises. Specifically, the speed and degree of transmission of infectious diseases in a crisis, whether the purpose can be achieved without processing sensitive information, whether it unfairly violates the interests of third parties or information subjects, and the effectiveness of introducing quarantine policies through processing sensitive information can be used as major evaluation factors. On the other hand, the collection, provision, and use of infectious disease data for research purposes will be used through pseudonym processing under the Personal Information Protection Act, consent under the Bioethics Act and deliberation by the Institutional Bioethics Committee, and data provision deliberation committee. Therefore, the use of research purposes is recognized as long as procedural validity is secured as it is reviewed by the pseudonym processing and data review committee, the consent of the information subject, and the institutional bioethics review committee. However, the burden on research managers should be reduced by clarifying the pseudonymization or anonymization procedures, the introduction or consent procedures of the comprehensive consent system and the opt-out system should be clearly prepared, and the procedure for re-identifying or securing security that may arise from technological development should be clearly defined.

ATTACHMENT AND PSYCHOPATHOLOGY (애착과 정신병리)

  • Choi, Jee-Eun;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.40-60
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    • 2004
  • Introduction:Research on attachment in view point of the developmental perspective which began in the 1940s progressed during several decades. Many investigators focused mother-child separation in early attachment studies, and moved to the relationship with childhood psychopathology. Recently attachment theory and research are moving forward along the intergenerational transmission of attachment patterns, and adolescents and adult mental disorders in the developmental perspectives. Methods:We surveyed the research papers through Medline search, attachment-related monographs, and review or original papers published in Korean journal. Results:Developmental attachment researches have demonstrated convincingly that insecure attachment in infancy is associated with attachment disorder; several childhood psychopatholgy, such as institutional care and adoption, aggression and behavioral problems, childhood anxiety disorders and depressive disorders, gender identity disorder and feeding disorder, and child abuse and maltreatment; peer relationship and social competency, and parental behaviors. Recently the methodological advances including the Adult Attachment Interview that systematically assesses the adults' recollections of the earlier parent-child relationship they experienced could move beyond attachment researcher's initial concern with infancy to consider attachment processes throughout the life span. We could find that the quality of attachment was associated with several mental disorders in adolescents and adults significantly. Conclusion:Attachment theory would have focused on more specific parent-child relationship than general parental behavior. Recent attachment theory underscores its evolutionary origins to promote development of infant and contribute to human survival in psychobiological bases. Advances in attachment research could unite interests in evolutional biology and developmental psychology in understanding early parent-child relationship, and apply to clinical issues concerning mental health throughout the life span.

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Analysis to Determine the Employment Status of Married Women's on the Social Factors Associated (기혼여성의 고용지위 결정요인에 관련한 사회변인 분석)

  • Hwang, Hee-Sook;Kim, Youn-Jae;Park, Jung-Woo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.3
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    • pp.181-190
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    • 2012
  • After industrialization, the labor force participation rates of women, especially married women is drastically increasing. So, this study was designed to analyze the determinants of married women's employment status considered. For this, the determinants of married women's employment status were divided into individual-related, children-related, household-related and job-related variables to establish the research models. Based on this, the following results were drawn from a multinominal logistic regression analysis of the determinants of married women's employment status. First, an analysis of individual-related variable showed that married women had the employment status of labor wages with residence in the center of the city and high academic background. Second, an analysis of children-related variable showed that they had the employment status of labor wages with many their children and no their children under the age of six. Third, an analysis of household-related variable showed that they had the self-employment status of labor wages with nuclear family and few income earners of family members. Finally, an analysis of job-related variable showed that they had the employment status of labor wages when they got a job before they got married, their husband didn't get a job, and their husband worked in a professional field. As for findings stated above, as there was a difference in the determinants of married women's employment status, the ways for improvement in the married women's employment status would be suggested as follows. First, married women with young children have the low employment status, basically, requiring problem-solving ways for this because the housekeeping and child-rearing burden caused by marriage and childbirth are factors that continue to obstruct a job. For this, the flexible working hours system, which housekeeping and child-rearing can harmonize with economic activities like developed countries, needs to be activated. But the activation of such flexible working system will produce actual results under institutional protection, such as a related-protection law. Second, the Leave of Child Care System is debated as one of the most representatively systems that housekeeping can harmonize with economic activities. Now, although the System is legislated, the use is very poor.

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A Study on Imposing Contribution in the Compensation for Uncontrollable Medical Malpractice during Delivery (분만관련 불가항력적 의료사고 보상제도에 있어 분담금부과에 관한 연구 -헌법재판소 2018. 4. 26. 선고 2015헌가13 사건을 중심으로-)

  • Beom, Kyung Chul
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.139-171
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    • 2018
  • The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.