• Safety and Health at Work
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• 제12권4호
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• pp.445-451
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• 2021

Background: This study aimed to evaluate the reliability and validity of the self-administered questionnaire for Korean radiation workers. Methods: From May 24, 2016, to June 30, 2017, 20,608 participants completed the questionnaire, providing information on sociodemographics, lifestyle, work history and practices, medical radiation exposure, and medical history, which was linked to the National Dose Registry and the National Cancer Registry. The validity of the questionnaire was evaluated using the responses of 20,608 workers, and reliability was evaluated using the responses of 3043 workers who responded to the survey twice. Results: Responses concerning demographic characteristics and lifestyle showed reliability with a moderate-to-high agreement (kappa: 0.43-0.99), whereas responses concerning occupation and medical radiation exposure had a wide range of agreement (kappa: 0.05-0.95), possibly owing to temporal variability during employment. Regarding validity, responses to the question about the first year of employment had an excellent agreement with the national registry (intraclass correlation coefficient = 0.9); however, responses on cancer history had a wide range of agreement (kappa: 0.22-0.85). Conclusion: Although the reliability and validity of the questionnaire were not distinguished by demographic characteristics, they tended to be low among participants whose occupational radiation exposure was minimal. Overall, the information collected can be reliable for epidemiological studies; however, caution must be exercised when using information such as medical exposure and work practices, which are prone to temporal variability.

• 의료법학
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• 제13권1호
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• pp.71-89
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• 2012

Just in case a patient's state couldn't get better or get even worse after medical practices, it is difficult for the patient's side to accept the result and it tends to think that its damage is caused by his doctor's malpractice. Medical practices of a doctor require highly advanced attention duty as a medical expert, because they are targeted at a human body of the best benefit and protection of the law. However, it is hard to prove the malpractice on the patient's side in medical dispute. Therefore, to solve a medical dispute quickly and fairly before the medical suit Korea Consumer Agency (KCA) has done a medical dispute adjustment business since 1999. For the past 5 years (2006~2010), the medical team of KCA had managed 4,171 cases as an injury relief, but it had dealt with them focusing on an injury relief business only after the occurrence of a medical accident. Afterwards, it is necessary to expand the range of its services in purpose of preventing the injury of consumers. If we can solve the problems -the clear statements about the cease of extinctive prescription in the fundamentals of comsumer act, the presence of parties directly concerned at comsumer dispute adjustment committee, and the effect of an agreement, etc. -, which have been founded in medical injury relief service of KCA and the management and procedures of the comsumer dispute adjustment committee of KCA and if we can also give KCA more workers and the proper budget of the government, we can expect KCA to become a more useful agency.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.229-235
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• 2016

Purpose: To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD. Methods: It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included. Detail history taken with special emphasis on breastfeeding and age of gluten introduction. Standard statistical methods used to analyze the data. Results: $Mean{\pm}standard$ deviation age of onset and diagnosis of CD in breastfed cases was $2.81{\pm}1.42$ years and $3.68{\pm}1.55$ years respectively as compared to $1.84{\pm}1.36$ years and $2.70{\pm}1.65$ years respectively in not breastfed cases (p<0.05). Those who had continued breastfeeding during gluten introduction and of longer duration had significantly delayed onset of disease. The age at onset of CD was under one year in 40.42% of the cases, who had started gluten before 6 months of age compared to only 12.58% of those who had started gluten later (p<0.001). The proposed statistical model showed that two variables, i.e., breast feeding status during gluten introduction and age at gluten introduction positively influencing the age at diagnosis of CD. Conclusion: Delayed gluten introduction to infant's diet along with continuing breastfeeding, delays symptomatic CD. However, it is not clear from our study that these infant feeding practices provide permanent protection against the disease or merely delays the symptoms.

• 대한한의학원전학회지
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• 제30권2호
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• pp.31-43
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• 2017

Objectives : Written by Yoongdongri in the 18th century Chosun, Chochangkyeul is a book that specially deals in Ungi. Yoon understood a person's body constitution by taking into factor the person's birth year, and used this information to determine his Ungi type, and understood his disease mechanism. Methods : Following the study on the first part of Chochangkyeul, named Ungiyeonron, the paper tries to study the book's second part, called Yongyakgwon. The book's core messages are summarized upon a thorough inspection. Results & Conclusions : Yoondongri was a highly-acclaimed doctor in the 18th century Chosun, and also an Ungi practitioner who utilized the theory of Ungi in his clinical practices. His practices were mainly based on the prescription of Ungi found in Chenwuze's Sanyinfang, coupled with almost all parts of Donguibogam's Husebang. He had an extensive clinical experience which helped him describe his methods of quickly responding to the side effects that sometimes occur due to misuse of medicine. Such detailed descriptions are never found in past medical books, which gives Yoon's book a great level of historical importance. Yongyakgwon divides the scripts between Gabsin, Muui, Byungye, Gyungjeong, and Yimgi in accordance with the theory of Ounhabgi, and also introduces treatments based on Yukisachun. Jangbupasuyak also introduces about six external organs and six internal organs with relation to treating wind medicine, treating heat medicine, treating cold medicine, treating dry dampness medicine, dryness-moistening medicine, pulling meridian medicine. All of these can be applied to patients easily.

• 품질경영학회지
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• 제31권2호
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• pp.82-97
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• 2003

The study attempts to review TQM models used in the health care sector and the obstacles to the application of TQM in the sector. Even though the TQM models in the manufacturing and service sectors were successfully applied, the applicability of TQM in the health care sector is still in question. The reason is the unique characteristics of the medical sector such as medical and management practices. The most of the TQM models in the health care sector come from manufacturing industries. The importance of the professional groups is, however, more emphasized in the sector than in manufacturing sector. The role of the groups are idiosyncratic to the sector. They generate some obstacles to the application of TQM in the sector. The barriers include cultural obstacles of health care organization. It naturally follows that the TQM in the health care sector requires the change of the organizational culture of the sector. The culture embraces the norms, rules, regulations, compensation system, morale, practices, and common experiences. To change the culture needs long term effort and modification of the rules, regulations, compensation system, and practices. It also requires staffs' training in the problem solving methods. The TQM in the health care sector needs that the interested parties should change. Since doctors group and nurses group are controlled in the bureaucratic and authoritative manner, they should learn the problem solving techniques which require the interaction with other groups. The management also needs to learn management skills and get thorough training on them.

• 간호행정학회지
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• 제15권1호
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• pp.64-71
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• 2009

Purpose: This study shows the prehospital emergency nursing practices, and analyzes them associated with their individual characteristics and job conditions. Method: Based on a survey of the National Emergency Medical Center in Korea(2008), principal components were extracted from 7 prehospital emergency nursing practices by factor analysis, and some regression analyses of principal components(CPR-AED and V/S-I.V.) were executed on individual characteristics and job conditions. Results: The PENs gave themselves higher order ratings for vital sign check, airway management for loss of consciousness patients, CPR for suspicious cardiac arrest, keeping vein open for shock patients, AED for abnormal pulse rate, AED for suspicious cardiac arrest, and AED for loss of consciousness. Age and duty periods were statistically significant influential factors on the CPR-AED component. Conclusion: The results indicate that the PENs were competent in overall prehospital emergency activities and procedures even some weak self-evaluations, and that the standard curriculum and practice standard for prehospital nursing should be developed in order to increase nursing leadership in prehospital emergency settings.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.263-275
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• 2022

Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.7-17
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• 2023

Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

• 대한예방한의학회지
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• 제14권1호
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• pp.25-35
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• 2010

Objectives : This study was aimed to investigate attitude of western medicine(WM), Korean medicine (KM), and nursing school students toward the east-west collaborative medical practices(EWCMP). Methods : The participants were 185 WM students, 123 KM students, and 230 nursing students belonging to two universities (P and D) in Busan metropolitan city, Korea. Data were collected with self-administered questionnaires and analyzed with descriptive statistics, $X^2$ test, t-test and ANOVA with SPSS win 14.0. Results : Of 538 participants, overall 87.1% has heard EWCMP. Preferred type of EWCMP was significantly different by participants' backgrounds. WM students preferred (western) medical treatment with minor supportive Korean medical care(85.5%). However, KM students emphasized EWCMP with the same weight in both medical and Korean medical treatment(59.0%), and nursing students were in between two schools. Intention to recommend EWCMP for the consumer was 67.4%, and also showed very different between WM students and others, 37.3% of WM students, 89.4% of KM students, and 83.9% of nursing students. WM students showed more negative opinion on the EWCMP than KM and nursing students, Conclusions : The attitude of WM, KM, and nursing school students toward EWCMP was very similar to that of WM doctors, KM doctors, and nurses, respectively. WM students showed big difference in the overall attitude toward EWCMP from that of KM and nursing students. It is recommended to introduce the joint curriculum or exchange programs between WM and KM schools.

• The Korean Journal of Pain
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• 제27권1호
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• pp.35-42
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• 2014

Background: Epidural steroid injection (ESI) is one of the most common procedures for patients presenting low back pain and radiculopathy. However, there is no clear consensus on what constitutes appropriate steroid use for ESIs. To investigate optimal steroid injection methods for ESIs, surveys were sent to all academic pain centers and selected private practices in Korea via e-mail. Methods: Among 173 pain centers which requested the public health insurance reimbursements for their ESIs and were enrolled in the Korean Pain Society, 122 completed questionnaires were returned, for a rate of 70.5%; also returned were surveys from 39 academic programs and 85 private practices with response rates of 83.0% and 65.9%, respectively. Results: More than half (55%) of Korean pain physicians used dexamethasone for ESIs. The minimum interval of subsequent ESIs at the academic institutions (3.1 weeks) and the private practices (2.1 weeks) were statistically different (P = 0.01). Conclusions: Although there was a wide range of variation, there were no significant differences between the academic institutions and the private practices in terms of the types and single doses of steroids for ESIs, the annual dose of steroids, or the limitations of doses in the event of diabetes, with the exception of the minimum interval before the subsequent ESI.