Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.
Currently the oriental medical care services in the health centers is getting popularity because of their unique aspects which western medicine can not cover. This study was conducted to speculate the current status of oriental medical care services in health centers and possibility of how to effectively provide the oriental medical care services(or traditional medical care services) in health centers. For the study, the survey questionnaires were distributed to all 269 health centers and 138(51.3%) of them were collected. Eight of the collected were inadequate for the analysis and 130 of 269 questionnaires were finally chosen for the study. The SPSS/PC WIN 8.0 was used for the statistical analysis. The results are as follows. First, 91 out of 130 sample health centers(70%) are providing oriental medical care services. The results show that the willingness of the directors and the public awareness in community are the most important factors to provide oriental medical care services in health centers. In contrast, the lack of cooperative efforts between western and oriental medical doctors and the lack of government supports are considered as factors that intervene the oriental medical care services in health centers. About 80% of the sample health centers respond that the government supports is needed for oriental medical care services in health centers. Second, it was asked to the directors of 39 health centers which do not provide oriental medical care services regarding their future plan to include the services. About 70% of health centers respond that no plan is available now. They acknowledge that the demand on the services is the most important factor to consider the oriental services as their future medical services. Third, 69.2% of the oriental medical doctors in health centers are public health doctor. 95.6% of the sample health centers have space for the oriental medical care services in their facilities and some health centers provide the services through the private clinics nearby facilities. Finally, the surveyors consider both budgetary constraints and difficulty in recruiting doctors as barriers for the effective oriental medical care services in health centers. Finally, t-test and LSD were employed to find out the difference among several groups. The analysis shows statistically significant difference among groups about their recognition on health care policy, health care system, and effectiveness of oriental medical care services. To be conclude, the study shows the necessity of oriental medical care services in health centers. To do so, the government supports, cooperative efforts between oriental and western medical doctors, and providing job security for doctors should proceed to provide effective oriental medical care services in health centers.
Objectives : This study was aimed to facilitate mutual comprehension between Western and Traditional Korean Medicine (TKM) by analyzing recognition of medical school students on traditional medical prescription and treatment such as herbal medicines and acupuncture. Methods : We conducted a survey targeting medical school students of four medical schools from April through May 2009, and analyzed 208 cases responded. Results : Survey results revealed that medical school students took knowledge of traditional medicine from TV programs and on the Web in general. They thought they had considerable traditional medical knowledge but did not almost understand for professional contents. Regardless of some positive recognition for traditional herbal medicine, negative perspectives were more common and its safety and efficacy on the drug reference were considered as a major reason. On the other hand, recognition on acupuncture was comparatively positive. Scientific data for both herbal medicine and acupuncture are lacking in reality but the attitude only for acupuncture was different. Of the survey respondents, 57.8% had negative attitude against diagnostic methods of TKM and 59.1% opposed to the usage of modern medical equipments by TKM doctors. With regard to the future position of TKM, they tacitly approved that TKM would be absorbed into the complementary and alternative medicine (CAM) and importance of TKM objectification, followed by Government's support. Conclusions : Medical school students neither affirm nor deny TKM as a whole but the state of awareness for each item was similar to the physician. In terms of TKM its internal and external innovation would be required to continuously establish objectification of TKM prescription and scientific research on treatment technology.
The purpose of this study was to understand how vegetarian diets in Taiwanese hospitals are well established and provide suggestion for successful implementation in Korea. Micro-ethnographic case study with in-depth interviews, field observations, and paper reviews were used for this study. Experiences of doctors and nutritionists from Taiwanese hospitals where deliver vegetarian hospital diets were analyzed. This research found out Taiwanese life respect culture has influence on introducing vegetarian diets in hospital, besides most Participants agreed to use vegetarian diets for the medical purpose according to their clinic experiences and research results. Meanwhile there is no restriction to compel patients to keep vegetarian diets. All participants answered food has a large effect on the human body and further study on vegetarian diets' efficacy is required. The hospital chief's decision making is crucial to introduce vegetarian diets in hospitals. For the bigger picture, social supports, organizational supports and national policy supports are all important factors for it. The implications and recommendations for Korean hospitals were discussed. The public awareness for vegetarian diet for medical purpose along with research on its efficacy would be needed. In order to make good use of a vegetarian diet for medical purposes, we first need to build a vegetarian-friendly environment, go deep into the study of a diet's effects using diverse methodologies, and combine the diet with traditional medicine theory. Based on the results of this primary study, more related studies should be carried out in the future.
목적: 본 연구는 임상에서 많은 빈도로 사용되고 있는 향정신성 약물이 간독성을 발생시킬 수 있음을 임상 예를 통해 보여줌으로써, 한의진료현장에서 이에 대한 경각심과 더불어 약인성간손상에 대한 최신 정보를 제공하고자 한다. 방법: 본 임상 예의 논문은 향정신성 약물을 사용한 후 약인성간독성의 의심과 진단 및 약물의 중단 후 증상과 간손상 효소의 개선과정을 자세히 제시하였다. 결과: 평소 혼합결합조직병으로 한방병원에서 수년 동안 침과 뜸 치료 등으로 잘 유지되고 있던 56세의 여성 환자가, 어느날부터 갑자기 심한 피로감과 전신적 불편편함을 호소하였다. 혈액검사를 시행한 결과, 혈청 AST, ALT가 정상 경계의 2.5-배 이상 증가하였고, 촤근 복용한 향정신성약물에 대한 RUCAM score가 9점으로 약인성간손상 진단에 부합하였다. 이 의심 약물들을 중지한 뒤에 주관적 불편함이 빠르게 개선되었으며, 혈청 간손상 효소 수치 또한 2주 안에 정상화되었다. 결론: 본 증례는 향정신성약물로 생길 수 있는 간손상의 전형적인 임상 예로서, 향정신성약물의 일반화된 상황에 비추어 한의원에서 환자의 진료 과정에서 하나의 중요한 고려사항을 암시한다.
Seo, Heenam;Song, Seoung Yeon;Kim, Dahye;Park, Ji Hwan;Shin, Yoonho;Lee, Kang Hyuk;Choi, Soo An;Lee, Ju-Yeun;Kim, Do Young;Shin, Wan Gyoon;Kim, Eunyoung
한국임상약학회지
/
제32권2호
/
pp.84-92
/
2022
Background: Topical corticosteroids (TCs) are available both as over-the-counter drugs and prescription medicines at pharmacies. Although they are generally safe drugs, inappropriate and excessive use could result in potential side effects. Thus, it is important to have appropriate knowledge regarding the use of TCs. We performed a cross-sectional survey to assess public knowledge and the potential misuse or overuse of TCs. Methods: A cross-sectional and nationwide online survey was conducted among participants who were aware of TCs. The survey items included sources of information, indications, potential side effects, and methods of application of TCs. A comparative analysis was conducted between those with (TC users) and without (TC non-users) an experience of using TCs. Results: Among 3,000 participants, 74.4% were TC users. The mass media was the most common information source of TCs, and only one-third of the surveyed people relied on pharmacists or doctors for information. Regarding indications and application methods, incorrect answer rate was high in some items, but respondents showed adequate knowledge. However, awareness of the safety of TCs was low. Overall, the TC users showed a higher knowledge of TCs than TC non-users. Conclusions: Public knowledge of the use of TCs appears to be appropriate. However, we found potential misuse or overuse of some items and a lack of awareness of the side effects concerning TCs. Thus, healthcare professionals' significant role is required.
Objectives : Cancer patients who are afraid of unpleasant therapy and doubt a perfect cure often seek out traditional Korean medicine or many other kinds of complementary and alterative medicine (CAM) instead. This study was carried out in order to learn the prevalence and kinds of the traditional Korean medicine and CAM to evaluate awareness of and attitude toward it. Methods : 213 patients with gastric cancer who had undergone surgery in the department of gastrointestinal surgery and visited for routine follow-up from November to December of 2004 were included. A questionnaire survey was done by trained interviewers for CAM and demographic information. Results : 96.7% of patients had experience with CAM. The kinds and frequencies of CAM were diet and nutrition 21.0%, folk remedy 21.0%, pharmacological treatment 13.5%, oriental medicine 5.3% and mind-body intervention 1.4%. 56.8% of patients had experienced 2-6 kinds of CAM, 37.4% more than 7. Among diet and nutrition, ginseng (62.9%) was highest, followed by ox leg bone soup (50.8%) and pumpkin (31.5%). Among the folk remedies, elm tree was highest at 46.5%, followed by phellinus linteus (Sang-Whang) at 26.8% and ganoderma lucidum (Young-Gee) 20.7%.satisfaction with CAM was relatively low (43.2%), many patients (78.2%) replied that they would use it continuously. Conclusion : Most patients had experience with many kinds of CAM, but didn't discuss it with medical doctors. If scientific study proves whether or not each kind of CAM is actually effective ondisease, it will help to improve the health of patients and prevent the inappropriate usage and cost.
When a new educational system for college students in South Korea was established in 1946, the National Committee for Educational Planning adopted a 6-year curriculum of medical education, consisting of a 2-year premedical component and a 4-year medical component. For more than half a century, the premedical curriculum has received little attention. However, it is very important for premedical students to have a range of experiences that could be useful in their future medical careers. In 2005, another change was made to the system of medical education, in which medical schools without a 2-year premedical curriculum were established. This began to stimulate interest in premedical education, and more and more professors have become interested in premedical education as 6-year medical colleges have become more popular than before. Since 2015, the Education and Cultural Center of the Korean Association of Medical Colleges has annually hosted a workshop for redesigning premedical education; these workshops quickly fill up with registrants, reflecting the participants' lively interest in premedical education. The problems of premedical education are mostly due to students' and educators' attitudes. A more effective approach will be needed in the educational system of the future to train highly competent medical doctors. To judge whether an educational program is successful, its aims must be clearly articulated. For this reason, medical colleges must prepare premedical education curricula based on their educational aims. It is expected that the system of premedical education will be strengthened in the future due to the growing awareness of its importance.
Deficiency and excess pattern differentiation is unique characteristic of traditional oriental medicine on diagnosis and treatment. This differentiation is accomplished through pulse, tongue diagnosis and question examination, but most of these processes need to be objectified for efficacious treatment and traditional medicine development. In this study, we developed the deficiency and excess pattern questionnaire for objectification of question examination. The deficiency and excess pattern questionnaire was made out through The Traditional Oriental Medical Literature with Delphi Technique. Patients who visited oriental medical hospital filled out the questionnaire by themselves. Diagnosis of deficiency and excess pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the deficiency and excess pattern questionnaire. (Ordinary health degree, pain pattern, fatigue, weight change, sweating, uncomfortable awareness on chest and abdomen) Deficiency symptoms group acquired internal consistency, but excess symptoms group did not. (Cronbach's ${\alpha}$ > 0.6) There were significant associations between doctor's diagnosis and deficiency and excess symptoms in 'ordinary heath degree', 'voice weakening', and 'chest distress' (p-value < 0.1) There were significant differences between deficiency and excess syndrome patients groups in deficiency questionnaire score but there were no significant differences between deficiency and excess syndrome patients groups in excess questionnaire score. We acquired the internal consistency and significant result of deficiency pattern questionnaire, but we can find out some difficulties in development of the excess pattern questionnaire. These difficulties are associated with insufficiency description of traditional literature and small number of patients diagnosed as excess pattern.
Objectives : From mechanism studies using animal models to high-level evidence based research such as randomized controlled trials or systematic reviews, various acupuncture studies have been performed. Nevertheless, the current research appears insufficient to satisfy clinicians' needs. We aimed at investigating clinicians' perception on the translational research and suggesting ways of symbiosis between basic research and clinical practice. Methods : Data were collected using a web-based questionnaire made available to Korean medicine doctors who were informed through social networking service or e-mail. The survey participants indicated their awareness of acupuncture research and their thoughts on the applicability of research in practice. Results : Forty-seven clinicians completed the survey. While most respondents agreed that acupuncture research is very important, only 40% of them answered that the results of acupuncture research are useful to their own practice. In more than half of those who responded to the survey, the current acupuncture research is not viewed as reflecting clinical practice very much. Respondents agreed that acupuncture research should be based on clinical practice, and they recognized the need to collect valid clinical data from real-world practice. Also, as many as 77% of clinicians had no scruple to participate in research programs. Conclusions : There is no doubt among practitioners that acupuncture research is necessary. More importantly, practice-based research remains essential in order to feed-back research outcomes to clinical practice. Communications and academic exchanges between clinicians and researchers can mutually benefit research and practice with better information, resulting in symbiosis.
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