• Korean Medical Education Review
• /
• v.24 no.3
• /
• pp.240-249
• /
• 2022

This study explored the public's response to an incident involving publicity about how physicians broke bad news to a terminal cancer patient by analyzing 1,960 comments from three online news websites that reported on this event using Braun and Clarke's theme analysis methods. Three themes and 10 subthemes emerged from the public's responses to the way the physicians broke the bad news. Theme 1 (a physician is a person who tells the facts) contained the following subthemes: physicians are responsible for delivering facts, but it is a matter of consideration for patients to deliver bad news to them, empathy and consolation should be expected from people other than physicians, and physicians who say what patients want to hear are cheaters. Theme 2 (there is a problem with physicians) included the following subthemes: the physicians' empathy or personality and problems with their communication methods. Theme 3 (there are obstacles to communication with dying patients) had the following subthemes: physicians become emotionally dull and find it very stressful to break bad news, giving hope to dying patients can lead to medical disputes, and empathy and consolation are also costly. When breaking bad news, the physicians delivered factual information, but they did so inappropriately, and emotional support for the patient was insufficient. In medical communication education, it is necessary to emphasize training in emotional support. In the medical field, an environment should be created where physicians can communicate as they have learned.

• Journal of Chest Surgery
• /
• v.56 no.1
• /
• pp.6-13
• /
• 2023

Background: Coronavirus disease 2019 (COVID-19) has been found to cause life-threatening respiratory failure, which can progress to irreversible lung damage. Lung transplantation can be a life-saving treatment in patients with terminal lung disease (e.g., acute respiratory distress syndrome caused by infection). This study aimed to present the clinical course and results after initial lung transplantation in patients with severe COVID-19 who did not recover even with optimal medical care. Methods: From August 2019 to February 2022, this study enrolled 10 patients with COVID-19 (5 men; median age, 55.7 years) who underwent lung transplantation at a single center in Korea. All patients' characteristics, clinical pathway, overall survival, complications, and operative data were collected and analyzed. Results: Veno-venous extracorporeal membrane oxygenation or an oxygenator in a right ventricular assist device circuit was applied to 90% of the patients, and the median length of extracorporeal life support before operation was 48.5 days. There were no cases of mortality after a median follow-up of 372.8 days (interquartile range, 262.25-489 days). The major complications included the requirement for postoperative extracorporeal membrane oxygenation support in 2 cases (20%), re-transplantation in 1 case (10%), and re-exploration due to bleeding in 2 cases (20%). During the follow-up period, 3 out of 10 patients died. Conclusion: Excellent early outcomes were observed for patients who underwent lung transplantation. Thus, lung transplantation can be an effective and feasible treatment for patients with end-stage lung disease caused by COVID-19.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.3
• /
• pp.48-61
• /
• 2023

Purpose : This study aimed to identify and describe the leadership experience of advanced practice nurses (APN). Methods : Data were collected through five focus group interviews in 2022 with a total of 24 APNs in groups of 4-6 participants. All interviews were recorded, transcribed, and data were analyzed using qualitative content analysis. Results : Nine categories emerged from three main themes. First, "Roles of APN leadership" comprised a trusted clinical expert, a moderator for the entire team, a resource person for nurturing the next generation, and a change agent for improving clinical practice. Second, "Facilitators and barriers to APN leadership" included ambiguity of APN role, support system, and institutional backing. Third, "Strategies for strengthening APN leadership competencies" comprised systematic leadership education and speaking up for APNs. Conclusion : APNs are passionate about their expertise and practice, but lack the legal and organizational authority and support to provide successive leadership. Systematic education including leadership and organizational advocacy will enable APN to provide leadership that benefits patients, institutions, and the wider healthcare system.

• The Journal of Korean Medical History
• /
• v.36 no.2
• /
• pp.49-59
• /
• 2023

This paper describes the transformation of the knowledge system of Korean medicine in the early 20th-century colonial context of the 1920s in terms of 'identity formation'. At the time, newly introduced Western medicine was the dominant form of medical knowledge due to strong support from the colonial government but had did not enjoy popular support from the general public especially when compared to Korean medicine. Furthermore, the Japanese colonial government needed to utilize Korean medicine practitioners' labor due to a serious shortage of Western medicine doctors. In this context, Dongseo uihak youi (Essentials of Eastern and Western Medicines) provides an overview of the role of Korean medicine practitioners in the colonial healthcare system of the time. The book contains a figure of a 'modern' Korean medicine practitioner working within a healthcare system influenced by colonial modernity. The association of Korean medicine doctors at that time not only published Dongseo uihak youi but also attempted to establish a school specializing in both Eastern and Western medicines or integrated Korean medicine, which would produce "the Chosŏn doctors" (Chosŏn ŭisa) on a par with doctors trained in Western medicine. Although their attempts did not materialized, they provide a clue as to how and in what direction Korean medicine pursued its identity in the 1920s.

• Korean Journal of Health Education and Promotion
• /
• v.23 no.3
• /
• pp.99-119
• /
• 2006

Objectives: This study intends to understand the difference within group of social support level and the effect of social support to health behaviors and health status of the elderly by selecting the old of local society as target. Methods: Data were obtained from self-administered questionnaire of 8,688 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, social support(family support, other support, quality of support), physical health state(subjective health status, number of chronic disease), physical function state(activities of daily living; ADL, instrumental activities of daily living; IADL), cognition state(mini-mental state examination-Korean; MMSE-K) and depression state(short form of geriatric depression scale; SGDS), health behaviors(smoking, drinking, exercise, eating habit). Univariate, multinominal logistic regression and covariance structure analysis were employed to analyze factors affecting on the social support of the elderly. Results: When considering the degree of social support by the sociodemographic characteristics of the older adults, the family support, other support and quality of support is better when the old is male, young, high education and self-reported living status is good and it has significance statistically. When considering the relation between social support and health status, the family support, other support and quality of support is better when the old's subjective and objective physical health status is good. The family support, other support and quality of support is better when the old's subjective health status is better. The other support and quality of support is better when the old's ADL(activities of daily living) and IADL(instrumental activities of daily living) are good. The family support, other support and quality of support is better when the old's cognitive function and depression state is better. When considering the relation between social support and health behaviors, in case of smoking and drinking, the quality of support, family support and other support is better when the old smokes and drinks rather than the old does not. In case of exercise and eating habit, the family support, other support and quality of support is better when the old exercises and eats regularly rather than the old does not. It has significance statistically. From the result of performing covariance structure analysis by structural equation modeling(SEM) with two endogenous variable(health behaviors and health status) and one exogenous variable(social support), factor loading of health status is 0.74 and factor loading of health behaviors is 0.05. The social support explains health status of 55.4% and health behaviors of 2.9%. Conclusions: This study has the meaning that it finds the difference of social support generating from inside of the group for the old residing in city and country and specifies the effect that the difference of social support influences to health status and health behaviors. From now on, in the development of health improvement strategy of the olds, it is necessary to approach from inclusive aspect while considering psychosocial factor such as social support and social economical factor as well as health status.

• Korean Medical Education Review
• /
• v.14 no.2
• /
• pp.95-101
• /
• 2012

As North Korea passed from the Devotion (Jeongseong) movement to the black market (Jangmadang) system, the medical service system in that country was effectively destroyed. North Korean physicians who have successfully defected to South Korea (North Korean defector physicians, NKDPs) have experienced socio-economic hardships on their way to becoming incorporated into the South Korean medical system due to different medico- social cultures, different (English-based) medical terminology, and the clinical knowledge gap between North and South Korea. Since 2009, we have operated programs at the Seoul Medical Center to help NKDPs prepare for the South Korean medical licensing examination. These programs consist of clinical education at the medical center, personal mentoring, arrangement of educational programs at the medical college, mock tests at the consortium, and administrative aid. Looking forward, we hope to achieve the following: 1) More systematic support plans are needed involving medical education experts, field physicians, and experts on reunification. 2) An evaluation of defector physicians' current medical knowledge may provide information about the areas where supplementary education is most needed and the standards for certificating licenses. 3) In the short term, a customized glossary should be developed to assist defector physicians prepare for the examination. 4) To secure internships and residencies is the most important issue for further sustained training of NKDP physicians to become good clinicians after certification. Hopefully, this short report on the current ongoing educational course will lead to more extensive discussion.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2002.09a
• /
• pp.497-500
• /
• 2002

The objectives of the International Organization for Medical Physics (IOMP) are to organize international cooperation in medical physics, to contribute to the advancement of medical physics in all its aspects, especially in developing countries; and to encourage and advise on the formation of national organizations of medical physics in those countries that lack such organizations. The objectives of the Asian-Oceania Federation of Medical Physics (AFOMP) are to advance medical physics in our geographic region, especially in those countries that do not yet have national organizations of medical physics. We must focus on the development of AFOMP in science, professional relations, education and training in our geographic areas and to seek funding and support from the IOMP for these activities. Since its formation in 2000, the Asian-Oceania Federation of Medical Physics (AFOMP) has been participating actively in IOMP. Our goal now should be to gain more influence by placing members on various committees of IOMP as well as preparing members for leadership roles at the upper levels. AFOMP is already on the world map of medical physics with the upcoming two world congresses - Sydney and Seoul.

• Korean Medical Education Review
• /
• v.25 no.1
• /
• pp.3-16
• /
• 2023

Unlike in the past, standards for the quantity and quality of work expected from medical school faculty are continuously rising, causing changes and stress in various areas. This highlights the need for career development among medical school faculty for professional, personal, organizational, and societal reasons. The role of medical school faculty has become more diverse, leading to an increase in the types and levels of competencies required. Medical schools must support their faculty members with diverse identities in fully utilizing their capabilities to achieve the institution's mission. Furthermore, societal changes suggest that career development for medical school faculty will become even more crucial in the future. To achieve this, both individuals and organizations must make efforts and play appropriate roles. For this purpose, medical schools use a combination of promotion and tenure evaluations and faculty development programs, while individual faculty members follow a career path within the medical school environment. Medical school faculty must be able to meet the evolving demands at each stage of their careers. It is important for professors, who engage in career development, to have a clear sense of their identity and values, and to prioritize their career goals. Medical schools should also ensure that the implicit messages they convey align with the organization's explicit values. Finally, proactively preparing for future changes in society and generations is essential from a long-term perspective.

• Clinical and Experimental Pediatrics
• /
• v.52 no.8
• /
• pp.851-855
• /
• 2009

Death is not only a medical problem; it is also an ethical problem. When doctors face a dying neonate, their knowledge of bioethics and the opinions of ethical specialists and religious leaders are helpful for them and the family of the dying baby. In recent years, due to the increase of surviving babies who have suffered from severe illness, those born too small or too early, and those with severe anomalies in neonatal intensive care unit (NICU), we have met with complicated bioethical problems frequently. To lessen the burdens of doctors and the parents of the dying baby, I reviewed medical, ethical and religious articles about bioethics in adult death. My suggestions are listed as follows: 1) regular bioethical education and activation of bioethical committees in NICU, 2) a well-controlled nationwide database, 3) a hospice unit space and programs for dying baby in NICU, and 4) social support for pregnant women and financial support for the NICU.

• Journal of Korea Society of Digital Industry and Information Management
• /
• v.8 no.1
• /
• pp.221-229
• /
• 2012

A model for expressing meta data syntax in the eXtensible Markup Language(XML) was developed to increase the portability of the Arden Syntax in medical treatment. In this model that is Arden syntax uses two syntax checking mechanisms, first an XML validation process, and second, a syntax check using an XSL style sheet. Two hundred seventy-seven examples of MLMs were transformed into MLMs in ArdenML and validated against the schema and style sheet. Both the original MLMs and reverse-parsed MLMs in ArdenML were checked using a Arden Syntax checker. The textual versions of MLMs were successfully transformed into XML documents using the model, and the reverse-parse yielded the original text version of MLMs.