• Title/Summary/Keyword: Medical conflict

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Analysis and de lege ferenda of the Acts Related with Spread of MERS in Korea in the Year 2015 - Focused on the Controversial Clauses of Medical Service Act and Infectious Disease Control and Prevention Act - (중동호흡기증후군 2015년 사태와 관련된 의료법령의 분석과 입법론 - 「의료법」 및 「감염병의 예방 및 관리에 관한 법률」의 쟁점 조항을 중심으로 -)

  • Kim, Cheonsoo
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.197-225
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    • 2015
  • The presentation of this paper was triggered by the spread of MERS in Korea in the year 2015. The analysis of the present acts related with MERS is necessary in order to cope efficiently with any probable spread of such infectious diseases as MERS in future. The acts that should be analyzed in this paper include 'Medical Service Act' and 'Infectious Disease Control And Prevention Act' (hereafter, IDCAPA). At first the classification of the infectious diseases in IDCAPA should be referred to. The Act does not properly classify them because the scope of concept of each group of the infectious diseases overlaps each other. This overlap should be removed. The present system in IDCAPA is not proper for the efficient notification and reporting of the infectious disease patients. This is so in some viewpoints including the persons obligated to make the notification and reporting, the persons to whom they should notify and report such patients, and the process of notification and reporting. The efficient approach to the information related with the infectious disease is necessary for the rapid prevention of its spread. Cohort isolation and quarantine of the infectious patients and exposed contacts are the strongest and most efficient steps for the prevention of spread of the infectious diseases. One of the great problems related with such steps would be the conflict of powers or attributions, the likelihood of which is inevitable under the present system of IDCAPA. The IDCAPA distributed the power or attribution to take the steps to the three governments including the central government, the metropolitan government and the primary local government. The power should be concentrated in the central government, which could afford financially to compensate for the huge amount of damages caused likely by the steps. The power to take the steps would be actually just a useless thing for its holder without such financial capacity. The remedy for the victims by the fault of spreader should be approached to in the sense of national wealth. The general principle of tort law could not supply the victims with the sufficient remedy because the damages would be likely too huge for the wealth of such spreader to cope with. In future another parliamentary inspection could reveal another problems in the administration by the government of the MERS event in the year 2015. Any problem caused by defect in the legal system of the control and prevention of the infectious diseases should be taken into consideration when the legal system would be reformed in future.

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A Comparison of Sensory Processing Ability Depending on the Smartphone Usage of Toddlers in the "Smartphone Addiction" Risk Group (스마트폰 중독 위험군 유아의 스마트폰 사용시간에 따른 감각처리능력의 비교)

  • Kim, Yun-Kyeong;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.18 no.1
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    • pp.34-43
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    • 2020
  • Objective : The purpose of this study was to investigate the difference between smartphone addiction and sensory processing ability depending on the time of smartphone usage by at risk of smartphone addiction. Methods : Participants of this study were 124 toddlers in a The data collection period was from September 2019 to December 2019. Measurements in this study included a questionnaire on general information about the subject, a smartphone addiction scale, and a short sensory profile. Methods for the data analysis included descriptive statistics and an independent t-test using SPSS 22.0. Results : There were significant differences between groups depending on smartphone usage time in terms of total smartphone addiction, salience, impulse-compulsive use, withdrawal, tolerance, and interpersonal conflict among toddlers. There were also significant difference in sensory processing ability between groups according to the total Short Sensory Profile score (and in all sub-domains; p=.000 ~ .042). Conclusion : This study found that there was a difference in smartphone addiction and sensory processing ability depending on the smartphone usage time of toddlers at risk of smartphone. It is meaningful because it raises the need for education on the use of smartphones by toddlers.

Determinants Influencing Labor Union Commitment of General Hospital Employees' by the Characteristics of Unions (종합병원 직원의 노동조합성격에 따른 노조몰입 결정요인)

  • Kim, Wook-Soo;Ha, Ho Wook;Sohn, Tae Yong
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.56-83
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    • 2008
  • The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of general hospital organization management. The subject of this study were 686 employees in 12 General Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from March 20 to May 10, 2005 through survey questionnaires. The main results of this study were as follows: 1. the commitment level of the subjects according to their characteristics was higher in older employees than the younger ones, large family to support than small family to support and those who had higher positions in labor union. 2. The commitment level of the subjects according to the job and role related variables were higher those who had higher satisfaction level to their job and manager, role conflict in all hospitals. 3. The commitment level of the subjects according to union related variables, variables jointly controlled by union and employer was satistically significant positive correlation. In other words, the commitment level of the subjects according to the subjects' labor union involvement was higher in those who had higher satisfaction in labor union and perceived their colleagues' attitudes more positively in all hospitals. Regarding the atmosphere of the relationship between union and employer and the level of commitment in labor union, the better the atmosphere of the relationship between union and employer was, the higher the level of commitment in labor union was in all hospitals. 4. The results of multiple regression analysis shows that formal and informal socialization, union participation to the union management cooperation program, job satisfaction, satisfaction with the labor union's were all found as important antecedents of labor union commitment. 5. Job and role-related variables, union-related variables, variables jointly controlled by union and employer, and labor union commitment level were all found significantly different in accordance with the characteristics of unions concerned. To summarize study results, the level of commitment in labor union depends on job satisfaction, manager's attitudes, satisfaction to their jobs, union satisfaction, their colleagues attitudes toward union and the atmosphere of employer-employee relationship. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as formal and informal socialization, union participation to the union-management cooperation program is important determinant in union commitment, hospital managers should have countermeasures to enhance the colleague attitude and job satisfaction level of hospital employees. Since this study deals with psychological nature of workers not a few drawbacks and shortcomings may be detected in the finding. Nevertheless, the finding of this study, to become a momentum that will stimulate further research to detect all the cues of labor union commitment and to provide valuable reference in forming logical union commitment and labor union-management cooperation.

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Development of Good Manufacturing facility for Radiopharmaceuticals (우수방사성의약품 생산시설 개발)

  • Shin, Byung-Chul;Choung, Won-Myung;Park, San-Hyun;Lee, Kyu-Il;Park, Kyung-Bae;Park, Jin-Ho
    • Journal of Pharmaceutical Investigation
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    • v.33 no.2
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    • pp.145-149
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    • 2003
  • Manufacturing facilities of the pharmaceuticals must meet certain level of the cleanness required so that foreign substances such as dust, moisture, heat, microorganism, or virus do not contaminate the product. In case of radiopharmaceuticals for medical treatment and diagnosis, not only should the operators and environment be protected from radiation but also need to be isolated from the foreign contaminant. Therefore, manufacturing facilities for radiopharmaceuticals must satisfy the design standards of both hot cell and clean room which are specified by GMP. However, standards of maintaining negative pressure for preventing spread of radioactive contaminant in isolated facilities conflict with the standards of maintaining positive pressure for keeping cleanness. To solve this problem, air pressure of hot cell was designed lower than in the adjacent area to meet standards of the radiation safety. To keep higher cleanness in certain part of the hot cell for filling, minimal relative positive pressure allows. In order to effectively maintain the cleanness that is required for production of Tc-99m generator, which takes 70% of whole demand of radiopharmaceuticals, the rooms placed in each side of production room are used as a buffer area and three lead hot cells are installed in production room. In this research, we established the appropriate engineered design concept for Tc-99m generator manufacturing facility, which satisfies both GMP cleanness standard for preventing particles, bacteria, other contaminants and the regulations of radiation safety for supervising and controlling the amount of radiation exposure and exhausted radioactivity. And the concept of multi-barrier buffer zones is introduced to apply negative air pressure for hot cell with first priority and to continue relative positive air pressure for clean room.

A Study on the development of leadership training program for first-line nurse managers (일선 간호관리자를 위한 리더십 훈련 프로그램 개발)

  • Koh, Myung-Suk;Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.333-345
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    • 2000
  • The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

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An Analysis of Nursing Decision Tasks, Characteristics, and Problems with Decision Making (환자 간호에 대한 간호사의 의사결정 내용과 특성 및 의사결정 장애요인에 관한 분석)

  • 최희정
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.880-891
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    • 1999
  • The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

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A Study on the Sensitivity of Conversion Factor According to Change of Base Year (기준연도 조정에 따른 환산지수 민감도 분석 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.4
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    • pp.201-209
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    • 2020
  • In this study, issues related to changes in base year, which have controversial effects on fees in service contracts, were reviewed. In this regard, sensitivity analysis was conducted on the effects of changes in base year on conversion factor by type. The benefits and disadvantages of each specific type of medical institution were examined. Main conclusions are as follows. First, changing the base year to be closer to the present time had a beneficial effect on the conversion factor of hospitals. Second, changing the base year to be closer to the current point of time had an adverse effect on the conversion factor of pharmacies and clinics and had a significant adverse effect on clinics. Third, assuming that a single conversion factor is collectively applied to all types, a favorable effect occurred in all cases when the base year was changed to be closer to the present time. Base year changes can bring about conflicts of interest between insurer and providers, and within providers. Therefore, changing the base year should be pursued upon mutual agreement on a reasonable basis for resource allocation. In addition, it is necessary to provide incentives for temporary compensation for the types of losses incurred.

Determination of Appropriate Sampling Time for Job Stress Assessment: the Salivary Chromogranin A and Cortisol in Adult Females

  • Hong, Ran-Hi;Yang, Yun-Jung;Kim, Sang-Yon;Lee, Won-Young;Hong, Yeon-Pyo
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.4
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    • pp.231-236
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    • 2009
  • Objectives : This study was conducted to determine the appropriate sampling time of the salivary stress markers, chromogranin A (CgA) and cortisol as objective indices of job stress assessment in adult females. Methods : The subjects were 20${\sim}$39-year-old women (13 office workers, 11 sales-service workers, and 11 college students) who were eligible for the study and free of acute and chronic medical conditions. Salivary CgA and cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA). Saliva samples were collected (2 $m{\ell}$ each) at 7:00, 8:00, 10:30, 12:00, 17:30, and 22:30 on a typical day. Salivary CgA and cortisol levels, according to sampling time, were compared among the three groups using general linear model. The full version of the Korean Occupational Stress Scale (KOSS), which includes socioeconomic characteristics, health behavior, workrelated characteristics, and BMI, was used to access the subjects' job stress. Multiple regression analysis of the job stressors identified by the KOSS was performed on salivary CgA and cortisol levels. Results : The salivary CgA level peaked at 7:00 (time of awakening), then decreased and were maintained at a low level throughout the day, and increased slightly at 17:30. The salivary cortisol level increased steeply within the 1st hour after awakening, followed by a gradual decrease by 12:00, and was then maintained at a low level throughout the day. The salivary cortisol levels of subjects who worked ${\leq}$5 days per week and graduated from the university were significantly lower at 8:00 (p=0.006). The salivary cortisol levels of non-smokers were significantly lower at 7:00 p=0.040) and 8:00 (p=0.003) compared to smokers. There were no significant differences in salivary CgA and cortisol levels at 10:30 and 12:00 in general characteristics. The regression coefficients on salivary CgA level were significant with interpersonal conflict at 17:30 and job insecurity at 22:30. Regression coefficients on salivary cortisol level were significant with organizational system and total job stressors at 17:30. Conclusions : We suggest that the appropriate sampling times for the salivary stress markers, CgA and cortisol, are at 7:00 (time of awakening), 8:00 (1 hour after awakening), 17:30 (early evening), and 22:30 (before sleep).

A Study on a Role of a Nurse for the Community Welfare Center Being Recognized by Nurses for the Community Welfare Center and Social Workers (사회복지관 간호사와 사회복지사가 인식하는 사회복지관 간호사의 역할)

  • Jang, Youn-Kyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.4
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    • pp.495-513
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    • 2004
  • As this study is the descriptive research study that tries to present the basic data aiming to establish a role of nurses for the Community Welfare Center, by surveying the role expectation and the degree of role performance towards nurses for the Community Welfare Center that nurses for the Community Welfare Center and social workers recognize, it carried out the Questionnaire research targeting nurses who are working for the Community Welfare Center located in Seoul and social workers of institutions where nurses are working, and then analyzed the results, and the study results are as follows. Both the group of nurses and the group of social workers were highly recognizing the necessity and the importance of nurses for the Community Welfare Center, and expected that more effective services will be possible to be offered by means of that nurses do work for the Community Welfare Center. However, compared to the degree that social workers recognize a nurses specialty, the nurses thought that their specialty is not acknowledged in the Community Welfare Center, and even in case of duty friction between groups being felt while social workers and nurses are working together, nurses were experiencing further friction of duties. While nurses are well recognizing their roles, they are statistically and significantly recognizing the degree of role performance lower than expected, thus the difference between the role expectation and the role performance could be seen. Also, the group of nurses showed the higher role expectation towards nurses than the group of social workers, and in relation to roles of a counselor, referral resource, an advocator, an educator, a case manager, a and a coordinator, the degree of role expectation by the group of nurses is statistically and significantly higher than the group of social workers, thus it could be seen that there is difference in the expectation degree between both groups, as to a role of nurses for the Community Welfare Center. In particular, as to a role of universally medical services, the expectations between nurses and social workers showed mutual agreement, but in relation to a role of nurses for community in the more expanded sphere, social workers did not show a receptive attitude, thus it was indicating that there exists an element of role conflict. In relation to the role performance of nurses for the Community Welfare Center, nurses were feeling the disorder degree more than social workers, in all items of disorder factors, and there was difference in recognition between nurses and social workers, as to the priority of disorder factors. Because of, through this study, having been found the difference in recognition of role expectation, the degree of role performance, and a disorder factor between nurses and social workers, as to the nurses for the Community Welfare Center, it is required a study with a more diversified method on a role of nurses for the Community Welfare Center.

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The Effects of work and psychosocial stress on job satisfaction, organizational commitment, and leaving intention in general hospital female office workers (종합병원 사무직 여성의 직무 및 사회심리적 스트레스가 직무만족, 조직몰입, 이직의향에 미치는 영향)

  • Lee, Jeong-Hyun;Cho, Woo-Hyun;Chang, Sei-Jin;Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • v.17 no.1
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    • pp.1-22
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    • 2012
  • This study tires to examine affects that job and socio-psychological stresses of female office workers influence job satisfaction, organization commitment, and leaving intentions. A complete data are collected by conducting a survey with 240 female office workers from 9 medical institutions regarded as almost general hospital in Seoul. It is analyzed that the relation between socio-psychological stress and job satisfaction, organization commitment, and leaving intentions by using t-test; analysis of variance; correlation analysis; principal component analysis; linear structural equation modeling; etc. The results of this study are summarized as following. First, as it was comprehended by specific characteristics of subjects that the female office workers' level of job and socio-psychological stress, job satisfaction, organizational commitment, and leaving intention, there were statistically significant distinctions from their age, marital status, presence of children, position in the organization, type of employment, and monthly average income. Second, this study regarded relationship between the female office workers' level of job and socio-psychological stresses, job satisfaction, organizational commitment, and leaving intention. Job and socio-psychological stresses were negatively correlated with job satisfaction and organizational commitment, but the stresses were positive with leaving intention. Third, after evaluating effect that 8 features related to the job stress could influence job stress, the most effective valuables were in order to unfairness in organizational structure, workplace culture, inadequate compensation, and relationship conflict. Fourth, when looking at the overall effects of the job and sociopsychological stresses on job satisfaction, organizational commitment, and leaving intention, work autonomy was the most influencing factor of work stress levels. The level of the job stress seemed to be a prevalent impact on the leaving intention and it showed the most negative relationship that path coefficient from leaving intention to organizational commitment and also from organizational commitment to job satisfaction. Based on these findings, it can be defined that the job and socio-psychological stresses strongly influence job satisfaction, organizational commitment, and leaving intention.

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