• Title/Summary/Keyword: Medical practice

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The Effects of Characteristics of Nurses on Knowledge and Nursing Performance Evaluation of Evidence Based Hemodialysis Nursing Practice in Hemodialysis Unit Nurses (혈액투석실에서 근무하는 간호사의 특성이 근거기반 혈액투석간호지식과 수행정도에 미치는 영향)

  • Lee, Hee Soo;Jung, Eun Sook;Choi, Kyong Ah;Yu, Seung Oh
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.225-237
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    • 2016
  • Purpose: The purpose of this study was to identify the effects of characteristics of nurses on knowledge and nursing performance of evidence based hemodialysis nursing practice among hemodialysis unit nurses. Methods: The participants were 180 nurses working in hemodialysis unit for more than 6 months in 23 private and general hospitals in Seoul and Gyeonggido. Data were collected from March 30th to April 15t in 2016 and were analyzed using stepwise regression analysis, descriptive statistics, t-test and ANOVA. Results: Nurses' knowledge on evidence based hemodialysis nursing practice was $15.87{\pm}4.52$ out of 23 points. Type of hospitals working in and adherence to evidence based hemodialysis guidelines were significant factors to knowledge and these two factors explained 30.0%. Nurses' nursing performance on evidence-based hemodialysis nursing practice was 4.52 out of 5 points. The performace level was significantly related to total nurisng career and necessity of hemodialysis nursing education and these two factors explained 8.0%. Conclusion: A development of guideline and continuing education is necessary for improving knowledge and performance of evidence based hemodialysis nursing practice.

Effect of practice guideline reminder and flow-sheet for improvement of quality in management of hypercholesterolemia (고콜레스테롤혈증 환자 진료의 질 향상을 위한 임상 지침 리마인더(Reminder)와 추적 관리지의 효과)

  • Cho, Han Kyu;Park, Hye Soon;Cho, Hong-Jun
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.230-240
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    • 1997
  • Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

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Practice and Barriers of Mammography among Malaysian Women in the General Population

  • Al-Naggar, Redhwan A.;Bobryshev, Yuri V.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3595-3600
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    • 2012
  • Objective: The objective of this study was to determine the practice and barriers of mammography and associated factors among Malaysian women in the general population. Methodology: A cross-sectional study was conducted among 200 women in Shah Alam, Selangor; Malaysia. The questionnaire contained 27 questions and was comprised of two sections; socio-demographic characteristics and practices, knowledge and barriers of mammography. All the data were analyzed using the Statistical Package for the Social Sciences (SPSS) 13.0. Results: Of the 200 Malaysian women who participated in this study, the majority were under the age of 50 years (65.5%), Malay (86%), and married (94.5%). Regarding any family history of cancer in general, the majority of the participants had none (78%). However, some did report a close relative with breast cancer (16.5%). While the majority of them knew about mammography (68%), 15% had had a mammogram once in their life and only 2% had the procedure every two or three years. Univariate analysis showed that age, family history of cancer, family history of breast cancer, regular supplement intake, regular medical check-up and knowledge about mammogram were significantly associated with mammogram practice among the general population (p=0.007, p=0.043, P=0.015, p=0.01, p=0.001, p<0.001; respectively). Multivariate analysis using multiple linear regression test showed that age, regular medical check-up and knowledge about mammography testing were statistically associated with the practice of mammography among the general population in Malaysia (p=0.035, p=0.015 and p<0.001; respectively). Lack of time, lack of knowledge, not knowing where to go for the test and a fear of the test result were the most important barriers (42.5%, 32%, 21%, 20%; respectively). Conclusion: The practice of mammogram screening is low among Malaysian women.

Opinions and Perceptions on Allowing Nursing Students' Practice among Inpatients at a University Hospital (종합병원 입원 환자의 간호대학생 실습허용에 대한 견해 및 인식)

  • Kim, Youngjin;Kim, Jeesun;Kim, Hyerim;Park, Subi;So, Saetbyul;Jung, Bosung;Choh, Eunae;Lee, Seonyoung;Kim, Jeongeun
    • Perspectives in Nursing Science
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    • v.14 no.1
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    • pp.10-20
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    • 2017
  • Purpose: The aim of this study was to explore the patients' perspectives on nursing students' clinical practices in the wards, and to investigate their willingness for allowing students to practice on them. Methods: This was a descriptive study. 116 inpatients were recruited from the S University Hospital. A 60-item questionnaire was applied to collect the data. The participants were 19 years and older with sound judgement, and were not in special or intensive care units. Data analysis was done in SPSS/WIN 22.0 using descriptive statistics, Fishers exact test, and the ANOVA test. the participant answered to questionnaire from April 29th 2016 to May 10th. Results: 40 participants (34.5%) stated they would allow students' practice, while 72 (61.2%) said they would allow only under staff supervision. 5 participants (4.3%) stated they would not allow whatsoever. The 3 most allowed were emotional support, oral care, and vital signs measurement while the 3 least allowed were gastric feeding, intravenous catheterization, and urinary catheterization. Conclusion: Patients were more inclined to allow students to practice on them when a member of the medical team was present. A fair number of participants said they would be more inclined to allow students' practice if they felt the student was competent; hence, reinforcing simulation sessions is vital in enhancing students' competency and ultimately practice allowance.

A survey of dentists' opinions on the performance of dental hygienists (치과위생사 수행업무에 관한 치과의사의 견해조사)

  • Han, Yang-Keum;Kim, Seung-Hee;Yang, Jin-Young;Yu, Ji-Su;Bae, Soo-Myoung
    • Journal of Korean Academy of Dental Administration
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    • v.7 no.1
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    • pp.1-9
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    • 2019
  • This study examined the opinions of dentists on dental hygienists' practice and attempted to use it as the basis for the revision and modification of the legal system associated with dental hygienists. The subjects of this study were a total 15 dentists, including two from Gyeonggi, two from Gangwon, two from Gyeongsang, two from Jeolla, two from Chungcheong, and two from Seoul, who were surveyed face-to-face. This study revealed that from the perspective of dentists, the most important job of dental hygienists was scaling, and the most difficult job was patient counseling and response. From the perspective of dentists, there is a difference between what the dental hygienists actually perform and what is legal, and there is a high need for change. The inclusion of dental hygienists in the category of medical personnel should be accomplished to cover the practice of dental care support, and dentists opinionated that it is appropriate for dental hygienists to be included in the category of medical personnel because they directly perform oral health-related procedures. A careful review of the dental hygienists' scope of work should be performed to ensure that revisions to the law are made in accordance with the dental hygienists' actual practice. Further, it is necessary to revise the Medical Law and include dental hygienists among the medical personnel and simultaneously revise the scope of work of dental hygienists to reflect the actual dental practice.

Consensus on definition and quality standard of clinical practice guideline using RAND method (RAND 방법으로 합의한 임상진료지침의 정의와 질 평가 기준)

  • Ji, Seon-Mi;Kim, Soo-Young;Sheen, Seung-Soo;Heo, Dae-Seog;Kim, Nam-Soon
    • Health Policy and Management
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    • v.20 no.2
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    • pp.1-16
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    • 2010
  • Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

Review on the Enhancement of Accessability to Rehabilitation Therapy -Especially on the Solo Practice of the Physical Therapists (재활치료에 관한 접근성 제고 방안에 관한 단상 -물리치료사의 단독 개업 중심으로)

  • HAN, Seungsoo
    • Journal of Korean Physical Therapy Science
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    • v.22 no.1
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    • pp.19-27
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    • 2015
  • Purpose : The purpose of this study is to check the current status of accessability to rehabilitation therapy in local areas and to review how to improve the accessability. In fact, first, it is very hard for patients to find out a local medical center with rehabilitation therapy capability. Moreover they needs to wait long time to get a treatment they need, because of lack of nearby rehabilitation centers. The best way to enhance the accessability to the rehabilitation therapy service is to allow therapists to set up rehabilitation centers in local areas on their own, physically independent from medical doctors. Basically, the current law does not prohibit therapists' own sole practice. However, it needs to be amended by inserting an explicit legal basis on the setting-up process. If it is legally permissible for the therapists to set up rehabilitation centers to perform a rehabilitation treatment with referrals from of medical doctors (though physically independent from the doctors), it would result in the increase of profits for the doctors and at the same time raise therapists' freedom of occupation, a constitutional right. Furthermore, with their own places to practice, therapists will have to compete with other therapists, that would raise the quality of their treatments, which will in turn benefit patients ultimately. A proposed bill of amendments to the Act on Medical Technicians and etc. is pending for review at the National Assembly. I look forward to vigorous discussion on the bill based on this article, and resulting in revision of the law for the benefits of patients.

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Study on Systematization of Advanced Practice Nursing in Korea (한국 전문간호사의 분야 체계화 관련 연구)

  • Kim, Min Young;Choi, Su Jung;Jeon, Mi-Kyeong;Kim, Jeong Hye;Kim, Heeyoung;Leem, Cho Sun
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.240-253
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    • 2020
  • Purpose: This study was conducted to provide basic data for the systematization of 13 areas related to Advanced Practice Nurses (APN). Methods: The three-phase study was conducted as follows. 1) review of APN system and curriculum, 2) Focus Group Interviews (FGI) with 9 APNs, 6 physicians, and 3 nursing professors on the APN system, 3) analysis of clinical practice of the 13 APN areas, and of the accreditation and certification system for APNs, medical board, and medical subspecialty board. Based on the above data, a systematic plan was drawn. Results: The 13 APN areas could be divided into 7 groups based on a review of the APN system and curriculum for the 13 areas. Analysis based on clinical practice showed that the 13 APN areas could be divided into 4 groups. Two themes and seven categories emerged in FGI. The two themes were 1) 13 APN areas that need to be discussed, 2) improving the curriculum for APN. Considering these themes from FGI and the system of the medical subspecialty board, results could be integrated into 2 groups - clinical area and non-clinical area. Conclusion: The 13 APN areas need to be integrated in order to activate the APN system. For that, further discussions on improvements and a standard curriculum according to legislation related to APN should be carried out.

An improvement plan of Curriculum in Departments of Dental Technology (치기공과 교육과정의 개선방안)

  • Bae, Bong-Jin;Lee, Hwa-Sik;Park, Myung-Ho
    • Journal of Technologic Dentistry
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    • v.31 no.4
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    • pp.55-66
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    • 2009
  • This research collected the curriculum for Dental Technology from a total of 20 schools --3-year colleges and 4-year colleges-- all in Korea. And we analyzed the average credits of subjects from students. As a result of this analysis, we get the conclusion below: 1. In the arithmetic mean of the major basis subjects which graduates and undergraduates answered about each subjects; Seminar, Dental morphology I II, Dental morphology practice I II, and Dental devices & instruments don't have many credits. And averages of the major application subjects credits which are Implants(especially low), Occlusal anatomy practice I II, Dental ceramics practice I II, and Dental ceramics practice are low, mostly have a converged tendency in high points. 2. In an analysis of the correlation which is based on the major basis subjects: Dental esthetic, oral anatomy I II, Dental materal practice III, Dental casting pracedure, Oral hygiene, Health & medical law, Management administration, and Medical terminology have a meaningful difference. (${\rho}$ < 0.05) 3. In an analysis of the correlation which is based on the major application subjects; Crown and bridge prosthodontics practice IV, Complete denture prosthodontics I II III, Complete denture prosthodontics practice I II III, Dental ceramics I II, Dental ceramics practice I II, Dental ceramics practice IIII, Occlusal anatomy I II, Occlusal anatomy practice I, Operative dentistry laboratory technology I, Operative dentistry laboratory technology practice II, Dental attachment laboratory technology practice, Implants, and Dental laboratory clinical practice have meaningful difference. (${\rho}$ < 0.05) 4. In an analysis of the correlation which is based on the ratio of a theory to an actual training; 40:60(38.57%) is the highest, followed by 30:70(30.04%), 50:50(23.32%), 60:40(5.83%), and 70:30(2.24%). These have meaningful difference. (${\rho}$ < 0.05) 5. In an analysis of the correlation which is based on the distinction of sex: Partial denture prosthodontics practice I II III, Complete denture prosthodontics I II III, Complete denture prosthodontics practice I II III, Occlusal anatomy practice I II, Implants, Medical terminology have meaningful difference. (${\rho}$ < 0.05) For the purpose of training entrepreneurs of middle standing who is required by a future society, Department of Dental Technology's Curriculum need to be managed with planning a curriculum which reflects opinions of graduates, undergraduates and a society, and also are considered not focusing on a supplier but focusing on a user.

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Difference in Outpatient Medical Expenditure and Physician Practice Patterns between Medicaid and Health Insurance Patients (건강보험환자와 의료급여환자 간 의원 외래 의료이용 차이와 공급자 진료행태)

  • Joo, Jung-Mi;Kwon, Soon-Man
    • Health Policy and Management
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    • v.19 no.3
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    • pp.125-141
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    • 2009
  • The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.