• Title/Summary/Keyword: Medical practice

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The Attributes and Practical Principle of Medical Professionalism (의학 직업전문성의 특성과 실천 원리)

  • Hwang, Eun Young;Yang, Eunbae B.
    • Korean Medical Education Review
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    • v.12 no.1
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    • pp.9-22
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    • 2010
  • It is the most important thing at present for physicians to posses the qualification of medical professionalism. A lot of medical schools have made all-out efforts to develop leaders of medicine, who will be able to meet the needs of medical professionalism in this complex medical environment. The purpose of this study is to review the cognitive base of medical professionalism leading the curriculum development of medical professionalism. The discussion of medical professionalism started in the 20th century. During the 1960s, there were attempts to reshape the concepts and attributes of medical professionalism. The government began to intervene in the autonomy of physician and the self regulation policy of medical society in 1970s. Physician may be asked to play as a healer and professional (what?) during their medical practice. The fundamental role of healer such as care, compassion, honesty, integrity, confidentiality, ethical behaviors, and respect with patients were nothing fresh to tell even though the age was changed. The attributes of professional which are physician's autonomy, self regulation, teamwork, and responsibility to society has been changed dramatically over the past five decades. In general, medical educators agreed that professionalism is demonstrated through a foundation of clinical competence, communication skills, and ethical and legal understanding, upon which is built application of the principles of professionalism: excellence, accountability, altruism, and humanism. If physicians fail to show professionalism in society, they will confront the crisis which can be under the government control. The only way to keep their autonomy is to practice medical professionalism. So far today, medical schools have laid more stress on competence than value standards in educational systems and it was restricted for medical students to learn the value standards for medical practice. To understand and practice the medical professionalism, it is the most realistic way to solve the complicated medical problems.

Study on Diet-related Quality of Life in Online Self-help Diabetes Mellitus Patients Who Practice Dietary Regimen (식사요법을 실천중인 당뇨병 자조모임 환자의 식사관련 삶의 질에 관한 연구)

  • Lee, Han-Sul;Joo, Jin-Hee;Choue, Ryo-Won
    • Korean Journal of Community Nutrition
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    • v.16 no.1
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    • pp.136-144
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    • 2011
  • Assessment of quality of life (QOL) is a new method to investigate the effectiveness of dietary regimen. Particularly, diet-related QOL is the most appropriate method to estimate social and psychological problems originated from dietary regimen practice. The purpose of this study was to evaluate the diet-related QOL and the correlation between diet-related QOL and health-related QOL, and dietary regimen practice in online diabetes self-help patients who practice the dietary regimen. Sixty one subjects who intended to practice dietary regimen were recruited from online diabetes self-help community, and instructed to fill-up the self report questionnaires. Contents of questionnaire were comprised of general characteristics, clinical characteristics, dietary compliance, and dietary regimen practice. As a result, the mean score of the 'Dietary impact' among the diet-related QOL sub-scales was the lowest suggesting most of the subjects suffer from burden of dietary regimen practice. The "Dietary impact" was correlated with "Taste", "Convenience" and "Cost" (p < 0.05). "Self-care" and "Satisfaction" were positively associated with well-controlled blood glucose and dietary regimen compliance, but negatively associated with "Dietary impact". Diet-related QOL was significantly correlated with the Health-related QOL, particularly the mental and social component (p < 0.05). Diet-related QOL was negatively associated with BMI, and self monitoring blood glucose was negatively correlated with "Self-care" (p < 0.05). In conclusion, Diet-related QOL might be appropriate to evaluate the effects of dietary regimen or nutrition education. The need for dietary education of cognitive-behavioral strategies and problem-solving ability is required.

Medico Legal Aspects of Clinical Practice Guideline (표준 치료 지침서(Clinical Practice Guideline)의 의료법학적 의의)

  • Bae, Hyun-A
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.181-207
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    • 2008
  • With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

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Evaluation of the Effect of Clinical Practice Guideline using Systematic Review (체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가)

  • Lee, Sun-Hee;Ha, Gwi-Yeom;Kim, Ju-Hye;Seo, Ju-Hyun;Kim, Hyun-Mi
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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Understanding of National Health Insurance Non-benefit (건강보험 비급여의 이해)

  • Moon, Kitae
    • The Journal of the Korean life insurance medical association
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    • v.33 no.2
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    • pp.15-17
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    • 2014
  • All Korean people are eligible for National Health Insurance(NHI). But large non-coverage of NHI is a big problem. The origin of this problem is from medical fee schedules. NHI calculate all hospital income including insurance medical practice, non-insurance medical practice and non-medical income(i.e. a funeral hall, a parking lot, stores in hospital).

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Poor Knowledge and Practice Towards Breast Cancer among Women in Baghdad City, Iraq

  • Hasan, Tiba Nezar;Shah, Shamsul Azhar;Hassan, Mohd Rohaizat;Safian, Nazarudin;Azhar, Zahir Izuan;Syed Abdul Rahim, Syed Sharizman;Ghazi, Hasanain Faisal
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6669-6672
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    • 2015
  • Background: Breast cancer is one of the most common cancers among females worldwide. The aim of this study was to assess the knowledge and practice about breast cancer and its related factors among women in Baghdad city, Iraq. Materials and Methods: A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO. Results: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively. Conclusions: Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.

Development of Nursing Practice Guideline for External Ventricular Drainage by Adaptation Process (수용개작을 통한 뇌실외배액 간호 실무지침 개발)

  • Jung, Won Kyung;Yi, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.3
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    • pp.294-304
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    • 2016
  • Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)'s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.

A Study on the Regulation of Dental Medical Advertisements -Focusing on the Decisions of the Supreme Court and the Constitutional Court- (치과 의료광고 규제에 관한 소고 - 대법원 판결과 헌법재판소 결정을 중심으로 -)

  • Chang, Yeonhwa;Baek, Kyonghee
    • The Journal of the Korean dental association
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    • v.55 no.1
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    • pp.53-62
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    • 2017
  • As the citizens' life and body are the object of medical practice, it should ultimately protect the citizens' right of health. For this reason, medical practice possesses characteristics of non-profit and public and such special characteristics caused heavy regulations in the medical industry as exemplified by medical advertisements. For advancement of market economy, the government has been moving toward relaxing regulations in the medical industry and this trend can be shown in medical advertisements. Moreover, as a type of commercial advertisements, medical practitioners should be able to express their freedom of expression and freedom to occupation. From the perspective of patients who are medical consumers, they need access to information to locate appropriate medical practitioners and institutions for their symptoms. Therefore, medical advertisements can help realize the patients' right to know. This study will first analyze the general theories behind the necessity of medical advertisements and details of regulations, then analyze the issues from the cases of the supreme court and the constitutional court that are related to dental medical advertisements.

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Evaluation of Development and Necessity of Therapeutic Diet Manual Practice (진료를 위한 식이처방 지침서의 개발과 필요성 평가)

  • 조여원
    • Journal of Nutrition and Health
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    • v.28 no.2
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    • pp.162-169
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    • 1995
  • This study was conducted to evaluate the necessity and development of a therapeutic diet manual which contains basic nutritional science concepts that refer to nutritional management of patients in clinical settings. One hundred and fifty-four medical doctors, forty dietitians, and sixty-three students majoring in nutrition participated. The survey included questions about nutritional knowledge, nutrition-related concerns, and nutrition counseling in medical practice. The knowledge score of medical doctors was 47.7%. Lower percentages occurred in the amount of sodium allowed in the sodium restricted diet and the food sources of vitamin B1 were 16.9%, 31.2% respectively. Seventy-four percent of doctors strongly urged nutrition counseling for patients. Seventy one percent of doctors agreed that the present medical-nutrition education was inadequate in medical school curricura. Most doctors (79.2%) agreed that a therapeutic diet manual would be helpful and necessary. The average percentage of nutritional knowledge test scores for dietitians and students majoring in nutrition were 76.0% and 68.3%, respectively. Over ninety percent of dietitians working and their prescriptions. The result of this study strongly suggests that the development of a comprehensive therapeutic diet manual is necessary, especially for medical doctors.

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Radiological Operating Technicians's Protective Behaviors on Radio-medical Measures in Hospitals (의료기관 방사선종사자들의 방사선안전관리에 대한 행위)

  • Han, Eun-Ok;Moon, In-Ok
    • The Journal of Korean Society for School & Community Health Education
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    • v.8 no.1
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    • pp.69-77
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    • 2007
  • Background & Objectives: International radiation protection committee recognized the importance of radiation protection from medical practices because the exposure to the radiation in medical practice is higher than any other exposure. The factors on knowledge, attitude and practice of radiation safety of the medical workers engaged in radiation were analyzed in order to improve radiation safety technology. Method: Questionnaires were used for 1200 radiation workers in medical institution from July 23 through September 4 and collected for analysis. Results: Different level of safety measures were practiced by age, marital status, career, and medical facility. The difference was statistically significant. Higher levels of safety measures were practiced in the age group of 50s and married persons. The workers who have more than 20 years experience have higher level of safety measures. The workers of health centers have higher level of safety measures to compare with other workers. The factors which give more concerns on safety practice were self efficacy, practice and knowledge in order. Conclusion: Safety conscious operators should get additional education program to maintain higher level of safety. The operators who do not have much safety concern should be intensive training program for self efficacy and safety.

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