• The Journal of Korean Medicine
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• v.42 no.3
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• pp.86-98
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• 2021

Objectives: This study aims to evaluate the impact of patient-physician communication curriculum on students of Korean medical school in terms of cognitive, affective, and psychomotor level of communication skills. Methods: A communication curriculum was developed considering COVID-19 pandemic situation. Lectures, peer role-play, open interview with standardized patient (SP), discussion and feedback were conducted by online, and face-to-face 1:1 SP-interview was performed. Scores of written test, peer role-play of medical communication, SP-interview, self-evaluation on one's interview with real patients in clinical clerkship, and questionnaire of importance were collected and analyzed. Results: Converted to 100 point scale, the mean score of written test (cognitive level) was 91.2 while that of importance questionnaire (affective level) was 77.5. The mean scores of psychomotor level were 72.5, 77.5, and 62.5 for peer role-play, SP-interview, and real patient interview in clerkship, respectively. Conclusions: Students' performance is lower in higher level of competence. Curriculums should provide more opportunities of practices to students, and include evaluation focusing on performance skills.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.319-382
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• 2008

As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.3-46
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• 2017

Physician's Duty of Information is classified into three categories by legal function: 'Duty of Information to Report' to fulfill the patient's right to know; 'Duty of Information to Guide' patient's convalescing and staying healthy; 'Duty of Information to Contribute' to patient's self-determination. We classify the physician's duty of information because the legal effect from the breach of duty varies accordingly. The legal effect is focused on damage compensation responsibility for breach of duty. When a physician violates 'Duty of Information to Report', he subjects himself to liability of compensation for infringing on the patient's 'Right to Know'. When a physician violates 'Duty of Information to Guide', she subjects herself to liability for general medical malpractice. Finally, when a physician violates 'Duty of Information to Contribute', the physician is basically liable for violation of the patient's 'Right to Self- Determination' which refers to infringement on freedom of choice. However, in the case of situation that patient's refusal to the medical treatment would be presumed, the physician bears all liability for the patient's damage which includes both of property and mental damage.

• Annual Conference of KIPS
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• 2017.04a
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• pp.728-730
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• 2017

The proposed application design for emergency medical system includes the functions that help securing the window of opportunity for the patients in an emergency situation and efficiently link rescue agency, emergency medical treatment center and patients together. First, the treatment time can be saved at the emergency room by understanding the patient's condition by entering his/her health information such as anamnesis, family history, social history and blood type together with an identification number. Also, if the siren function which signals whereabouts of patients to the rescue crew is used, it will be much easier to find the location of the patient in need. The design allows rescue crew to call the patient to check whether he/she is conscious or not. Just by receiving the call, he/she will be deemed conscious.

• International Journal of Computer Science & Network Security
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• v.21 no.2
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• pp.171-180
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• 2021

Currently, hospitals and medical practices have a large amount of unstructured information, gathered in time at each ward or practice by physicians in a wide range of medical branches. The data requires processing in order to be able to extract relevant information, which can be used to improve the medical system. It is useful for a physician to have access to a patient's entire medical history when he or she is in an emergency situation, as relevant information can be found about the patient's problems such as: allergies to various medications, personal history, or hereditary collateral conditions etc. If the information exists in a structured form, the detection of diseases based on specific symptoms is much easier, faster and with a higher degree of accuracy. Thus, physicians may investigate certain pathological profiles and conduct cohort clinical trials, including comparing the profile of a particular patient with other similar profiles that already have a confirmed diagnosis. Involving information technology in this field will change so the time which the physicians should spend in front of the computer into a much more beneficial one, providing them with the possibility for more interaction with the patient while listening to the patient's needs. The expert system, described in the paper, is an application for medical diagnostic of the most frequently met conditions, based on logical programming and on the theory of probabilities. The system rationale is a search item in the field basic knowledge on the condition. The web application described in the paper is implemented for the ward of pathological anatomy of a hospital in Romania. It aims to ease the healthcare staff's work, to create a connection of communication at one click between the necessary wards and to reduce the time lost with bureaucratic proceedings. The software (made in PHP programming language, by writing directly in the source code) is developed in order to ease the healthcare staff's activity, being created in a simpler and as elegant way as possible.

• Journal of Korean Academy of Nursing
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• v.24 no.2
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• pp.190-205
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• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• Journal of Korean Foot and Ankle Society
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• v.18 no.1
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• pp.8-13
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• 2014

Amputation of diabetic foot ulcer and infection is a critical modality for saving a patient's life from life threatening infections or ischemic limbs. However, it can cause serious handicaps or complications, such as lifetime shortening and re-amputation of the other limb. The minimal amputation is the main goal of amputation in diabetic patients. However, insufficient amputation can have a harmful effect on patients. The decision of amputation is very difficult and should be made using multidisciplinary approaches. All aspects of the patient's situation, including vascular status, degree of infection, and medical conditions should be considered. The foot surgeon should keep in mind the notion that proper amputation can lead to a new life for diabetic foot patients.

• Journal of Information Processing Systems
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• v.13 no.6
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• pp.1602-1612
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• 2017

Since rapidly disseminating of Internet of Things (IoT) as the new communication paradigm, a number of studies for various applications is being carried out. Especially, interest in the smart medical system is rising. In the smart medical system, a number of medical devices are distributed in popular area such as station and medical center, and this high density of medical device distribution can cause serious performance degradation of communication, referred to as the coexistence problem. When coexistence problem occurs in smart medical system, reliable transmitting of patient's biological information may not be guaranteed and patient's life can be jeopardized. Therefore, coexistence problem in smart medical system should be resolved. In this paper, we propose a distributed coexistence mitigation scheme for IoT-based smart medical system which can dynamically avoid interference in coexistence situation and can guarantee reliable communication. To evaluate the performance of the proposed scheme, we perform extensive simulations by comparing with IEEE 802.15.4 MAC protocol which is a traditional low-power communication technology.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.597-615
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• 1994

This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.4
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• pp.171-174
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• 2017

While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.