• Journal of Acupuncture Research
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• v.31 no.1
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• pp.75-93
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• 2014

Objectives : This study was designed to establish medical trust realization system by finding factors influential to it using questionnaire. Methods : 277 subjects were participated in this study. After a treatment, we conducted a survey from April 1st to October 31th about medical service perception index, medical trust index, patient satisfaction index, patient reliability index, patient flow degree index, recall intension index, and hospital image index. To evaluate the influence of medical service perception with other 6 indexes, we statistically made regression analysis of the results through the survey. Results : By the results of the analysis, evaluation of hospital image influenced all 6 indexes. The systemicity of treatment process had an effect on 5 indexes except for the flow degree of patients. The humanity of medical team brought out the estimation of 4 indexes except for the patient flow degree and hospital image. The empathic ability of doctor and appropriacy of medical costs hold the next rank influencing 3 indexes. It reached the conclusion that the systemicity of medical team tend to determine the medical trust and patient reliability. The expertise, professional skill of doctor, the fault, commercial application, fame of medical team, the speed of treatment process, the newest and clean medical facility affected each one index. Conclusions : Korean medicine should find a way to consider the mind of patients for improving the medical quality through trust realization system, keeping up with times. As a result of this research, we can find out important causes which influence the trustful medical system. From now on, we should apply this result to actual treatment of psychology customized system. Also, more simple and clear questionnaire was organized through this research, it can be used to forward research to apprehend patient mentality more conveniently.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.729-734
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• 2015

Background Insufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria. Methods Patients (250) were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma), underlying issue (functional/symptomatic vs. cosmetic) and revision surgery details were also collected with the added use of a real-time, hospital database. Results Telephone contacting was achieved for 211 patients (214 scar revisions). Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016) and by females vs. males (85.52% vs. 75.36%, P<0.05), particularly in the elective group where males (36.17%) were more likely to report no change or worse outcomes versus females (16.04%) (P<0.01). Conclusions Successful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.415-423
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• 2017

Patient's trust in their physician is crucial for relationship between patients and their doctors, treatment outcomes such as satisfaction and adherence or revisits. The purpose of this study is to investigate the meaning of trusting the doctor in the doctor - patient relationship and to examine it through the multidimensional measurement tools. Using the convenience sampling method, 328 respondents in their 20s or older who had visited the hospital within 6 months were used as the analysis data. As a result of the research, it is difficult to define the meaning of the patient's trust in the doctor, but it can be summarized as having at least four meanings. First, the doctor should listen carefully to the patient's story and show communication behaviors expressing interest and forming an atmosphere of dialogue. Second, the patient's health should be considered first to understand the patient and empathize with the patient. Third, it should be honest in the examination and procedures related to the treatment as well as the technical ability. Finally, we should try to cooperate with patients.

• Health Policy and Management
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• v.22 no.2
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• pp.183-206
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• 2012

Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.

• Quality Improvement in Health Care
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• v.28 no.1
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• pp.34-44
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• 2022

Purpose:We investigated physicians' responses to a series of clinical vignettes consisting of patient safety incidents, with and without disclosure of patient safety incidents (DPSI). Methods: An anonymous survey was conducted to investigate physicians' responses to the DPSI via online communities of physicians, and additional participants were recruited using a snowballing sampling method. We evaluated physicians' responses to the DPSI using eight hypothetical scenarios (HS) from the following perspectives: thoughts regarding medical errors, revisiting the physician, recommendation, lawsuit, criminal prosecution, trust score, and compensation amounts. We used the chi-square test to evaluate the overall differences in response rates among the scenarios. Statistical analyses were performed using the Student's t-test to compare the trust scores and compensation amounts. Results: A total of 910 physicians participated in this survey. An overall comparison of trust scores among HS showed that HS 1 (unclear medical errors, minor harm, and DPSI) had the highest trust score. In contrast, in the opposite scenario, HS 8 (clear medical errors, major harm, and DPSI not conducted) received the lowest scores. Cases with minor harm to patients (HS 1, 2, 5, and 6) showed lower compensation amounts than the others (HS 3, 4, 7, and 8). Physicians were more likely to think of situations with DPSI as not having medical errors (53.1% vs. 55.2%). In addition, the scenarios with DPSI were evaluated favorably in terms of intention to revisit, recommend, suit, and engage in criminal proceedings. Physicians showed higher trust scores (6.2 vs 5.4) and gave lower compensation amounts ($27.7 million vs $28.1 million), although there was no significant difference in terms of compensation amounts to the physician conducting DPSI. Conclusion: Our study showed overall positive perceptions regarding DPSI among Korean physicians.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.153-159
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• 2020

Background Perforator artery flaps based on the branches of intercostal arteries and lateral thoracic artery can be used for reconstruction after breast-conserving surgery (BCS). Although described more than a decade ago, these have not been adopted widely in clinical practice. We report on short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps from a prospective multicenter audit. Methods All patients operated for BCS and partial breast reconstruction using intercostal artery perforator or lateral thoracic artery perforator flaps from January 2015 to October 2018 were included in the analysis. Oncoplastic breast surgeons with appropriate level of training performed all tumor excisions and reconstructions as a single-stage procedure. Patient characteristics, treatment details and surgical outcomes were noted. Specific outcomes recorded were margin re-excision and complication rates. Results One hundred and twelve patients underwent the procedure in the given study period. The median age was 54 years. Median specimen weight was 62.5 g and median volume of excision was 121.4 mL. Fifteen patients (13.39%) underwent a margin re-excision for close or positive margins without additional morbidity. One patient required a completion mastectomy. Eight patients (7.14%) had an early complication. None of the patients required a contralateral symmetrization procedure. The results were comparable across the participating centers. Conclusions Chest wall artery perforator-based flaps are an excellent option for lateral and inferior quadrant partial breast reconstructions. The short and long-term surgical outcomes are comparable across sites and can be performed with minimal morbidity. Patient-reported outcome measures need to be studied.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.128-129
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• 2016

• Health Policy and Management
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• v.23 no.3
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• pp.289-300
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• 2013

Background: Patients' trust in their physicians or hospitals is important to guarantee the effectiveness of care and to encourage revisits. This study aimed to identify the relationship between the experience of requesting verification of healthcare benefit coverage via the Health Insurance Review Agency (HIRA) and patients' trust in their physicians or hospitals. Methods: For this population-based study, 800 adult respondents aged 20 to 65 years were recruited using random sampling and telephone surveys. Respondents were divided into two groups: 1) 400 people had experience in requesting the HIRA verification service for the purpose of confirmation of whether the costs they paid were appropriate among metropolitan habitants, and 2) 400 people comprised members of the public who had no experience requesting the verification service. Results: Experience with requesting verification services was likely to lower the patients' trust in medical institutions, but not in their physicians (p<0.05). In addition, patients who were satisfied with their physicians and hospitals were more likely to trust the physicians and hospitals than dissatisfied patients. Conclusion: Patients' trust might be an important factor influencing hospital success. Patients' trust in medical suppliers, such as physicians and hospitals, encourages a positive relationship between medical suppliers and patients. Therefore, medical suppliers must provide appropriate care to patients to improve patients' trust in them.

• Korea Journal of Hospital Management
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• v.16 no.1
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• pp.27-49
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• 2011

This study tried to examine the antecedents of antecedents of trust and customer response at the healthcare service. A total of 230 patient' data were used with a structural equation analysis. They were verified by covariance modeling, using SPSS 18.0 and AMOS 5.0program. Trust is significantly affected by the three factors. Doctors' professionalism and effort of relationship continuity have a positive impact on trust simultaneously. Also, brand reputation have a positive impact on trust simultaneously. But, Trust is not significantly affected by tangibles. And, Trust has a not positive impact on the word of mouth(WOM). Satisfaction has a positive impact on the repurchase and WOM. Repurchase has a positive impact on the WOM.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.1
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• pp.68-77
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• 2018

Purpose: The aim of this study was to establish a hypothetical model on silence regarding patient safety and to verify the model's goodness of fit and hypotheses. Methods: The participants in this study were 330 registered nurses working in tertiary hospitals with over 300 beds. Data were collected between July 1, and August 30, 2017, from nurses who agreed to participate. A covariance structure analysis was performed. Results: The model of fit index was $x^2=59.54$, normed $x^2=2.29$, GFI=.97, AGFI=.93, SRMR=.05, NFI=.99, CFI=.95 and RMSEA=.05. The organizational culture had an influence on patient safety motivation (${\beta}=.26$, p=.003) and attitude (${\beta}=.43$, p<.001). RN-MD collaboration had an influence on patient safety motivation (${\beta}=.33$, p<.001), attitude (${\beta}=.35$, p<.001), and patient safety silence (${\beta}=-.17$, p=.026). Supervisory trust had an influence on patient safety motivation (${\beta}=.26$, p<.001), attitude (${\beta}=.12$, p=.036), and patient safety silence (${\beta}=-.23$, p=.002). Patient safety motivation had an influence on patient safety silence (${\beta}=-.33$, p=.006). The model of patient safety silence explained 36.0% of the variances. Conclusion: This study is meaningful in that it provides basic data for nursing education and program development for rejecting patient safety silence.