• 제목/요약/키워드: Patient-centered outcomes

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의사의 환자중심 커뮤니케이션이 환자만족과 치료성과에 미치는 영향 : 환자참여의 매개효과를 중심으로 (Effect of Doctors' Patient-centered Communication on the Patient Satisfaction and Treatment Outcomes : Focusing on Mediating Effect of Patient Participation)

  • 이종학;김찬중
    • 한국콘텐츠학회논문지
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    • 제13권11호
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    • pp.249-260
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    • 2013
  • 본 연구의 주된 목적은 의사의 환자중심 커뮤니케이션(경청요인, 배려요인, 금지요인)이 환자만족과 치료성과에 미치는 영향, 그리고 의사의 환자중심 커뮤니케이션과 환자만족, 치료성과 간 환자참여(행동적 참여, 감정적 참여, 정보적 참여)의 매개효과 여부를 검증하는데 있다. 이러한 연구목적 달성을 위해 C지역의 종합병원에서 진료를 한 339명의 외래환자를 중심으로 실증분석을 수행하였다. 연구결과 첫째, 경청요인과 배려요인은 환자만족과 치료성과에 유의한 정(+)의 영향을 보였으나 금지요인은 그렇지 않았다. 둘째, 경청요인과 배려요인은 감정적 요인과 정보적 요인에 유의한 정(+)의 관계를 보였으나, 금지요인은 환자참여의 3개 요인에 유의한 영향을 보이지 않았다. 셋째, 의사의 환자중심 커뮤니케이션과 환자만족, 치료성과 간의 관계에서 환자참여의 부분 매개효과가 존재하는 것을 확인하였다. 마지막으로 이러한 연구결과를 중심으로 환자만족과 치료성과를 높이기 위한 방안들을 제시하였다.

환자중심 목표설정이 아급성기 뇌졸중 환자의 재활치료 성과에 미치는 영향 (The Effect of Patient-Centered Goal Setting on Rehabilitation Outcomes in Patients With Subacute Stroke)

  • 원종임;안창만;박민희
    • 한국전문물리치료학회지
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    • 제25권1호
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    • pp.31-38
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    • 2018
  • Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

Academic Medicine은 환자 중심 의료이다 (Academic Medicine Is Patient-Centered Medicine)

  • 안신기
    • 의학교육논단
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    • 제21권2호
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    • pp.80-91
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    • 2019
  • The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

Quality of life, patient preferences, and implant survival and success of tapered implant-retained mandibular overdentures as a function of the attachment system

  • Ilze Indriksone;Pauls Vitols;Viktors Avkstols;Linards Grieznis;Kaspars Stamers;Susy Linder;Michel Dard
    • Journal of Periodontal and Implant Science
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    • 제53권3호
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    • pp.194-206
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    • 2023
  • Purpose: A novel attachment system for implant-retained overdentures (IRODs) with novel material combinations for improved mechanical resilience and prosthodontic success (Novaloc) has been recently introduced as an alternative to an existing system (Locator). This study investigated whether differences between the Novaloc and Locator attachment systems translate into differences in implant survival, implant success, and patient-centered outcomes when applied in a real-world in-practice comparative setting in patients restored with mandibular IRODs supported by 2 interforaminal implants (2-IRODs). Methods: This prospective, intra-subject crossover comparison compared 20 patients who received 2 intra-foraminal bone level tapered implants restored with full acrylic overdentures using either the Locator or Novaloc attachment system. After 6 months of function, the attachment in the corresponding dentures was switched, and the definitive attachment system type was delivered based on the patient's preference after 12 months. For the definitive attachment system, implant survival was evaluated after 24 months. The primary outcomes of this study were oral health-related quality of life and patient preferences related to prosthetic and implant survival. Secondary outcomes included implant survival rate and success, prosthetic survival, perceived general health, and patient satisfaction. Results: Patient-centered outcomes and patient preferences between attachment systems were comparable, with relatively high overall patient satisfaction levels for both attachment systems. No difference in the prosthetic survival rate between study groups was detected. The implant survival rate over the follow-up period after 24 months in both groups was 100%. Conclusions: The results of this in-practice comparison indicate that both attachment systems represent comparable candidates for the prosthodontic retention of 2-IRODs. Both systems showed high rates of patient satisfaction and implant survival. The influence of material combinations of the retentive system on treatment outcomes between the tested systems remains inconclusive and requires further investigations.

환자중심의료를 위한 병동디자인이 환자가족 및 의료진에 미치는 효과에 대한 연구 - 미국의 환자중심의료를 위한 중환자병동 사례를 중심으로 (A Study on the Effect of Unit Design for Patient-Centered Care on Family Members and Caregivers - A Case Study of the Intensive Care Unit (ICU) for Patient-Centered Care in the United States)

  • 최영선
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권3호
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    • pp.37-45
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    • 2015
  • Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

사람과 사회 중심의 기본의학 학습성과 (Human and Society-Centered Learning Outcomes in Basic Medical Education)

  • 김대현
    • 의학교육논단
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    • 제18권3호
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    • pp.150-155
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    • 2016
  • Learning objectives for human and society-centered basic medical education to improve physicians' ability to practice in a Korean context were developed by the Korean Association of Medical Colleges in 2015-2016. The task-force committee identified eight domains for medical practitioners: human illness, reflection and self-improvement, patient safety, communication and collaboration, medical ethics, legal issues, social accountability, and professionalism. A total of 172 enabling learning outcomes and 42 terminal learning outcomes were identified by the workshop. The workshop members were representatives from 41 medical schools, the Korean Medical Association, and a scientific group (medical ethics, legal issues, and medical communication). The curriculum for "medical humanity and social medicine" was first published in 2007. The human and society-centered learning objectives that were developed will be revised annually.

환자중심 스마트병원의 개요와 전망 (Overview and Prospects of Patient Centered-Smart Hospitals)

  • 박현영;조용진
    • 디지털융복합연구
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    • 제19권7호
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    • pp.419-426
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    • 2021
  • 정보통신기술이 발달함에 따라 스마트병원은 헬스케어 산업에서 새로운 트렌드가 되고 있다. 본 논문에서는 문헌고찰을 통해 스마트병원의 개념, 주요 기술, 적용분야, 직면과제 및 사용자 중심의 스마트병원 구축 전략에 대해 살펴본다. 스마트병원에서는 상호연결된 디지털 네트워크 안에서 임상가들이 환자중심의 통합적 의료서비스를 효율적으로 제공하도록 함으로써 보다 나은 환자결과에 도달할 수 있게 될 것이다. 그러나 향후 보다 성공적인 환자중심 스마트병원을 위해서는 비용이나 기술, 보안, 표준 등과 관련된 여러 장애요소들이 극복되어야 하며, 디지털 솔루션의 최종 사용자인 환자와 의료인의 참여가 요구된다.

Comparison of Intensive Care Unit Nurses' and Family Members' Priorities of Patient and Family-centered Care in Ghana

  • Mohammed, Shaibu;Tak, Sunghee H.
    • 중환자간호학회지
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    • 제15권1호
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    • pp.13-23
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    • 2022
  • Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

Survey on Value Elements Provided by Artificial Intelligence and Their Eligibility for Insurance Coverage With an Emphasis on Patient-Centered Outcomes

  • Hoyol Jhang;So Jin Park;Ah-Ram Sul;Hye Young Jang;Seong Ho Park
    • Korean Journal of Radiology
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    • 제25권5호
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    • pp.414-425
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    • 2024
  • Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion: There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.