• Health Policy and Management
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• v.11 no.4
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• pp.54-69
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• 2001

This study was conducted to assess factors associated with the degree of performance of qualify improvement(QI) activities. A mailed questionnaire survey was conducted between September 15 and October 30, 2000, with the staffs being charge of QI at each of the hospitals with 400 beds or greater. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used for the analysis. Using the Malcolm Baldrige National Quality Award Criteria(MBNQAC), perceived performance of QI was measured in terms of the improvement of the quality of clinical practice, clinical supporting department, administrative procedure of receiving care, customer satisfaction, efficiency and standardization of work process. Factors evaluated for the association were the extent of QI implementation, compliance to 5 QI principles, participation of hospital CEOs, budget allocation, history of QI, and bed size. Path analysis was performed to assess the relationship between QI performance and these factors. Major findings of this study are as follows. Hospitals showing higher degree of QI implementation (path coefficient=0.5967, p<0.001)) and better compliance with the basic principes of QI(0.5736, p<0.05) tended to achieve better performance. Path analysis results showed that interest and participation of hospital CEOs(0.1954, p<0.05) and compliance with the basic principes of QI(0.4028, p<0.0001) indirectly affected the outcomes of QI by influencing the intermediate variable of the level of QI implementation. This study results suggest that having employees have a good orientation of the basic concept and principes of QI through relevant training be the most important requirement to achieve better outcomes from QI activities. In addition, to educate leaders of hospitals the need of active implementation of QI is important to encourage their participation and draw strong support for QI programs.

• Journal of Korean Medical classics
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• v.23 no.6
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• pp.1-14
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• 2010

The conclusions after studying the rules and the principles of the six-drugs mixing forming the prescription of Yukmijihwanghuan(六味地黃丸) are as follows: 1. Yukmijihwanghuan cares for the three viscera; the liver, the spleen and the kidney and the three entrails; the urinary bladder, the gall bladder, and the stomach and it strengthens them as well. The drug can be used mainly for the cure of the Three Yang Channels of Foot and the Three Yin Channels of Foot. 2. The three drugs of Yukmijihwanghuan; Rehmanniae Radix, Dioscoreae Rhizoma, Corni Fructus altogether has the tonifying effect and the other three; Alismatis Rhizoma, Moutan Cortex, Poria has the purging effect. The first three kinds of drugs tonifies and the last three kinds of drugs purges. While these two groups of drugs are pitted against each other, they also balance each other harmoniously increasing the curative effect(remedial[curative] value). 3. Yukmijihwanghuan cools off the lung which is under metal category, helps the spleen, an earth category to be strong. It also adds the Water Qi to the kidney so that it stabilizes the Fire Qi. 4. Yukmijihwanghuan helps the kidney strongly, helps the urine to be excreted well, cools down the Fire Qi and makes dry things wet. 5. Rehmanniae Radix, the principal drug of Yukmijihwanghuan and Corni Fructus, the minister drug of the medicine have a taste of thick and are materially heavy. The two drugs do the descending action that it tonifies Yin Qi and adds Essence of Life. The other ingredients of Yukmijihwanghuan; Moutan Cortex, Poria, Alismatis Rhizoma have effects on lowering the Fire Qi. If Fire Qi descends, then Water Qi ascends. Yukmijihwanghuan has an efficacy of lowering Fire Qi and increasing Water Qi.

• Journal of Korean Medical classics
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• v.37 no.3
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• pp.61-82
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• 2024

Objectives : The objective of this study was to understand the Korean Medical understanding of the principles and physiology of breathing. Methods : Contents related to breathing were searched in the Korean Medical texts, after which they were categorized according to theme, then analyzed. Results : Breathing is a manifestation of life force originating from the 'innate original qi [先天一氣]'. Humans connect to the Heavenly qi-the origin of life- through breathing, through which the rhythm and consistency of yin/yang movement that enables maintenance of life qi could be embodied. The specific result of breathing is the circulation of qi and blood and the brightness of spirit. In addition, breathing is the process that connects human to heaven, allowing for the pulse or its rhythm to be maintained. Hence, breathing is alternately called 'the head of pulses'. Conclusions : Breathing in Korean Medicine goes beyond the scope of its biomedical understanding as a metabolic process of oxygen and carbon dioixde exchange, as it is concerned with the question of the origin of life. As such, the principle and effect of breathing is broadly connected to both innate and acquired life phenomena, wherein jing(精,) qi(氣,) shen(神) are all associated.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.6
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• pp.911-920
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• 2010

The basic principles in the "Spleen-stomach theory(脾胃論)" sets up the phases and roles of spleen-stomach (脾胃) by establishing Earth(地 坤 土) and exposing the reality of spleen-stomach(脾胃) of human body which has its own shape and form with Heaven's reality exhibited. The meaning of Earth is based on the constant meaning of Earth in 'Earth Original-Earth as extended and stable ground(坤元一正之土)' giving form and shape, and Earth's movement with circulation, then exposes itself as 'Earth as plowing land(耕種之土)' concerning both the application of Five Phases and the physical characteristics of Earth. The Yin-Yang recognition on Earth is revealed as Yin Earth(陰土)-Yang Earth(陽土). Spleen(脾) was established as Yin Earth(陰土) and Stomach(胃) as Yang Earth(陽土). The seasonal assignment of Earth is Indian Summer(長夏), which is divided from Summer, and becomes Heat(熱), and the Yin-Yang recognition of Earth comes to be the meaning of the center and border. According to the Five Phasic recognition, it becomes Earth(土) and gets to be Dampness(濕) in accordance with Six Qi(六氣). 'Extreme Yin(至陰)' indicates Qi's status exposing the fundamental meaning regarding the role of creating, changing, and propelling Spleen-Stomach(脾胃) as a characteristic Yin Earth. Earth comprehends 'Four Courses(四維)' meaning, recognizes them as four parts of the 12 Earth's Branches(辰戌丑未) and the terminals of four seasons(四季之末), and has the meaning of the president of the change in four seasons. The theory of principle in the "Spleen-stomach theory(脾胃論)" stands on the basis of the 'Form Qi theory(形氣論)' and that of 'Upbearing, Downbearing, Floating, and Sinking theory(升降浮沈論)'. It manifests the theory of movement in the interaction between Form(形) and Qi(氣), and 'Qi Interior Form Exterior(氣裏形表)' indicates that Qi(氣) moves interiorly and Form(形) exteriorly.

• Journal of Korean Medical classics
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• v.35 no.1
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• pp.59-79
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• 2022

Objectives : Huangyuanyu's interpretation of the six channel diseases of the Shanghanlun were examined based on contents on the six channel qi metabolism theory in his works, Shanghanxuanjie, Shanghanshuoyi, and Sishengxinyuan. Methods : Contents related to the six channel qi metabolism theory in the Shanghanxuanjie, Shanghanshuoyi, and Sishengxinyuan were extracted and examined to identify a fundamental principle from the perspective of the six channel qi metabolism theory. Characteristics of each of the six channel diseases were organized. Results : Huang's understanding of the six channel diseases in the Shanghanlun could be summarized by the six channel. Its features could be explained as following. First, in examining the principles of the controlling qi[司氣] and constitutionally influenced transformation[從化], the rise and fall of the body's yang qi was emphasized. Second, center qi[中氣] was considered important, the taiyin Spleen being the key to life and death. Third, the pathology of 'earth dampness/water cold/wood stagnation' due to weakness of the center qi was suggested. Fourth, the principle of boosting-yang-suppressing-yin was emphasized in treatment, with criticism of the nurturing-yin-extinguishing-fire method. Conclusions : In understanding the six channel diseases in the Shanghanlun, Huangyuanyu focused on the body's yang qi and center qi based on key theories such as the 'five circuits and six qi' and 'six channel qi metabolism' theories. His perspective could be helpful in understanding Zhangzhongjing's work more comprehensively.

• Journal of Korean Medical classics
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• v.26 no.2
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• pp.9-24
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• 2013

Objectives : I would find out the interpretation of cong Yin yin Yang(從陰引陽) cong Yang yin Yin(從陽引陰) in Su Wen(素問) Yin Yang Yin Xiang Da Lun(陰陽應象大論) and its clinical meanings. Methods : I had searched the opinions of annotators about this paragraph and compared treatment principles that TCM clinicians, such as Li Dong-yuan(李東垣), Zhang Jie-bin (張介賓), Yu Jia-yan(喩嘉言) developed. Results : This paragraph is related to treatment principles of the paragraph Yang bing zhi Yin(陽病治陰) Yin bing zhi Yang. Li Dong-yuan applied it to treatment principle of internal injuries(內傷病), Zhang Jie-bin extended its clinical meanings to the opposite treatment principles(反治) such as gu han wu xie(求汗於血) sheng Qi wu Jing(生氣於精), yin huo gui yuan(引火歸源) and na Qi gui shen(納氣歸腎), Yu Jia-yan used it as treatment principle of tuo zheng(脫症). Conclusion : This paragraph can mean several messages and be applied to several treatment principles.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.4
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• pp.589-595
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• 2011

In order to analyze principles of taking concoction and make clear the origin of contraindication against five pungent vegetables, the regulations of Guizhitang prescription in "Shanghanlun" the twelfth article and "Wushierbingfang", "Wuweihandaiyijian", "Jinguiyaolue" were researched. Four principles of taking concoction were put in order; strengthening the effect of concoction by eating hot rice gruel and wearing bedclothes, preventing decline of drug effect by food regulations, optimization of elution and effect of material herbs by crushing, low heating, determination of administration time based on manifestations of drug effect by sweating and its aspect. These principles and methods of taking concoctions were developed from boiling to simple processing of material herbs, contraindication in the middle of taking concoction and perspiration by wearing bedclothes and eating hot rice gruel in order from the analysis of medical literatures. The contraindication against pungent vegetables were generalized in early Dong-Han dynasty already, and the five pungent vegetables were inferred as Allium tuberosum, Allium bakeri regel, spring onion, wild rocambole and garlic in medical context to the exclusion of religious idea. The reason of prohibition against five pungent vegetables could be interpreted as optimization of therapeutic effects by pharmacological control of pungent ingredients because the healthy qi damage and evil qi retention were resulted from destroying of harmonious ying and wei by overeating pungent vegetables during disease state. Conclusively the regulations of Guizhitang prescription referred to taking concoction in "Shanghanlun" fulfilled their functions to maximize pharmacological effects through various ways inside and outside and these reasonal principles of taking concoction has been influenced over the traditional medical practice deeply.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.312-323
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• 1998

Background : Evaluation of patient's satisfaction is one of the most important aspects of quality improvement. If the patient highly satisfies with the medical service provided in the hospital, he/she will be likely to visit the same hospital again. Patient's satisfaction of a particular hospital is directly correlated with hospital profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the patient's satisfaction. This study is to find the effect of hospital QI activities on the patent's satisfaction level. Methods: After questionnares were developed, survey of measuring satisfaction level was performed in August, 1998. On the basis of survey results, QI activities were carried out to attain the target point of 4.0 and subsequent survey was done in November, 1998. Results: With three main principles of "problem solving approach with kindness". "helping patient to participate in medical procedure with sufficient information", and "putting employees into practice of attitude with human respect", the average level of satisfaction was enhanced from 3.45 to 3.55 level. Also kindness level of employees was increased from 3.71 to 3.82. Level of dissatisfaction about insufficient explanation and unkind attitude was dropped from 69% to 48% and from 82% to 46% respectively. Conclusion: With the result of this study overall satisfaction level was enhanced. In order to keep these advantages a operation of Quality Improvement Task Force Team in each subject will be required.

• Journal of Korean Medical classics
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• v.36 no.4
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• pp.93-108
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• 2023

Objectives : This paper aims to study the characteristics of zhongfeng treatment by examining the eight principles of zhongfeng treatment in the Zhongfeng Jiaoquan of Zhang Shanlei along with Zhang Bolong's treatment of 'Yangxu Leizhongfeng[Yang deficiency pseudo Wind damage]' which is missing from the eight principles. Methods : The treatment methods in the Zhongfeng Jiaoquan was organized in the order of cause, characteristic, symptom, treatment, and precautions, in order to analyze features that were emphasized by Zhang in zhongfeng treatment. Results : First, treatment for bizheng is to 'open and close', then apply methods of 'qianyang jiangqi(潛陽降氣)' and 'zhenni huatan(鎭逆化痰)' while that for tuozheng is to 'lianyin yiye(戀陰益液)' accompanied by medicinals that 'qianzhen xutang(潛鎭虛陽)'. Second, treatment for ganyang shangnizheng is to 'qianzhen rougan', while for tanzian yongsezheng, one must 'dangdi(蕩滌)' for those who are strong in qi, 'xiehua(泄化)' for those who are weak in qi, while for those who have qinizheng[qi reverse syndrome] to 'shunqi(順氣).' Third, for deficiency in xinye and ganyin, one must 'yuyin yangxue[育陰養血]', while for deficiency in shenyin, one must first 'qianjiang shena[潛降攝納]' then slowly apply the method of 'ziyang shenyin[滋養腎陰]' if there is no phlegm turbidity. Fourth, in order to communicate the meridians and unfold collaterals, if the pathogen is external, apply the method of 'yangxue tongluo[養血通絡]', while if the pathogen is internal, calm by doing 'qianyang zhenni[潛陽鎭逆].' Fifth, in order to treat pseudo zhongfeng caused by yang deficiency, one must 'lianyin gutuo[戀陰固脫]' while using medicinals that 'jiangxiang[潛降]'. Conclusions : Treatment of zhongfeng in the Zhongfeng Jiaoquan diverged from 'wenjing sanhan', the usual approach to zhongfeng which sees it as external, and established the 'qianjiang zhenshe [潛降鎭攝]' treatment method based on the internal wind theory. It suggests a new Korean Medical pathology based on theories of Western medicine, and introduces eight principles in treating zhongfeng, which would influence the treatment of zhongfeng in the future.

• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.3-10
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• 2001

Psychology and esters medicine are congenital therapeutic partners. they are closer in concept and practice to each other than either is to the principles of western science and medicine. Estern medicine, like most psychotherapies, is concerned with an individual's unique physical and emotional state. The aim of this study is to review Ii-Geug-Byun-Qi(移精變氣療法) therapy which is one of the psychotherapies in estern medicine. We studied few representative books which are about in estern medicine and also studied some clinical case reports on psychotherapies by estern medicine therapy, specially about Ii-Geug-Byun-Qi(移精變氣療法) therapy. Generally we understood Chukyoo(祝由) is the eldest psychological therapy which is based on Shamanism and controlled by Shaman as a doctor. and it is similar to simple psychoanalysis in western medicine. The psychologic therapy of Ii-Geug-Byun-Qi (移精變氣療法) is typical estem medicine psychologic therapy since the principle of estern medice had built like Hwang-Chi-Nei-Ching(黃帝內經). The meaning. of Ii-Geug-Byun-Qi(移精變氣療法) therapy is holistic psychologic therapy which are based on the harmony of mind and body. The practical method of Ii-Geug-Byun-Qi(移精變氣療法) are to refresh patient's emotional condition, like ventilaltion. The second healing method of Ii-Geug-Byun-Qi(移精變氣療法) is persuasion by dialogue. The third method is to clear patient's doubt by explainning of some qutestions. Therefore, the indication of Ii-Geug-Byun-Qi(移精變氣療法) therapy are psychosomatic disease or psychogenic problems. In conclusion, I suggest that the Ii-Geug-Byun-Qi(移精變氣療法) therapy could be powerfully adopt to prevent or treat lots of disease which is related with mind and body induced by stressor.