• Title/Summary/Keyword: Quality of Medical Service

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Model for the Structural Relationships of Safety Education by a Marine Leisure Sports Experience Center to First-Aid Coping Skills and Experience Satisfaction (해양레저스포츠 체험센터의 안전교육이 응급처치 대처능력 및 체험만족도에 관한 구조적 관계 모형)

  • Choi, Mi-Young;Moon, Tae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.552-561
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    • 2019
  • The purpose of this study was to verify a model for the structural relationships of safety education provided by a marine leisure sports experience center to first-aid coping skills and experience satisfaction. 307 male and female customers who used a marine leisure sports experience center located in the city of S-si, K-do Province, were investigated from June 15 to August 30, 2017. The collected data were statistically analyzed by SPSS/PC+ 20.0 and Amos 16.0. The findings of the study were as follows: First, the safety education offered by the marine leisure sports experience center was found to have affected first-aid coping skills(t=3.425, p<.001). Second, the safety education by the marine leisure sports experience center was found to have exerted an influence on experience satisfaction(t=3.751, p<.001). Third, the first-aid coping skills of the marine leisure sports experience center was found to have had an impact on experience satisfaction(t=6.781, p<.001). The measurement model for the hypothesis test in this study was found to be appropriate(GFI=.978, NFI=993, CFI=984). Given the findings of the study, more extended safety education is expected to be effective, as customers who use marine leisure sports experience centers will be able to enjoy marine leisure sports more safely and improve their quality of life when they are compulsorily required to receive safety education.

Improvement for the Degree of Client Satisfaction in the Sample Collection Room (검체채취실의 고객만족도 향상)

  • Park, Youn Bo;Kang, Hee Jung;Kwon, Hung Man;Ahn, Sang Jin;Yang, Suk Hwan;Tae, Yeun Ju;Chin, Young Hee;Jo, Hyon Koo;Lee, Bok Ja;Koo, Sun Hoe
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.2
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    • pp.222-232
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    • 2004
  • The sample collection room(SCR) will have much more influence than all the other departments for the improvement of hospital image, if anyone coming to the SCR in the hospital goes back with the perfect complacency and because most clients who have much stresses and fatigues pay a final visit to the SCR via receipt-diagnosis- acceptance process. SCR has improved its image for the purpose of gratifying clients, in order for clients to visit the hospital again, the quality improvement(QI) team in the Diagnosis Inspection Medical Department has come to a conclusion as follows. The degree of client gratification before improvement marks 65.9 point, but the degree after improvement was 74.2 point. Therefore, satisfaction has increased by 8.3 points. The degree of client gratification in groups before improvement marks (1) service parts-89.2 points (2) facilities and environments-49.1 point (3) toilet facilities-46.3 point. But its gratification after improvement marks (1) 92.5 point (2) 60.1 point (3) 61.0 point. Therefore the degree of satisfaction has increased by (1) 3.3 point, (2) 11.0 point, (3) 14.7 point. The progress of facility improvement plans and the exclusion of improvement on the facility contents in the hospital have made facilities and environments of SCR and toilet facilities to be poorly improved. Although service parts have a good mark, and the facilities and environments are not scoring well, the whole degree clients' gratification of SCR couldn't be helped by the low grade. Therefore the bottom line for the clients' gratification of SCR in the future is to ameliorate the facilities and environments. SCR will take the clients' gratification survey every year and if any items get low marks, that is, below 90 point throughout the survey, SCR will immediately starts the improvement work for the clients' gratification with operating the programs of controlling quality continually, and SCR should induce the operation of services, participating in the kind campaign drive for clients. So SCR will adopt the incentive system for the best staff members who perform these kinds of services.

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Survey for the Understanding of Elderly Disease and Work Environment for Physical Therapists in Elderly Care Facilities (노인요양시설물리치료사들의 노인복지정책과 노인질환에 대한 이해도 및 직무 환경에 대한 조사)

  • Kim, Soon-Ja;Kim, Jeong-Seon
    • Journal of Korean Physical Therapy Science
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    • v.14 no.1_4
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    • pp.25-36
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    • 2007
  • The results of researching on duties of physical therapist, understanding of elderly diseases and policies related with elderly welfare came out from the survey before beginning of education to physical therapists who attended National Elderly Welfare Physical Therapist Workshop during Sep. 11th to 14th, 2007. They have already understood about long-term elderly care insurance from the policy, and responded that those policies will bring more advantage to elders. On contrary, negative response had reason of low service quality. About elderly care system, there were positive answer of appropriate alternatives to support them, but also other critics had opinion of inevitable choice for living conservation. About understanding of elderly diseases, there were more comprehension of diseases as age gets higher, but most did not understand dementia and paralysis. Past experience and process of medical treatment for their disease were such arthritis, paralysis, broken bone, and dislocation of joint. Prognosis of technical training was mostly answered positively, but linking with other related disease programs were not welcomed. Most respondents thought that professional training were needed. The results of understanding diseases during senescent had high percentage of understanding as age and education was high, and it had eye upon statistics of the survey (p < 0.05) Most of those questioned responded that it is appropriate to have six working days per week and eight hours of daily work, however, present wage is not reasonable. Most of those questioned had negative response of work independence, and had an-swered that there should be certificates needed in related fields. For difficulties during work period, they had hardship instituting direction of treatment by lack of program, level of wage, and physical difficulties. Physical therapists averagely wished to have fewer than thirty patients per therapist. After the research, physical therapists who work in those facilities of elderly care systems agreed on policies, though it should not lower service quality. In addition, they were pros to have elderly care system, yet they are still inevitable option to maintain living. For work environment, the period of work was appropriate, but had different opinions for work independence and regular number of patients. Therefore, there should be more organized treatment program that also should be linked to other practical programs at this beginning point of the policy enforcement and the time that many therapists hope to work in elderly care system.

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Psychosomatic Integrative Care for Psychosocial Distress of Patients With Breast Cancer (유방암 환자의 정신사회적 디스트레스에 대한 정신신체의학적 통합치료)

  • Yang, Chan-Mo;Jang, Seung-Ho;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.77-85
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    • 2021
  • Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

A Study on status of school health and analysis of factors affecting school nursing activities in the secondary school in Seoul (서울지역 국민학교(國民學校) 양호교사의 학교간호업무(學校看護業務) 수행정도(遂行程度)에 관(關)한 연구(硏究))

  • Kim, Eun Hee
    • Journal of the Korean Society of School Health
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    • v.1 no.2
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    • pp.50-65
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    • 1988
  • This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

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A Systematic Review and Meta-analysis of Acupuncture Trials in Republic of Korea that Used Sham Acupuncture as a Control Group (거짓침을 대조군으로 사용한 국내 침 임상시험에 대한 체계적 고찰과 메타분석)

  • Kim, Jung-Eun;Kang, Kyung-Won;Kim, Tae-Hun;Lee, Seung-Hoon;Kim, Joo-Hee;Baek, Seung-Min;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.28 no.6
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    • pp.1-17
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    • 2011
  • Objectives : This study aimed to review randomized controlled trials of acupuncture performed in South Korea that used sham acupuncture as a control group. Methods : The following databases were searched through the end of September 2011: Koreanstudies information service system (KISS), Korean medical database (KMbase), national discovery OR science leaders (NDSL), oriental medicine advance searching integrated system (OASIS), and research information service system (RISS). The following search terms were used: acupuncture AND (sham or placebo). The reference lists of searched articles and Korea institute of oriental medicine (KIOM) reports(2005~2009) were identified. The following data were extracted: year/first author, disease, number of participants, blinding, intervention, outcome, and result. Where appropriate, we performed meta-analysis. The methodological quality was assessed according to the Jadad scale and 'risk of bias' by Cochrane Handbook procedure. Results : Twenty-nine studies were included in this review. In eighteen studies, penetrating sham controls were used as the control intervention, whereas the remaining eleven studies adopted non-penetrating sham controls such as the Park Sham Device or blunt auricular acupuncture. Nine studies showed statistically significant difference in outcomes. Twelve studies concerning insomnia after stroke, chronic tension-type headache, idiopathic Parkinson's disease, Hwa-Byung, and smoking cessation were included in meta-analysis. A meta-analysis of insomnia after stroke only found significant difference(MD -4.31, 95% Cl -6.19 to -2.42, $p$<0.00001). In general, all of the studies showed low methodological quality(Jadad score: mean 2.1). Risk of bias by Cochrane Handbook procedure varied. Conclusions : The results of this study could not suggest conclusive evidence that acupuncture is more effective than sham acupuncture in several diseases. In the future, more studies with rigorous acupuncture trials using sham controls should be conducted.

Characteristics and Death Risk Factors of Patients in Long-Term Care Hospital Connected to Special Hospital (일개 특수 요양병원 환자들의 특성 및 사망 위험요인)

  • Park, Un Je
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.12
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    • pp.651-659
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    • 2020
  • The objective of this study is to provide high-quality medical service, by understanding the characteristics and death risk factors of patients at V long-term care hospital, that has established and operated the cooperative treatment system in connection with a public institution, the S veterans hospital. A follow-up survey targeting a total of 850 discharged patients was conducted for the year 2017. Average age of patients was 79.2 years, with 86.4% belonging to the 70 years or over group. The men of national merit were 75.4%, which was more than three times higher than general patients. Hospitalization for 180 days or more was 46.4%, which was higher than general long-term care hospitals (37%). The major death risk factors were age and the number of hospitalized days. Our data indicate that transfer to S veterans hospital results in providing quicker treatment and higher effectiveness of the numerous recovery therapies. We therefore propose that the cooperative treatment system should be expansively operated to increase the quality of happy life, by alleviating the health of patients with chronic diseases in a long-term care hospital.

Application of the Development Model of Day Care Center for Dementia (치매주간보호사업 개발모형의 적용)

  • Chung, Yeun-Gang;Baik, Kyung-A;Hyun, Hye-Young;Yeoum, Soon-Gyo;Kim, Kyung-Hee;Choi, Mi-Hye;Han, Sung-Hee
    • Research in Community and Public Health Nursing
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    • v.14 no.1
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    • pp.106-119
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    • 2003
  • This study was executed to develop the model of the format of the day care center which supplies the total service on the health care in the day time and social program related with the work and to evaluate the processing courses which was adjusted for 3 years from March 1999 to December 2001 in order to improve the quality of life of the family who experience dementia, dementia prevention, and the old and the burden of daily activities. The processing courses of this business model were evaluated to the confirmation on the health condition, application of the nursing processes, and the precise medical examination, and 20 sorts of social programs. The methods used in this model were the simplified MMSE-K, Ability for ,Daily Life(ADL), Instrumental Activities of Daily Living(IADL), and nursing process, and so on. The execution effects of this model are as follows. 1. It can contribute to the delay in the dementia process of the old people who are related with the dementia and maintenance and improvement of the health by confirming the stopping of the process of the dementia as the objective estimation method while the dementia symptom is maintained as the current condition through the medical and social total services. 2. The reduction of the burden for the daily care of the subject people and their families for the old people who are concerned with the dementia helped to improve the quality of life of the subject people and their family by enabling them to have jobs. 3. It enabled them to positively cope with the demand for the health and nursing of the local residents related to the old people. 4. It enabled them to enhance the recognition for the socialization of the local social organization and residents for the old people. 5. It enabled them to reinforce the related system among the local social organizations, and develop and provide the various social programs which are proper for the old people.

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An Analysis of Fall Incidence Rate and Its Related Factors of Fall in Inpatients (입원환자 낙상 발생 실태와 원인에 관한 분석 연구)

  • Kim, Chul-Gyu;Suh, Moon-Ja
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.210-228
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    • 2002
  • Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

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Evidence-based Clinical Practice Guidelines On Kampo (Japanese Herbal) Medicine : The Current State of Kampo Clinical Practice Guidelines (근거 중심 Kampo medicine 임상진료지침의 현황)

  • Sasaki, Yui;Huang, Ching Wen;Kim, Kyeong Han;Park, Yu Lee;Shim, Ho Jong;Park, Dong Sun;Jeon, Yoon Jeong;Kim, Ji-Hwan;Jang, Bo-Hyoung;Shin, Yong-Cheol;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.1
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    • pp.55-64
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    • 2016
  • Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.