• Title/Summary/Keyword: Relationship with Patients

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A Study on Patient'S Obligation in Medical Cooperation and Doctor'S Medical Malpractice (환자의 진료협력의무와 의사의 의료과실)

  • Baek, Kyoung-Hee
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.91-123
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    • 2012
  • Doctors and patients for the purpose of healing and treatment of disease through the contract will make a relationship. Doctors perform the medical practice for the state and illness of patient. Given that the patient did not cooperate in the doctor's medical practice, it is difficult to achieve the goal of disease healing. If the patient don't cooperate the medical care, and it is linked with a doctor's medical malpractice, patient's violation of obligation in medical cooperation is considered with negligence on the part of patients. However, this negligence should be limited to obvious cases that the patient's behavior is unreasonable although the doctor provides medical information to patients and induced the patient's response. Also, patient's violation of obligation in medical cooperation must result in adjusting the indemnification via a setoff of fault except the cases having causal relationship between doctor's fault and malpractice.

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The Relationship between Age and Speech Improvement in the Patients Performed Pharyngeal Flap for Correction of Velopharyngeal Dysfunction (구개인두기능부전의 교정을 위한 인두피판술의 나이에 따른 발음 개선 효과)

  • Kim, Kyoung-Hoon;Bae, Yong-Chan;Nam, Su-Bong;Choi, Soo-Jong;Kang, Cheol-Uk
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.294-298
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    • 2009
  • Purpose: The pharyngeal flap is one of the popular surgical method to treat the problem of velopharyngeal dysfunction. This study evaluated speech outcomes of patients who underwent superiorly based pharyngeal flap surgery based on timing of surgery. Methods: A restrospective review of 50 patients who underwent pharyngeal flap surgery for velopharyngeal insufficiency between September 1996 and January 2008 was undertaken. Thirty patients with an available preoprative and postoperative speech assessments with at least 6 months of follow-up were included in this study. We checked out the significance of speech improvement after surgery analysing preoperative and postoperative scoring of speech assessment. We also investigated the direct relationship between the age at surgery and the degree of speech improvement, and the improvement score in different age groups. Results: The mean score of preoperative speech was $52.6{\pm}7.4points$ and postoperative speech was $58.6{\pm}6.5points$, which presented significant postoperative speech improvement with an average of 5.9 points(p<0.01). There was a significant inverse relationship between the age at operation and speech improvement degree(p<0.01, r = -0.54). Comparing the age groups, the age group of 4 to 5 years presented statistically significant speech improvement(p<0.01). Conclusion: we propose that all patients indicated should take pharyngeal flap irrespective of age. In this study, the younger the age at surgery, the higher degree of speech improvement, for which we suggest that surgical approach should be undertaken as early as possible, especially younger than age 5 years.

The Effects of Anti Chemotherapy Individualized Education Relationship with Knowledge and Promoting Self Care for Cancer Patients (화학요법에 관한 개별적 환자교육이 암환자의 지식과 자가간호 수행에 미치는 효과)

  • Cho, Young-Su;Ryu, Eun-Jung;Choi, Kyung-Sook
    • Asian Oncology Nursing
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    • v.2 no.1
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    • pp.27-35
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    • 2002
  • The Cancer Patients are rapidly growing and it became one of the main cause of death. Lately with the effect of Chemotherapy, drastically improved patients quality of life and also Prolonged Life of Cancer Patients. But the Chemotherapy not only Kill the Cancer cells but also harm to normal cells witch Cancer lots of side effect. This study was designed to identify the effectiveness of patient education to reduce side effect and help promote self care. The date was collected from October, 2001 to February, 2002 by questionary Survey Method. The subjects were 24 patients Who were and Anti Chemotherapy C University Hospital. Educated booklet contained what is Chemotherapy, what are the side effects, and to promote Self care, Pre test was given after 3-4 weeks re admission period. Analysis data was done by SPSS Program Paired t-test was used to differentiate Knowledge and difference of performing self care. Relationship in between Knowledge and promoting Self care was used Pearson Correlation. As the result of education, knowledge of self care and performance was drastically increased but the relationship in between knowledge of self care performed was not significant. Therefore it is proposed as follows: 1) Further research with experienced subjects to differentiate experience group and control group. 2) Education program need to be develop and standardize for anti cancer Chemotherapy patient. 3) During 6 cycle of Chemotherapy what is ideal number of in order to get the best result.

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CLINICAL STUDY ON THE POSITIONAL CHANCE OF THE MANDIBLE AFTER TREATMENT OF CLASS III MALOCCLUSION(Permanent Dentition) (III급 부정교합 치료후의 하악골의 위치변화에 관한 임상적 고찰(영구치열에서))

  • Park, Hyo-Sang
    • The korean journal of orthodontics
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    • v.24 no.1 s.44
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    • pp.63-86
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    • 1994
  • The purpose of this study was to find out some relationship between the positional change of mandible during treatment and the prognosis after treatment of ClassIII malocclusion. The patients selected for this study were sucessfully treated two patients, and three patients who wert also sucessful in active treatment but showed relapse during observation. Serial Cephalograms, photos, models, treatment record of these patients were analysed in each term of treatment and observation period. The results might be summarized as follows: The patient with swing back type in which mandible rotated posteroinferiorly during active treatment showed good dental md skeletal relationship during observation. Among the patients with Y-axis type, one who had harmonious growth between maxilla and mandible showed stable dental relationship during observation, the other who had not showed relapse. The swing back type was not changed during and after treatment but the patients who had Y-axis type were unchanged in some patients, and changed into forward type in the others. During active treatment, was lower facial height(ANS-Me) increased in all 5 patients, and in observation period the patients showing increase in lower facial height had stable occlusion but the others having decrease showed unstable dental relationship.

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Relationship between anticipatory postural adjustment of the trunk, dual tasks and physical performance with chronic stroke survivors: a pilot test

  • Hwang, Won Jeong;Cho, Min Kwon;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.4 no.1
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    • pp.44-48
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    • 2015
  • Objective: The purpose of this study was to investigate the relationship between anticipatory postural adjustment (APA), single task, dual tasks and physical performances. The trunk muscles of APA consist of bilateral erector spinae (ES) and bilateral internal oblique (IO) adnominal muscles, during rapid stepping with the affected or unaffected leg in a sitting posture. Design: Cross-sectional study. Methods: In patients with chronic stroke, electrodes of surface electromyography (EMG) were attached on the bilateral erector spinae (ES), bilateral internal oblique adnominal (IO), and bilateral rectus femoris (RF) muscles. RF acts as the prime mover. The stroke patients performed hip flexion until $20^{\circ}$ as fast as possible at each leg in a sitting posture according to a visual cue. The visual cue unexpectedly appeared on monitor in front of the stroke patient. The single task was the Timed Up and Go (TUG) test. The dual tasks were the TUGconitive, which increased cognitive capacity, and the TUGmanual task, which had an external focus. Results: All EMG data showed earlier onset latency before the prime mover. In affected leg raising, the onset time of unaffected ES muscle of the stroke patients was correlated with the single and dual tasks (p<0.05). In unaffected leg raising, the onset time of the affected IO muscle was related to all the tasks (p<0.05). Gait speed showed a relationship with the unaffected ES muscle only. Conclusions: The trunk muscles of the bilateral ES and bilateral IO play an important role in APA. The single and dual tasks using TUG test were correlated with the APA s of ES and IO muscles. Dual task by the TUG test is a good measuring tool for reflecting the real life in patients with chronic stroke.

Convergence Study on the Relationship between Kinesiophobia and Fear of Falling in Patients with Stroke (뇌졸중 환자의 운동공포증과 낙상공포 사이의 관계에 대한 융합 연구)

  • Jo, Sungbae;Choi, Wonjae;Jung, Jihye;Park, Jiyu;Lee, Seungwon
    • Journal of the Korea Convergence Society
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    • v.10 no.10
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    • pp.33-41
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    • 2019
  • This study aimed to investigate the convergence relationship between kinesiophobia and fear of falling in patients with stroke. A total of 113 patients with stroke participated in this study. Participants underwent inpatient rehabilitation and completed surveys with three different questionnaires including the fall efficacy scale (FES), translated Tampa Scale for Kinesiophobia 13 (TSK-13), and activity-specific balance confidence scale (ABC). TSK-13 and FES showed weak negative correlation (r=-0.226), and TSK-13 and ABC showed moderate negative correlation (r=-0.300). FES had a very strong positive relationship compared with ABC (r=0.838). Faller showed significantly low FES and ABC scores compared with non-faller (p<0.05). These results present that patients with stroke had mild kinesiophobia, and kinesiophobia is related to fear of falling. It is necessary to evaluate kinesiophobia in stroke rehabilitation.

Microsurgical strategies for small unruptured dorsal internal carotid artery aneurysms

  • Kanghee Ahn;Woong-beom Kim;You-Sub Kim;Sung-Pil Joo;Tae-Sun Kim
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.475-484
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    • 2023
  • Objective: This study aimed to develop microsurgical strategies based on the anatomical relationship between dorsal internal carotid artery (ICA) aneurysms, the falciform ligament (FL), and the anterior clinoid process (ACP). Methods: Between 2017 and 2022, 25 patients with unruptured dorsal ICA aneurysms (less than 4 mm in diameter) underwent microsurgical direct clipping. These cases involved the left ICA (n=17) and the right ICA (n=8), with a mean aneurysm size of 3.3 mm (range, 2.5 to 4 mm). We used computed tomography angiography (CTA) and digital subtraction angiography to elucidate the anatomical relationship between dorsal ICA aneurysms and other structures. All procedures involved an ipsilateral pterional approach with securement of the ipsilateral cervical ICA for proximal control. Results: Among the 25 dorsal ICA aneurysms, 8 (32%) were clipped without the FL being incised. Another 5 (20%) were clipped solely after the FL was cut. For the remaining 12 cases, the aneurysms were successfully clipped following FL incision and partial ACP removal. Patients exhibited favorable postoperative recoveries with good outcomes, and postoperative CTA revealed complete aneurysm clipping without any residual remnants. Conclusions: We were able to perform clipping without removing the ACP in 13 patients (52%), and in 8 of these (32%), the clipping was carried out directly without cutting the FL. Microsurgery, coupled with proximal control of the cervical ICA, can serve as a viable alternative for patients with small dorsal ICA aneurysms, especially when endovascular treatment options are limited, and 3D CTA confirms a clear anatomical relationship with the ACP.

Factors Related to Preoperative Shoulder Pain in Patients with Atraumatic Painful Rotator Cuff Tears

  • Park, In;Lee, Hyo-Jin;Kim, Sang-Ki;Park, Min-Sik;Kim, Yang-Soo
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.128-134
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    • 2019
  • Background: Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods: We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results: Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions: Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.

Impact of Uncertainty on Resilience in Cancer Patients (암환자의 질병에 대한 불확실성이 극복력에 미치는 영향에 관한 연구)

  • Cha, Kyung-Suk;Kim, Kyung-Hee
    • Asian Oncology Nursing
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    • v.12 no.2
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    • pp.139-146
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    • 2012
  • Purpose: This study was designed to identify the impact of uncertainty degree and uncertainty appraisal on cancer patients resilience. Methods: A sample of 181 patients with cancer was recruited from a hospital in Incheon. Data were collected from May 20 to August 25, 2011. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression with the SPSS/WIN 12.0 program. Results: The resilience for cancer patients showed a significant relationship with uncertainty degree and uncertainty appraisal. The significant factors influencing resilience were uncertainty degree and uncertainty appraisal, they explained 26.5% of the variance. Conclusion: Patients with cancer were adversely affected by uncertaint which led to a negative effect on resilience. The result suggests that intervention programs to reduce the level of uncertainty among patients could improve the resilience of cancer patients.

Patient-reported satisfaction after robot-assisted hysterectomy among Korean patients with benign uterine disease

  • Park, Suyeon;Lee, Young-eun;Cho, Seong-Sik;Park, Sung-ho;Park, Sung Taek
    • Obstetrics & gynecology science
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    • v.61 no.6
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    • pp.675-683
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    • 2018
  • Objective This study aimed to evaluate patient-reported satisfaction following robot-assisted hysterectomy due to benign uterine disease, and to identify the factors associated. Methods We used a questionnaire to evaluate patients' satisfaction with robot-assisted hysterectomy. The questions concerned overall patient-reported satisfaction and specific factors affecting satisfaction, including postoperative pain, return to daily life, the hospital experience, wounds, cost, the doctor-patient relationship, whether expectations were met, and whether detailed information was provided. We also collected data from patient records, such as uterine weight, rate of pelvic adhesion, operation time, rate of transfusion, delayed discharge, and readmission. One hundred patients who underwent robot-assisted hysterectomy participated in the study. Seventy-three fully completed questionnaires were returned. Results The majority of patients (95.9%) were satisfied with robot-assisted hysterectomy. The doctor-patient relationship, whether expectations were met, the hospital experience, wounds, and whether detailed information was provided were statistically significant factors influencing patients' overall satisfaction. Payment of fees and clinical and surgical outcomes did not significantly influence patients' overall satisfaction. Conclusion Our findings show that most patients reported high levels of satisfaction following robot-assisted hysterectomy, regardless of cost or clinical and surgical outcomes. Therefore, if gynecologists consider robot-assisted hysterectomy suitable for patients they need not hesitate based on potential costs; they should feel confident in recommending the procedure to patients.