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Needs of Parents Who have the Child with Congenital Heart Disease Related to the Informed Consent (선천적 심질환아의 수술동의서 작성과 관련된 부모의 요구)

  • Choi, Mi-Young
    • Korean Parent-Child Health Journal
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    • v.6 no.1
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    • pp.18-30
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    • 2003
  • Congenital heart disease is the most frequently shown congenital disease among children, most of them can be corrected with operation. However, Patients and their parents need nursing intervention when they face this risky incident of operation. Therefore, parents' experiences are absolutely needed to plan nursing intervention to give practical help to the patients and their parents. The purpose of this study is to provide basic resources to develop a feasible intervention program for the parents by understanding the experiences related to the informed consent of cardiac surgery of their child. From January to June 2003, 10 parents of children patients with congenital heart disease were interviewed who filled out Operation Agreement before the primary operation after they are diagnosed as congenital heart disease in pediatric chest surgery of A hospital in Seoul. They were asked to give opinion regarding pre-operation needs and the interviewed information was analyzed. The results of this study are as follows : Firstly, they were asked what they felt before they were told about the operation of their children from the doctor before filling out the informed consent of operation. They felt 1) vague, 2) confusion of choose, 3) risky, 4) resented, 5) uneasy, 6) guilty, and 7) the burden of operation. Secondly, they were asked what they felt after they filled out the informed consent of operation and the doctor gave them detailed information on the operation of their children. They felt 1) confused, 2) responsible, 3) rejected, 4) angry, 5) plain, 6) to have hope, 7) trying to trust medical people, 8) that consolation is needed, and 9) conditional reduction of the burden of operation. Thirdly, followings are the categories of congenital parents' demand before operation based on the analysis of experiences related to the preparation of the informed consent of operation. 1) Information Demand (1) Anticipatory information (2) Concrete and precise information (3) Individual information 2) Support (1) Empathy (2) Parental supporting (3) Support of parents in the same situation 3) Education and consulting (1) Children-oriented Education (2) Consultation Considering the results of this study, parents of the child with congenital heart disease seem to have various emotional experiences related to filling out the informed consent and they need concrete and practical helps before cardiac surgery. This study proposes that systematic nursing intervention is needed according to the needs of the parents who have the child with congenital heart disease before operation in the field of child health nursing.

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A Study on the Length of Stay In Hospital Before and After Operation (수술전.후 재원일수에 관한 조사연구)

  • Kim Mi-Young;Park Kyung-Sook;Kim Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.245-265
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    • 1997
  • The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

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A Study on the Nurse's Recognition and Performance in Intravenous Therapy Management (간호사의 정맥주사 관리에 대한 인식과 수행에 관한 연구)

  • Kim Myung-Hee;Kim Youn-Hwa
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.207-224
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    • 1998
  • The purposes of this study were to identify nurse's recognition and performance and to represent the factors of hindrance in the IV therapy management. The subjects were 420 nurses who worked at five general hospitals in Pusan. Tha data were collected using a questionnaire and the period of data collection was from January 1 to January 31, 1998. The instrument for this study was made by author oneself on the basis of guidelines Simmons et al', CDC' Stanley' and Kurdi' guideline, Cllinical Nurse's Association' that consist of 68 items for 5 fields ; pre-injection, just before-injection, needle-injection, during injection, post-injection field. Cron-bach Alpha coefficient of recognition and performance in the IV therapy management was .93 and .87. The datas were analized by a SPSS program using frequency, percent, paired t-test, t-test and oneway ANOVA. The results obtained were as follows : 1. The mean score of recognition in IV therapy management was significantly higher than that of performance(t=5.86, P<.001). 2. The items of lower than mean score of each fields in performance were the identification of drugs, hands washing, patient teaching about medication, disinfectional methods of the injection site and the rubber stopper in bottle, the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, use of tape and armboard, changing the IV tubing, labeling the dressing over the injection site, observation and recordings of patient's condition after medication and confirmation of the needle length at the needle removal. 3. The factors of hindrance in IV therapy were 'having no time', 'insufficiency of goods', 'unknowing of methods', 'no disadvantage', and 'factors of doctor's doing'. The most important factor was 'have no time', especially item of hands washing. The other factors of hindrance showed high frequency in the following items ; 'insufficiency of goods' in the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, 'unknowing of methods' in the certification of drugs compatibility, 'no disadvantage' in the labeling the dressing over the injection site, and 'factors of doctor's doing' in the changing the subclavian catheter dressing and checking the glucose level during the TPN infusion. In conclusion, there is necessity of educational program which can improve the nurse's knowledge of drugs, disinfection methods, comfort of patient and recordings in IV therapy management and alternative plan which are political and financial aids such as setting up the sink, giving of paper towels and necessary goods in the IV therapy for reducing the factors of hindrance for IV therapy management.

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Civil Law Study on the Arbitrary Uninsured Medical Benefits (임의비급여 진료행위에 관한 민사법적 검토)

  • Bae, Byungil
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.75-103
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    • 2017
  • There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

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A Study of father's care giving in infancy (아버지의 영아 돌봄에 관한 문헌연구)

  • Kim, Young-Hee
    • Korean Parent-Child Health Journal
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    • v.1
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    • pp.75-87
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    • 1998
  • These days social and economical changes have influence on the structure of family and the role of family members. Working mothers and widowers with children are increasing because of economical difficulties. Support from relatives are decreasing because of the conspicuous trend toward nuclear families. According to these reasons androgynous fathers are required. Today's fathers in Korea socially and culturally have learned about traditional parenting, but they are changing their fathering styles to meet the demands of the times. However they don't have their own fathering models. Therefore nurses who hold an advantageous position to teach and support from clinic have to encourage them to care their infants. The purposes of this study were to define father's care giving in infancy, understand influencing factors on fathering, and the differences between fathering and mothering, then contribute to nursing implementation for supporting fathers. This study was designed to review references about father's care giving. The results were follows: Six aspects of parent participation were direct care. indirect care, play, decision-making concerning the child, amount of time of sole responsibility for the child and overall availability to the child. Direct care involved feeding, bathing, going to child if child awakens. dressing, putting child to bed, taking child to doctor, nurse, or dentist, transporting child to and from sitter, day care, or school, washing child's hair. Indirect care involved cleaning up after child, preparing child's food, fixing child's broken playthings, washing child's clothes, arranging baby-sitting, shopping for child's toys and clothes, transporting baby-sitter to and from your home. Young fathers were gradually participating in direct care like feeding, taking child to doctor. Father's care giving stimulated mothering and promoted parent-infant relationship. Influencing factors of fathering would be divided into father characteristics, surrounding factors, infant attributes. Father characteristics were age, role perception, relationship with parent. Surrounding factors were the opportunity of early contact, support system, spouse's expectation, marital adjustment, feeding type, past experience of care giving. Infant attributes were temperament, behavior, age, sex. The differences between fathering and mothering were reviewed. Fathers were poor at care giving. but their caring was similar to mother's. This subtle difference positively worked upon infant's growth and development. On the basis of these theoretical data, nurses can empower fathers to cooperate with mothers in caring infants.

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Oral health and behavior by diabetic status: the fifth Korea national health and nutrition examination survey (당뇨상태에 따른 구강상태 및 행태: 제5기 국민건강영양조사)

  • Han, Yeo-Jung;Han, Mi Ah
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.233-240
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    • 2016
  • Objectives: The aim of this study was to evaluate the oral health status and behavior in Korean diabetic adults. Methods: The study subjects were 11,840 adults who participated in the fifth Korea National Health and Nutrition Examination Survey(2010-2012). Diabetic status was defined by doctors and fasting blood sugar(FBS) level. Oral health status was assessed by decayed-missing-filled teeth(DMFT), community periodontal index(CPI), periodontal disease, denture needs, limitation of oral function, and chewing difficulty. The oral health behavior was evaluated by oral examination within a year, brushing times a day, and use of auxiliary oral product. The data were analyzed by descriptive analysis, chi-square tests and multiple logistic regression analyses. Results: The prevalence rate of diabetes mellitus diagnosed by doctor and FBS was 8.3% and 10.2%, respectively. The prevalence rate of periodontitis was 25.4%. The proportions of $DMFT{\geq}20$, $CPI{\geq}3$, periodontal disease, denture needs, oral function limitation and chewing difficulty in the confirmed diabetic group by doctor were significantly higher than those of the non-diabetic group(p<0.05). In multiple logistic regression analysis, the adjusted odds ratio(aOR) for periodontal disease(aOR=1.73, 95% CI=1.41-2.12), presence of denture needs(aOR=1.40, 95% CI=1.06-1.84), limited oral function(aOR=1.43, 95% CI=1.15-1.78) and chewing difficulty(aOR=1.41 95% CI=1.13-1.77) in diabetic subjects were significantly higher than those of the non-diabetic subjects. There were similar associations between diabetes defined with FBS and oral health. In oral health behavior, diabetic subjects had significantly lower odds ratios for oral examination(aOR=0.76, 95% CI=0.60-0.98), brushing time ${\geq}2$ times(aOR=0.73, 95% CI=0.57-0.93), and auxiliary oral products(aOR=0.74, 95% CI=0.59-0.94). Conclusions: There was a significant relationship between oral health status and behavior in Korean diabetic adults. Further study is needed to evaluate the underlying mechanisms between diabetes mellitus and oral health status.

Comparative Study on Maternal Health Status With Island and Land Women in A Middle City Area (중도시내(中都市內) 도서(島嶼)와 육지거주부인(陸地居住婦人)의 모성보건실태비교(母性保健實態比較))

  • Kim, Kyu-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.65-75
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    • 1976
  • To compare the maternal health status between women in island and land, the study was conducted to adjacent land (kukdong) and island (kyonghodong) areas in Yosoo city during April 1976. The results obtained from 174 interviewee in island and 192 in land areas were the same as follow, 1. General characteristics of both area. Age: Land, group 20-29 year of age was the largest. Island, 30-39 year of age was the largest. Education; Low educated group, less than primary grade (land 88.6%, island 93.1%), was predominant in both area. Occupation of herself; agriculture and labor was the main occupation (land 50%, island 82.2%) in both area. Occupation of husband: labor and fishery was general (81.2%) in land, and agriculture and fishery was general (81.6%) in island. Duration of residence; Land, 25.0% being resided here more than 10 years. Island, 64.3% being resided here more than 10 years. 2. Marriage, Pregnancy, and Present children. Average age at marriage; Land, 20.7 years. Island, 20.9 years. Average frequency of pregnancy; Land, 4.4 times. Island, 4.3 times. Wastage of pregnancies: Land, 236 per 1000 pregnancies. Island, 151 per 1000 pregnancies. Wastage occupied by induced abortion; land, 73.5%. island, 60.5%. Number and sex of present children; Land, 3.3 per family, sex ratio 52.4 to 47.6. Island, 3.6 per family, sex ratio 53.3 to 46.7. 3. Prenatal and postnatal care. Prenatal consutation: Land, 16.1% received by doctor or midwife. Island 9.2% received by doctor or midwife. Complications during last pregnancy; Land, 46.6% complained. Island, 51.1% complained. Return to work within 1 week after delivery; Land, 40.6%. Island, 50.6%. 4. Delivery environment Home delivery; Land, 97.4% Island, 97.3%. Delivery attdended by non medical professions at home; Land, 80.2% Island, 93.7%. Solo home delivery; Land, 13.0%, Island, 12.9%. Delivery attended by layman without taking any disinfective preparations; Land, 48.1%, Island, 49.1%. Material mainly used to cut umbilical cord at home; Land, scissors (97.4%). Island, scissora (98.8%). Cord cutting material used without giving any disinfective preparations; Land, 79.9%, Island, 84.0%. Delivery sheets used at home; Cement bag paper (land 50.0%, island, 31.3%). Vinyl sheets (land,17.5%, island, 27.6%). News paper (land, 3.2%. island, 11.7%). No sheets (land 19.5%. island, 12.9%). etc. Maternal Meal; Seaweed soup with rice was the most general in both area. (land 95.3%, island, 91.4%).

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A Study on the Factors Giving Effects to Patient's Satisfaction in the Selection of Implant Operation (임플란트 시술선택에 있어 환자 만족도에 영향을 미치는 요인)

  • Kim, Gi-Ug;Choi, Sung-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4354-4359
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    • 2010
  • The study performed questionnaire to the patients receiving implant operation, who visited dental clinics and hospitals(2 hospitals and 5 clinics) from Jul. 1, 2009 to Sep. 12, 2009 in order to study the factors giving effects to patient's satisfaction in the selection of implant. 145 questionnaire papers collected from patients were analyzed with SPSS12.0 program. The result revealed that the satisfaction with implant operation was usually normal when implant was operated because of tooth extraction due to dental caries and periodontal disease and it was usually high when implant was operated because of wound(P<0.05). When considering each cause of tooth extraction, the satisfaction with pronunciation function was usually normal(P<0.001), the satisfaction with functional part including foreign body sense was very low when the cause of operation was periodontal disease(P<0.01). The satisfaction with hospital environment depending on the cause of hospital selection was usually high when hospital was selected because of doctor's fame. It was low when hospital was selected because it was close to home(P<0.001). The satisfaction with the number of hospital visits depending on the number of implanted teeth was usually low when many teeth were implanted(P<0.01). The analysis on the satisfaction with tooth shape and color showed that the satisfaction was high when '1~2' teeth and 'more than 6' teeth were implanted(P<0.05). In order to improve patient's satisfaction with implant, it is necessary to recognize individual's oral status and request correctly. It is determined that proposal of operation period, number of hospital visits, function and expected aesthetic satisfaction degree will contribute to the improvement of mutual reliance between doctor and patient and post-operation satisfaction degree.

Student Satisfaction and Achievement after Role-playing in a Pediatric Dentistry Class (소아치과 역할극 수업에 대한 학생들의 만족도와 성취도)

  • Kim, Min Jin;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.280-289
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    • 2018
  • This study aimed to investigate the effects of learning with role-playing on student satisfaction and achievement regarding behavior management teaching in pediatric dentistry. 93 students were divided into 19 groups and randomly assigned to role-play as a doctor, patient, parent, assistant, or narrator. Their performances were evaluated by the instructor and the satisfaction survey was conducted. All participants took the written test and were asked to compare lecture and role-playing with regard to the effectiveness of learning. Statistical analysis was performed with Mann-Whitney U test, Independent T-test, and Kruskal-Wallis test. 68 students (73.1%) who believed that the role-playing was more helpful than lecture showed higher level of satisfaction than students who believed lecture was more helpful. But there were no differences in the tutor evaluation score and the written test scores. Participants in the patient management scenario showed higher level of descriptive question scores of the written test and tutor evaluation score than those who participate in the parent management scenario. There were no differences between the role groups. Role-playing may help students to become more interested and participatory in learning behavior management. The level of satisfaction may differ by the design and content of the scenario.

The Levels of Psychosocial Stress, Job Stress and Related Factors of Medical Doctors Practicing at Local Clinics (일부 개원의사들의 사회심리적 스트레스 및 직무 스트레스 관련 요인)

  • Kang, Moon-Kuk;Kim, Jang-Rak;Jeong, Baek-Geun;Park, Ki-Soo;Kam, Sin;Hong, Dae-Yong;Kang, Yune-Sik
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.2
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    • pp.177-184
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    • 2007
  • Objectives : This study was conducted to investigate the levels of psychosocial stress, job stress and their related factors among medical doctors practicing at local clinics. Methods : A survey using a self administered questionnaire was administered to 1,456 doctors practicing at private clinics via post for 2 months (2006. 1 - 2006. 3). Psychosocial stress, job stress, demographic factors, job related factors and health related behaviors were investigated. Among the eligible study population, the respondents were 428 doctors (29.4%). Results : The average scores of psychosocial stress and job stress were 2.19 and 3.13, respectively. The levels of psychosocial stress and job stress were statistically lower in older respondents, those who worked shorter or who were more satisfied with their job, and those with higher socioeconomic status. The level of psychosocial stress was related with smoking status, drinking status and exercise. The level of job stress was related with smoking status and exercise. In multiple linear regression analysis using psychosocial stress as a dependent variable, age, working hours per day, job satisfaction and perception on socioeconomic status were significant independent variables. In analysis using job stress as a dependent variable, age, working hours per day and job satisfaction were significant independent variables. Conclusions : Stress affects the doctor-patient relationship, productivity and overall health level of people. Therefore, it is important to manage and relieve the stress of doctors. It is suggested that more advanced studies on stress level and related factors and ways to improve the stress and health related behaviors of medical doctors should be conducted.