• 의학교육논단
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• 제19권3호
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• pp.152-157
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• 2017

Interprofessional education (IPE) fosters effective team-based collaborative practice among members of different health care professions to advance high-quality and safe patient care. Although the importance of IPE has been recognized and IPE initiatives have expanded rapidly in the past decades, substantial difficulties in IPE assessment still exist. At present, a lack of consensus on the optimal approach to IPE assessment contributes to uncertainty about the level of attainment of collaborative team performance. This paper aims to provide an overview of the benefits and current challenges associated with IPE assessment. Furthermore, a multifactor model with an assessment matrix and assessment blueprints from a recent study is briefly discussed. We also provide examples of assessment blueprints for the team management of stroke patient discharge covering a competency examination at the levels of individuals, the team, and the task.

• 한국병원경영학회지
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• 제23권1호
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• pp.78-86
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• 2018

Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

• 대한물리치료과학회지
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• 제16권3호
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• pp.43-53
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• 2009

Background: The purpose of this study was to investigate the perception of home care team's home based physical therapy in public health center Method: We surveyed 11 questionnaires for hone care team in health center from 1st to 30th, November in 2008. Results: The person who recognized the exclusion fact of home-based physical therapy in long term care insurance was 64.2% in whole 109 people. About necessity of home-based physical therapy, "absolutely necessary" as the person answer was 43.1%. Home-based physical therapy in the insurance must come to be provided with a precedence was 81.3%. About starting time of hereafter home-based physical therapy "after 1 years" the opinion which was 60.7%. Opinion about operation institution of home-based physical therapy "the pubic hospital or health center" was 52.3%. In composition form of the home-based physical therapy team "with the physical therapist and occupation therapist come together" was investigated with 37.4%. Conclusion: As long term care insurance will be developed, discussion about quality- of-service must be continuous and depth. Relates hereupon, the academic, researchers, and the persons concerned must consider the best quality of life improvement of the citizen and prepare the ground which systemic, rational, and actual on starting of home-based physical therapy in long term care insurance.

• 통합자연과학논문집
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• 제15권2호
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• pp.55-61
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• 2022

Recently people require complex access to problems in various fields of health, medical and welfare by an aging society. For this reason, the need for interprofessional education is required at the site of university education. This study was conducted to investigate the effect of interprofessional education (IPE) on attitudes towards health care teams. The subjects were 29 sophomores in the fields of health, medical and welfare in a university. Attitudes Towards Health Care Teams Scale (ATHCT) was used to measure the attitudes towards health care teams of subjects. The subjects were provided with a IPE program. The collected data were analyzed by descriptive analysis and paired t-test using the SPSS 26.0 version program. The attitudes towards health care teams of subjects increased significantly after IPE education (t=-4.28, p<.001). And there were significant differences in the three sub-factors of attitudes towards health care teams (Team efficacy, t=-4.44, p<.001; Benefit of communication, t=-3.30, p=.003; Team value, t=-3.21, p=.003). Therefore, the IPE program is considered to be an effective education program to improve attitudes towards health care teams.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.1-12
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• 2021

Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master's-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

• 한국의료질향상학회지
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• 제10권2호
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2933-2934
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• 2014

Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

• 한국의료질향상학회지
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• 제27권2호
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• pp.18-29
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• 2021

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.

• 한국보건간호학회지
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• 제4권2호
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• pp.79-99
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• 1990

This study was conducted to identify the family problems of the in-patients and to analize factors Influencing to the family problems. The subjects for this study were 277 family members those who were giving care for the adult patients during hospitalized in general wards at Seoul National University Hospital in Seoul. Data were collected through interviews with the questionnaire from September second to September twentieth in 1989. The instrument used for this study was the family problems scale which was developed by the researcher. Analysis of data was done by frequency, percent, mean, t-test, ANOVA, Pearson-Correlation Coefficients, and Stepwise Multiple Regression Analysis. The results of this study are summarized as follows: 1. General characteristics of the care-giver in family. The average age of care-givers was 37.9 years, and the $26.4\%$ of monthly Income of family was 310,000-500,000 won group. The $93.5\%$ of family had taken the responsibility of caring for the patients instead of hiring the care-givers, and the $12.3\%$of the care-givers complained weakning of health status during care giving for the patients. The spouse took the largest part of responsibility of the care-giving services to the patient among the family members. 2. General characteristics of the patients. The average age of patient was 47 years, and the $80.9\%$ of patient was married status. The $39\%$ of patient was father in the position of family, and the $41.5\%$ had the responsibility to support their family before hospitalization. The average hospitalization period of patient was 24.3 day and the $50.9\%$ had admission experience. 3. The factors of family problems which were faced by the family were classified into six problems. The factors of family problems were ranked as follows; the first rank problem was related to care-giving for the patients. the second problem was resulted from the patients diseases, the theirds problem was related with adaptation to the hospital enviroments, the fourth problem was related to the arisen conflicts with medical team. the fifth problem was related to the change of family function. and the sixth problem was the financial problem. 4. The relationship between the family problems and the general charateristics of the care-givers showed that the nuclear type family was higher the family problems, that the admission period of patients became longer, and that the family who had the worse condition of health status of the care givers during care giving for the patients. From the above results, it was confirmed that the family care giving for patients was faced with some problems resulted from patient's illness, relation to the medical team, adaptation to the hospital enviroment, financial problem. change of family function, and care-giving for patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6941-6945
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• 2015

Background: Awareness and attitudes of nurses regarding end of life care are important factors in providing hospice care. In an extensive literature review, we found no related articles investigating Iranian nurses awareness and attitudes about providing such care. Objectives: The aims of this study were to investigate the awareness and attitudes of Iranian nurses in providing hospice care. Materials and Methods: In this descriptive-correlational study, 240 nurses employed in six educational centers were selected by non-randomized stratified sampling. The data collection instruments included an awareness test and attitudes regarding providing end of life care in hospice questionnaire. The data were analyzed using descriptive statistics and independent sample t-tests, one-way ANOVA, and Pearson correlation tests. Results: The nurses' awareness score was 14.3 out of 29 and 55.7% of them stated that they had not received any education in providing end of life care. Also, by obtaining the score of 91.7 out of 120 the attitudes of participants in providing end of life care in hospices were positive. In addition, the highest attitudes score of nurses were in the dimensions of benefits of implementation and health care team. Conclusions: Considering low awareness of nurses about end of life care in hospices, continuing education should be provided for them in this regard. Especially, by considering the positive attitude of nurses, providing such programs could help develop hospice care in Iran.