• 의학교육논단
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• 제26권2호
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• pp.140-154
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• 2024

A physician's empathy plays a crucial role in patient-centered care, and in modern medicine, patients, their caregivers, and society demand a high level of empathy from healthcare providers. The conceptualization of clinical empathy, which has emphasized cognitive empathy since the mid-20th century, has been widely accepted in medical schools and the healthcare industry without much critical ref lection. This study provides an overview of the ongoing debates on empathy versus sympathy and cognitive empathy versus affective empathy to clarify the concept of empathy. Based on recent research findings, clinical empathy is proposed to encompass three components: cognitive empathy, affective empathy, and empathic motivation. It is suggested that fully demonstrating these components requires empathic communication skills. Additionally, the cognitive characteristics of medical students and the features of the academic environment demonstrate the need for education to strengthen their empathy skills. Considering this, proposed intervention methods that medical schools can consider include utilizing tutoring programs and debriefing processes for team activities, which can facilitate problem-solving as a coping strategy for stress. Learning communities can create an environment where students can receive social support and recover from stress. Medical schools can contribute to the development of students' professional identities as practicing clinicians who embody empathy and respect by cultivating professors as positive role models. Additionally, utilizing scales to assess the empathic nature of doctor-patient communication or incorporating patients and caregivers as evaluators can actively improve empathic communication skills.

• 한국간호교육학회지
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• 제5권1호
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• pp.97-105
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• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

• 과학기술학연구
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• 제18권3호
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• pp.1-45
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• 2018

한국은 최근 세계 임상시험 중심지의 하나로 떠올랐다. 임상시험을 가장 많이 한 국가 순위에서 미국과 독일 등 전통적 제약 강국에 이어 6위를 차지했고, 도시별 순위에선 서울이 1위 자리에 올랐다. 이 논문은 한국에서 임상시험이 급격하게 증가한 배경으로 수요공급의 시장 메카니즘 외에 다른 요인, 즉 정부의 임상시험 산업화 정책이 중요했음을 보일 것이다. 1990년대 말 금융위기 이후 정부는 바이오테크놀로지(BT)를 차세대 국가 성장 동력으로 정하고 이를 위한 정책개발에 심혈을 기울였다. 바로 이러한 맥락에서 다국적 제약사의 임상시험을 국내에 유치하고 이 분야를 키울 계획을 세우게 된 것이다. 정부가 제도정비, 인프라 구축, 관련 인력 양성 및 국민의식 개선 등의 작업을 수행하는 가운데, 해외 CRO(Contract Research Organization: 임상시험수탁기관)가 들어와 사업을 시작했고, 국내 업체들도 생겨났다. 한국에서 임상시험은 정부에 의해 '초대?된 것이다. 이 논문은 한국의 임상시험 산업화 과정 속에 묻혀있는 생명윤리의 문제를 끄집어내 다루고자 한다. 이를 위해 최근 인류학과 과학기술학에서 논의되고 있는 ??생명자본?? (biocapital)과 ??윤리 가변성??(ethical variability)의 개념을 활용하여, 임상시험을 둘러싼 주요 행위자인 정부 담당자, CRO 직원, 병원 의료진, 환자 등이 실제로 어떤 동기와 목적을 가지고 여기에 참여했는지를 사회 구조적 관점에서 분석할 것이다. 임상시험 참여자의 동의서를 받고, IRB의 심의를 통과하고, 국제기준을 충분히 만족시킨다고 해도, 실제 상황에선 생명윤리의 원칙이 무시될 여지는 충분히 있고, 국가의 산업육성 프레임 안에서 생명윤리는 관련 서류를 갖추면 되는 절차상의 문제로 환원될 수 있음을 보일 것이다.

• 동의생리병리학회지
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• 제32권2호
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• pp.134-140
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• 2018

This study aims to evaluate healthcare providers' satisfaction and demands pertaining to the collaborative first-stage pilot project between Korean medicine and Western medicine. This survey was conducted via electronic mail among 33 healthcare providers participating in the pilot project. Likert type 5-point scale or Likert type 7-point scale was used to evaluate each item. The response of '${\geq}4$' on the 5-point scale, and '${\geq}5$' on the 7-point scale were analyzed as positive answers. A total of 27 healthcare providers (81.8%) responded, of which 9 were western medical doctors (33.3%) and 18 were Korean medical doctors (66.7%). In respect to satisfaction of the pilot project, 88.9% gave positive responses on improved patients' convenience, 59.3% on treatment efficiency and 55.6% on diagnosis efficiency. In terms of self-evaluation on the pilot project, 70.4% gave positive answers on changes in quality of collaborative treatment, 74.1% on cooperation of results, 63.0% on cooperation of structure and 51.9% on cooperation of process. In terms of demand for collaborative treatment or the pilot project, 'standardized manual' and 'simplification of administrative procedures' showed highest demand, resulting up to 88.9%, followed by 85.2% demanding more public relations and 63.9% demanding enlargement of participating hospitals. This survey revealed that healthcare providers are generally satisfied with patients' convenience and treatment effects. Further studies are needed to develop a standardized manual, simplified administrative procedures, and expanded pilot project contents.

• 대한치과보철학회지
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• 제42권2호
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• pp.142-153
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• 2004

Statement of problem: Increasing demand of esthetic restorations made lots of kinds of ceramic materials. Among them, zirconia has been being focused by many dentists. But, mechanical properties of zirconia were still unclear. Purpose : The purposes of this study were to analyze the flexural strength of various zirconia ceramics which had been currently used for clinic i.e., In-Ceram Zirconia(Vita Zahnfabrik, Bad $S\"{a}ckingen$, Germany), Celay Zirconia(Vita Zahnfabrik, Bad $S\"{a}ckingen$, Germany) and CAD/CAM Zirconia (Adens Zi-Ceram. Seoul , Korea). Material and methods: The four point bending test(ASTM Cl161) was used to measure the flexural strength of a specimen before and after circular heat treatment and fatigue loading. Results : 1. The average value of flexural strengths of CAD/CAM Zirconia, Celay Zirconia, In-Ceram Zirconia in dry condition were 806.5 MPa, 669.9 MPa, 605.6 MPa, respectively. There was a statistically significant difference in strength among the types (P<0.05). 2. After thermocycling, the average flexural strengths of CAD/CAM Zirconia, Celay Zirconia, In-Ceram Zirconia were 791.2 MPa, 604.2 MPa, 605.4 MPa, respectively. CAD/CAM Zirconia showed statistically significant higher strength(P<0.05). The others showed no significant difference after thermocycling(P>0.05). 3. After fatigue loading in wet condition. the average flexural strengths of CAD/CAM Zirconia, Celay Zirconia, In-Ceram Zirconia were 806.0 MPa, 674.9 MPa, 601.7 MPa, respectively. There was a significant difference in strength among the types(P<0.05). 4. There was no statistically significant difference in strength of the specimens according to experimental methods except for before and after thermocycling in Celay Zirconia(P>0.05). Conclusion: Besides high esthetic quality, zirconia had sufficiently high mechanical strength.

• Journal of Chest Surgery
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• 제25권3호
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• pp.307-314
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• 1992

The internal mammary artery has been advocated for use in bypass grafting owing to its superior long-term patency when compared to saphenous vein grafts. Concern exists that the flow through internal mammary artery may be inadequate during periods of peak myocardial demand when the internal mammary artery graft was used for proximal left anterior descending artery stenosis. This flow adequacy was investigated in 13 consecutive patients with a mean proximal left anterior descending artery stenosis of 84.2% who were selected for coronary bypass using internal mammary artery. We checked flow and diameter of left internal mammary artery without intraluminal dilatation just before anastomosis to left anterior descending artery during cardiopulmonary bypass. Clinical results were evaluated postoperatively with clinical symptoms, echocardiographies, stress tests, and coronary angiographies. The mean internal mammary artery flow measured just before anastomosis was 38ml/ min[range of 20 to 80ml /min] and its mean internal diameter 1.4mm. Maximal workload was improved from preoperative value of 6.3$\pm$2.5METS to postoperative value of 9.1$\pm$1.4 METS in 9 patients who Paired-test can be used. Cardiac symptoms recurred in two patients after bypass surgery, but they were not related to left internal mammary artery grafts. All patients were discharged in postoperatively 9.3 days[range of 7 to 20 days] after operation without mortality. Thus, on the basis of these findings, the internal mammary artery is a reasonable graft that we can routinely use for proximal left descending artery stenosis if internal diameter of the internal mammary artery is more than 1.0mm and its flow is more than 20ml /min at mean arterial pressure of 50 to 60mmHg during cardiopulmonary bypass.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2007년도 추계 종합학술대회 논문집
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• pp.457-461
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• 2007

레이저 슬라이드 마킹 시스템은 기존의 수작업으로 수행하던 작업 공정을 대체할 수 있으므로 병원의 임상병리과 등 관련 전문가들이 적극적으로 도입을 검토하고 있다. 현재 국내 병원에서는 IT기술의 발달로 각종 진단 결과의 처리에서 병원 내의 물류에 이르기까지 다양한 분야에서 전산화가 이루어지고 있다. 이에 따라 각종 검사 업무를 담당하고 있는 임상병리 부서에서도 검사 장비의 전산화, 자동화의 노력이 진행되고 있으며, 검사 업무의 핵심장비인 레이저 슬라이드 마킹 시스템을 도입하여 사용하려는 수요가 증가하고 있다. 레이저 슬라이드 마킹 시스템의 국내 시장규모는 2008년 2억5천만원이고, 2012년 17억5천만원으로 예상된다. 레이저 슬라이드 마킹 시스템은 2005년도에 국내에 처음으로 도입되었고, 제품수명 주기상 도입기에 해당하며, 향후 성장 가능성이 매우 높을 것으로 전망된다.

• 대한의생명과학회지
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• 제26권3호
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• pp.157-163
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• 2020

Long-term exposure to environmental pollutants can impair the human skin's barrier function and promote skin aging mechanisms. The visible consequences of these effects are dryness, wrinkles, black spots and worsening skin sensitivity. As awareness of the effects of environmental stressors on the skin has recently increased, consumers' demand for cosmetics that can provide anti-pollution effects is increasing. In this study, the possibility of anti-pollution cosmetic material was investigated by measuring the inhibitory effect of free radicals using a mixture of Nypa fruticans Wurmb (NF), Saussurea neoserrata (SN), Codium fragile (CF) and Enteromorpha compressa (EC), which has anti-inflammatory and antioxidant effects against irritation caused by dust. Combining the experimental results of a mixture of NF, SN, CF and EC by induction of fine dust stimulation, inhibition of inflammatory factors (PGE₂) and intracellular free radicals (ROS) by inhibiting effects were significant, indicating the possibility of use as anti-pollution cosmetics. The most plants used as sources of anti-pollution cosmetic ingredients contain antioxidants as active substances. In our highly industrialized and chemically polluted world, it is not surprising that most plants used as sources of anti-pollution cosmetic ingredients contain antioxidants as active substances. Considering our results, it can be suggested that this anti-pollutant consisting of NF, SN, CF and EC may be a good ingredient for skincare products for the cosmetic industry due to their antioxidant properties, which may especially alter skin aging.

• Physical Therapy Rehabilitation Science
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• 제8권1호
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• pp.22-31
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• 2019

Objective: For knee osteoarthritis (OA), there is a demand for alternative modalities in order to delay surgery and to avoid the side effects of medications. This study compared the effects of applying seaweed pack and mudpack for the treatment of knee OA. Design: Randomized controlled trial. Methods: Twenty-five patients with knee OA who satisfied the criteria were included. The patients were divided into two groups according to the treatment method: mudpack (n=12) and seaweed pack (n=13). The two groups were treated for 20 minutes, twice a day for five continuous days at the Ocean Healing Center at Wando Island, South Korea. Participants were assessed by clinical scores (Western Ontario and McMaster Universities Osteoarthritis Index, Hospital for Special Surgery Knee Score, Knee injury and Osteoarthritis Outcome Score and 36-Item Short Form Health Survey) and lab results (erythrocyte sedimentation rate, C-reactive protein, insulin-like growth factor-1 [IGF-1], tumor necrosis $factor-{\alpha}$ [$TNF-{\alpha}$]) during the follow-up period. Results: For the most part, clinical scores improved after therapy and maintained improvements for four weeks in both groups (p<0.05). In the seaweed group, $TNF-{\alpha}$ was significantly decreased at two weeks post-therapy (p<0.05). In both groups, IGF-1 was significantly increased immediately post-therapy (p<0.05). There were no statistically significant differences after therapy between the groups in clinical scores and labs. Conclusions: Seaweed packs and mudpacks had similar positive effects for knee OA. Additionally, the seaweed pack group showed decreased levels of $TNF-{\alpha}$ at two weeks post-treatment, which may explain the reduced inflammatory reaction. For rehabilitation therapy, use of seaweed packs may serve as an alternative modality for the treatment of knee OA.

• 한국간호교육학회지
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• 제27권3호
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• pp.227-239
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• 2021

Purpose: This study used an exploratory sequential approach (mixed methods) design to explore essential meaning through comparing and analyzing the experiences of nursing students in virtual simulation practice and high fidelity simulation practice education in parallel. Methods: The study participants were 20 nursing students, and data were collected through focus group meetings from July 17 to August 5, 2020, and via online quantitative data from November 10 to November 15, 2020. The qualitative data were analyzed using Giorgi's phenomenological method, and the quantitative data were analyzed using descriptive statistics, the Mann-Whitney U test, Kruskal-Wallis H test analysis of variance and Spearman's ρ correlation. Results: The comparison between the two simulation training experiences was shown in five contextual structures, as follows: (1) reflection of the clinical field, (2) thinking theorem vs. thinking expansion, (3) individual-centered learning vs. team-centered learning, (4) attitudes toward participating in practical training, (5) metacognition of personal competency as a prospective nurse, and (6) revisiting the method of practice training. There was a positive correlation between satisfaction with the practice and the clinical judgment ability of high fidelity simulation, which was statistically significant (r=.47, p=.036). Conclusion: Comparing the experiences between virtual simulation practice training and high fidelity simulation practice training, which has increased in demand due to the Coronavirus Disease-2019 pandemic, is meaningful as it provides practical data for introspection and reflection on in-campus clinical education.