• 제목/요약/키워드: consultation

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정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 정신사회적 측면 - (Therapeutic Approaches to the Patients Who were Referred for Psychiatric Consultation from Medical Departments - Psychosocial Aspects in Consultation-liaison Psychiatry -)

  • 박종철
    • 정신신체의학
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    • 제1권1호
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    • pp.98-100
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    • 1993
  • To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

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치과의원의 건강보험 진료비 수입분포와 관련요인 (Distribution of Dental Clinic's Income from Health Insurance)

  • 박재용;김준수;한창현
    • 보건행정학회지
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    • 제12권1호
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    • pp.84-101
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    • 2002
  • This study collected and analyzed the datum related to consultation fee in National Health Insurance Corporation and characteristics of dental clinics for 819 dental clinics in Daegu and Kyungpook districts to specify the distribution and concentration rate of health insurance consultation fee and the critical elements of insurance consultation fee income. The average health insurance consultation fee per one dental clinics is 77.2 million won and the case of women dentists is 78.7 million won. That is higher than 79.9 million won that the case of man dentist. According to age, under 39 is 85.5 million won that is highest, declining little by little above 60s the number decreased to merely 23.9 million won. And the dentists whose business years from 5 to 10 are the highest and declining gradually. The more of engaging members to dental clinics is the larger the income. The average insurance consultation fee of Daegu province is 69.3 million won, but that of Kyungpook is 89.6 million won. Decile distribution ratio of dental clinics consultation fee income is 0.526 and Gini coefficient is 0.303. Decile distribution ratio of Daegu district is 0.489, Gini coefficient is 0.320. This explain the larger inequality compared with Kyungpook(0.623, 0.273). With age, Gini coefficient of below 39 is 0.260, the higher age is, the larger the number is, up to abode 60 the coefficient is 0.504, the degree of inequality is most extremely. insurance consultation fee and the number of cases of consultation is related to the age of dentists, duration of practice, the number of dentists and staffs engaging and provinces. That is, the lesser the age is, the longer the years of engaging are, the more the number of dentists and staffs we, the larger insurance consultation fee income and the number of cases of consultations we. And the fee fur one case is closely related to age and provinces. The fee for one case is higher in lower age, and that of in Daegu dental clinics is higher than in Kyungpook.

서울시 거주자의 주택상담과 자료 요구도에 관한 연구 (Needs for the Housing Consultation and Information about Housing in Seoul Area)

  • 강순주
    • 가정과삶의질연구
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    • 제16권2호
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    • pp.71-82
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    • 1998
  • This study aimed to aimed to obtain some basis data for the housing consultation and information about housing through survey of needs for the housing consultation. Respondents were housewives from 395 households living in Seoul area. Questionnaire was used for survey and the collected data were classified by two items such as types of residence and age of housewives. The survey was performed during two weeks in September 1997 and analyzed by frequency mean and percentage using SAS program The finding are as follows; (1) According to the actual conditions of housing consultation the main source of information related to housing was a newspaper Those who had experience detached house had much more opportunities than those of multi-family house. The most frequent agency for housing consultation was a realty dealer showing 65.8%. However the percentage of visiting permanent housing exhibition centers was high among the people aged 20 to 30, noted 20.4%. (2) Level of understanding housing consultation showed 3.45 points among 5. This result indicated that the service system of housing consultation were required. Architects and interior designers were most preferred as specialists whom the respondents wanted to consult with . As to the contents of consultation the most required item was changing of interior space(22.6%). In case the housing information leaflet is sold the respondents were willing to pay 523 won for each of it. (3) Among leaflets related to various information leaflets about housing purchase were most preferred(21.0%) According to the result of the survey the need for the information about housing purchase indicated higher preference than about housing management. The fact could be thought that consumers' consciousness of housing should be changed. Therefore it is desirable to lead consumers to lengthen the expected life span of their house and value happiness of the house by providing them with consulting systems about housing management throug housing consultation materials and development of its programs.

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신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로 (Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry)

  • 류성곤;권희정
    • 정신신체의학
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    • 제16권1호
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    • pp.25-30
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    • 2008
  • 최근 노인인구의 급속한 증가로 인하여 정신과에서 노인에 대한 자문의 중요성이 확대되고 있다. 따라서 임상에서의 노인에 대한 정신과 자문의 특징과 지침에 대한 이해가 필요하다. 타과적 질환을 갖는 노인에 대한 정신과적 자문은 다른 연령층과는 다른 특성을 갖는다. 노화에 따른 장기 기능의 변화와 약동학 및 약력학의 변화에 대한 숙지가 노인에 대한 정신약물학적 접근에 매우 필수적이다. 타 연령층에 비해 노인에 대한 정신과적 자문은 상대적으로 적은 것으로 조사되었으나 실제 정신과적 자문이 노인질환의 재원기간이나 기타 사망률 등을 낮출 수 있음을 고려할 때, 노인에 대한 자문을 저해하는 요인들을 분석하고 교정하는 것이 매우 필요하다.

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정신과 자문이 의뢰된 내과 환자들의 추적치료 결정요인 (Significant Variables Affecting Follow-up after Psychiatric Consultation in General Medical Units)

  • 이상규;김도훈;손봉기
    • 정신신체의학
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    • 제6권2호
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    • pp.176-187
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    • 1998
  • This study was performed to identify the significant variables affecting Follow-up after psychiatric consultation in General medical units and the trends of psychiatric consultation at the Hallym University hospital in Chunchon. Subjects of this study were 107 patients from April 1, 1998 to August 31, 1998, who were referred for psychiatric consultation during hospitalization. The results were as follows ; 1) Referral rate of General medical units was 7.5% and ordered Gastroenterology, Cardiology, nephrology, Other part. 2) The rate of total follow-up was 58% and the rate of No-follow-up was 42%. 3) In the cases of referral timing over admission 8th days, the days hospitalized after consultation performed were lengthened, significantly. 4) Common reasons for no follow-up of consultation were 'early- discharge' and 'patient's unwillingness to psychiatric reconsult. 5) Significant variables affecting follow-up were 'treatment recommendation', 'concordance with psychiatric drug recommendation', 'concordance with laboratory recommendation', 'total days hospitalized', 'Days hospitalization after consult was performed' and 'referral reason'.

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환경영향평가 협의 시 대체서식지 조성을 위한 가이드라인 마련 (A Study on the Guidelines for Creating Alternative Habitats through Environmental Impact Assessment)

  • 심윤진;박용수
    • 한국환경복원기술학회지
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    • 제22권5호
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    • pp.69-79
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    • 2019
  • The purpose of this study is to suggest a guideline that can be used as a standard for consultation and review by environmental impact assessment consultation and review practitioner to enhance the practical effectiveness of creating alternative habitats. The consultation stage of environmental impact assessment was significantly divided into 1) preparation of draft environmental impact assessment reports and gathering of consensus thereon, 2) preparation of environmental impact assessment reports and consultation thereon, 3) follow-up survey of environmental impacts(under construction) and 4) follow-up survey of environmental impacts(in operation). And it was suggested that the procedures of creating alternative habitat by each consultation stage were linked in order of 1) planning, 2) designing, 3) construction, and 4) post-monitoring and maintenance. The basic principles were also proposed for each stage of consultation on environmental impact assessment and procedure for the creation of alternate habitats. Then, issues and methods to be reviewed by the consulting agency and review agency of environmental impact assessment were presented in detail. The guideline of this study provides important information not only to environmental impact assessment consultation and review practitioner, but also to developers and environmental impact assessment agents who plan, construct, and manage alternative habitats.

The Impact of Organizational Management Factors on Direct Employee Consultation in Distribution Channels

  • KIM, Seong-Gon;HONG, Seung-Hyun
    • 유통과학연구
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    • 제19권6호
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    • pp.21-28
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    • 2021
  • Purpose: Facing numerous challenges, organizational management is one of the most important research areas for organizations which handles workers' behaviors when they are within their workplace and organization to make more profits. The current research aims to analyze the effect of organizational management factors on direct employee consultation in distribution channels. Research design, data, and methodology: To achieve the purpose of the study and provide adequate empirical results, the current authors conducted the structural equation analysis using IBM AMOS 24.0 and collected 387 U.S employees in distribution channels (Wholesale and Retail shops). Results: Investigating the relationships between three organizational management factors and direct employee consultation, we found out that organizational practitioners in distribution channels face numerous challenges that must be resolved to ensure effective direct employee consultation to benefit employees. Empirical findings suggest that practitioners and leaders in distribution channels should focus on developing employee psychological management and utilizing direct employee consultation. Conclusions: In sum, the present research concludes that it must ensure that the employee in distribution channels should be a comfortable environment to appropriately respond to consultations. An approachable management team is ideal for employee consultations to find the right ways to keep employees at par with the consultation issues.

우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구 (A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms)

  • 윤나라;유승호;하지현;전홍준;박두흠
    • 정신신체의학
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    • 제29권1호
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    • pp.34-41
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    • 2021
  • 연구목적 본 연구는 우울 증상으로 정신건강의학과에 자문 의뢰된 환자들의 임상적 특징과 자문 의뢰 형태, 재협진 여부에 따른 차이를 알아봄으로써, 종합병원 입원환자의 우울장애의 특징을 조사하고자 하였다. 방 법 2005년 8월부터 2011년 12월까지 정신건강의학과에 자문 의뢰된 입원환자를 대상으로 하였고, 이중 우울증상으로 의뢰된 환자들의 의무기록을 후향적으로 분석하였다. 결 과 우울 증상으로 의뢰된 환자는 총 647명으로 전체 협진 중 13.82%에 해당하였다. 우울 증상으로 의뢰된 환자의 평균 나이는 58.6세로 전체 정신건강의학과에 협진 의뢰된 환자군의 평균 56.4세보다 높았으며, 3형 의뢰 형태(입원 이후 새롭게 발생한 정신건강의학과적 증상을 위한 협진 의뢰)가 가장 많았다. 이중 재협진 의뢰된 환자는 275명으로 전체의 42.5%였으며, 재협진군과 비재협진군을 비교해 보았을 때 통계적으로 유의미한 차이는 없었다. 그러나 자문 의뢰 형태에서 두 군의 산술적 차이가 있었는데, 재협진군은 3형(보수형)-2형(병렬형)-1형(상호보완형)의 빈도순을 보였고 반면, 비 재협진군은 2형(병렬형)-3형(보수형)-1형(상호보완형)의 빈도순을 보였다. 결 론 종합병원에서 우울 증상으로 의뢰된 환자군은 전체 정신건강의학과 협진 의뢰 환자 군에 비해 고령의 비율이 높았고, 그중 재협진군은 비재협진군에 비해 입원 이후 새롭게 증상이 발생하여 협진 의뢰된 비율이 높았다. 따라서 각 과 주치의들과 정신건강의학과 의사들은 입원환자들의 우울 증상에 주의를 기울이고, 적극적으로 치료계획을 논의함으로써 의료 서비스의 질을 향상시키고 위험 요인을 파악하여 필요하면 조기 개입할 수 있도록 노력해야 할 것이다.

섬망 및 우울장애로 자문 의뢰된 입원환자의 임상적 특징 및 의뢰 형태에 관한 연구 (A Study on the Characteristics and Consultation Type of Inpatients Referred for Delirium and Depressive Disorder)

  • 이성민;유승호;하지현;전홍준;박두흠
    • 정신신체의학
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    • 제31권1호
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    • pp.10-18
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    • 2023
  • 연구목적 본 연구는 섬망 및 우울장애로 정신건강의학과에 의뢰된 환자들의 인구학적 특성과 자문 의뢰 형태, 재협진 여부에 따른 차이를 알아봄으로써, 종합병원 입원환자에 있어 섬망 및 우울장애의 특징 및 자문 조정 정신의학의 개선 방향을 위한 자료를 얻는 것을 목표로 한다. 방 법 건국대학교병원에 2005년 8월 1일부터 2011년 12월 31일까지 입원한 환자들 중 정신건강의학과로 자문 의뢰된 4966명의 환자를 대상으로 전산화된 의무기록을 후향적으로 분석하였다. 자문의뢰형태는 정신과 과거력, 입원 시 주호소, 의뢰된 증상의 특성 등에 따라 각각 상호보완형, 병렬형, 보수형, 선행 과거력형, 오진형, 단순 재의뢰형의 총 6가지로 분류되었다. 결 과 우울장애 환자의 평균 나이는 57.0세, 섬망 환자의 평균 나이는 68.6세로 섬망 환자군에서 유의하게 더 높았다. 성비의 경우 우울장애 환자에서 여성이 66.7%, 섬망 환자에서 남성이 60.8% 로 각각 더 높았다. 입원환자의 과별 분포는 우울장애의 경우 내과계 환자의 비율이 67.7%, 섬망의 경우 외과계 환자의 비율이 50.1%로 각각 더 높은 비율을 차지하였다. 자문 의뢰 형태에서는 우울장애의 경우 병렬형-상호보완형-보수형의 순서를 보였고, 섬망 환자의 경우 보수형-병렬형-상호보완형 순서였다. 우울장애 환자군 내에서 재협진군과 1회 협진군을 비교해 보았을 때 재협진군에서 남성 비율이 유의하게 높았다. 자문 의뢰 형태 분석에서 재협진군은 병렬형-보수형-상호보완형의 빈도 순을 보였으며 1회 협진군에서 병렬형-상호보완형-보수형의 순서를 보였다. 섬망 진단 환자군 내에서 재협진군과 1회 협진군을 비교해 보았을 때 재협진군에서 외과계의 비율이 유의하게 높았다. 자문 의뢰 형태 분석에서 재협진군과 1회 협진군 모두 보수형-병렬형-상호보완형의 순서를 보였다. 결 론 정신과 자문 의뢰 형태를 분석한 결과 우울장애 환자군과 섬망 환자군에서는 연령, 성비, 자문 의뢰 형태, 재협진률 등에서 유의한 차이를 보였다. 이 같은 결과를 바탕으로 의료진은 환자를 입원시키는 시점부터 우울장애 및 섬망과 같이 호발하는 정신과적 공존 질환에 대해 정신건강의학과 자문을 통해 적극적으로 치료계획을 논의함으로써, 환자에게 이차적으로 발생할 수 있는 우울장애와 섬망 등의 위험 요인을 파악하고 조기에 개입하여 의료 서비스의 질을 향상시킬 수 있을 것이다.

정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 -환자에 대한 평가와 이해 - (Therapeutic Approaches to the Patients Who Were Referred for Psychiatric Consultation from Medical Departments - Focused on Evaluation and Understanding -)

  • 이정호;이기철
    • 정신신체의학
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    • 제1권1호
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    • pp.75-80
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    • 1993
  • To understand and evaluate the patients who were referred for psychiatric consultation from medical departments, the authors reviewed the concept of disease, psychological reaction to disease, problems on psychiatric diagnosis and evaluation which were encountered at the medical ward. In addition, we reviewed what psychiatrists should do during consultation.

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