• Quality Improvement in Health Care
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• v.23 no.2
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• pp.57-66
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• 2017

Purpose:The purpose of this study was to identify the patient's characteristics influencing patient's comprehensibleness of doctor's explanation. Methods: This study was conducted as a secondary data analysis using the raw data of The 6th Korea National Health and Nutrition Examination Survey (KNHANES VI) conducted in 2015. The survey sampled 22,948 adults, and 4,469 of them were included in this analysis. Multiple regression analysis was performed to determine the patient's characteristics influencing patient's comprehensibleness of doctor's explanation. Results: The patient's comprehensibleness of doctor's explanation were more higher as age (t=5.65, p<.001), female (t=4.40, p<.001), subjective good health status (t=3.48, p=.001) were higher. On the other hand, the patient's comprehensibleness of doctor's explanation were more higher education level (t=-6.80, p<.001), not-recent outpatient experience (t=-6.04, p<.001), pain/discomfort (t=-2.64, p=.008), anxiety/depression (t=-2.58, p=.010) were lower. Conclusion:It is necessary to be provided the patients who are higher education level, pain/discomfort and anxiety/depression with applying the doctor's detailed explanation and intervention programs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5639-5644
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• 2014

Objective: This study aimed to determine effects of doctor-patient communication on the quality of life among breast cancer survivors in 16 communities in southern China. Methods: Multistage random sampling was to use to recruit 260 females from the Guangzhou Cancer Registry Database who were diagnosed with breast cancer. A questionnaire provided data on the doctor-patient communication (including the doctor's attitude, the patient's participation with the medical decision and information about the disease) and QOL (quality of life), as measured using FACT-B. Univariate analysis, non-conditional logistic regression was used to evaluate the associations between the doctor-patient communication and QOL. Results: Females who received good attitudes from doctors demonstrated higher FACT-B (OR=4.65, 95% CI: 1.68-12.86), social well-being (OR=5.88, 95% CI: 2.16-16.05), emotional well-being (OR=4.77, 95% CI: 1.92-11.88), and functional well-being ((OR=5.26, 95% CI: 1.90-14.52) compared to the females who encountered worse attitudes from their doctor, adjusting for age, education, marriage, employment, family income, years since diagnosis, TNM stage, radiation therapy, chemotherapy and side effects, particularly when the TNM stage was 0-II and the patients exhibited no side effects. Regardless of the length of time after diagnosis, doctors' good attitudes resulted in higher QOL scores. Conclusions: This study demonstrated that the doctor-patient communication has a significant association with the QOL of breast cancer survivors, mainly dependent on the doctors' attitude. Effective intervention is required to develop optimal doctor-patient communication.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.69-118
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• 2007

In providing general medical treatments, the medical service contract between the patient and the doctor is the mutually responsible onerous contract. However, the nature of the mutually assumed contract standings of the patient and the doctor has been changing since the implementation of the national health insurance program. For instance, besides the cases of beyond excessive medical charges and medical negligence, if the doctor charged for his/her medical treatments violating the post-treatment/nursing cover criteria, the overpaid medical charge, regardless of being collected with the patient's consent, has to be refunded back to the patient. Medically needed aspects, treatment results, and unfair benefits favoring the patient are not at all taken into consideration in the health insurance scheme. This makes it easier for patients to get refunds for their share of the medical payments by involving the Health Insurance Review & Assessment Service or the National Health Insurance Corporation, without engaging in civil law suits (for reimbursement claim) against doctors. In other words, the doctor's responsibility to provide medical treatments and the patient's responsibility to pay for the medical treatment provided within the contractual realm are being demolished by the administrational arbitration of the National Health Insurance system. The basic rights of medical service providers, and the patient's right to choose are as important constitutional rights, as the National Health Insurance program, which is essential in the social welfare system. Furthermore, the development of the medical fields should not be prevented by the National Health Insurance system. If the medical treatment services can be divided into necessary treatments, general treatments, and high quality treatments, the National Health Insurance is supposed to guarantee the necessary and general treatments to provide medical treatments equally to all the insured with limited financial resources. However, for the high quality treatments, it is recommended that they should not be interfered by the National Health Insurance system, and that they should be left to the private contract between the patient and the doctor.

• Journal of Marine Life Science
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• v.1 no.1
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• pp.18-24
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• 2016

Since April 2012, doctor fish in the breeding tank and in the quarantine tank in Hanwha Aquaplanet Yeosu Aquarium have been dying, accompanied by diffuse bleeding around the mouth, in the chin, and at the bottom of the abdomen. In this study, the cause of death would be examined through the bacteriological study of doctor fish and the rearing water quality in the aquarium. The water quality and the bacterial counts of the rearing water in the exhibit tank and in the quarantine tank were analyzed once a week, starting from August to November 2014. Water quality was measured based on the following data: temperature was in the range of 24.5~26.8℃, pH at 6.77~7.94, DO at 6.15~8.61 ppm, ammonia at 0~0.93 ppm, nitrite at 0.009~0.075 ppm, and nitrate at 1.1~40.9 ppm. Studies revealed that the differences in these water quality factors were not related to the death of doctor fish. Bacterial counts in the rearing waters of Garra rufa slightly increased to 10³~10⁴ CFU/ml, just before the death of the doctor fish. Twelve strains of bacteria were isolated from the dead fish and rearing waters. The isolates were identified as Aeromonas veronii, Citrobacter freundii, Pseudorhodoferax aquiterrae, Shewanella putrefaciens, and Vibrio anguillarum on the basis of 16S rRNA gene sequences. The most dominant species was C. freundii, which showed medium sensitivity to florfenicol and norfloxacin, and was resistant to amoxacillin, doxycycline, oxytetracycline, tetracycline, and trimethoprim. Ten isolates were confirmed to be pathogenic to the doctor fish. Doctor fish infected with C. freundii and S. putrefaciens showed high mortality in the experimental groups. These results indicate that the variation in bacterial numbers in the rearing water was related to the death of doctor fish. C. freundii and S. putrefaciens were directly implicated in causing the death of doctor fish in the aquarium.

• The Journal of Information Systems
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• v.19 no.3
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• pp.263-278
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• 2010

Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.

• Korea Journal of Hospital Management
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• v.16 no.2
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• pp.19-30
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• 2011

This study aims to present ways to enhance the stabilization of electronic medical records, ensure the commitment to filling in information of the medical record and improve the overall quality Electronic Medical Record(EMR) information. For that purpose, the present state of the incomplete record rate and the doctor's satisfaction in Electronic Medical Record(EMR) have been surveyed by comparing and analyzing Paper-based Medical Record(PMR) and Electronic Medical Record(EMR). The survey was conducted on 31 doctors in charge of EMR system and each PMR and EMR inpatients were collected for a period of 5 months and analyzed. The results showed that the doctor's satisfaction level was higher for EMR, and the rate of incomplete record appeared to be lower in EMR in departments of both internal and external medicine. In this context, it can be said that the higher efficiency of EMR helped accomplish the increase in commitment to completing medical record information and improve the quality of the data.

• Asian Oncology Nursing
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• v.6 no.1
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• pp.37-46
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• 2006

Purpose: The purpose of this study was to identify the influencing factors on anxiety of patients who had received hemopoietic stem cell transplantation(HSCT). Method: A total of 81 patients who had undergone a HSCT at a university hospital were recruited from July of 2001 to June of 2002. They were asked to complete questionnaires about anxiety, self-esteem, family support, doctor's support and nurse's support. Result: The mean score of anxiety, self-esteem, family support, doctor's support and nurse's support was 41.9, 3.0, 4.6, 7.6 and 7.3, respectively. A significant negative correlation was found between anxiety and self-esteem. Self-esteem was positively correlated with family support, doctor's support and nurse's support. The major variable that influenced anxiety was the self-esteem, explaining 25.4% of the anxiety. Conclusion: On the basis of these results, it is necessary for HSCT patients to develop a nursing intervention for the enhancement of self esteem. Also, family support, doctor's support and nurse's support should be considered as a main support system in the nursing strategy for improving the quality of life of patients undergone HSCT.

• Journal of Oriental Neuropsychiatry
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• v.12 no.2
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• pp.85-93
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• 2001

Objectives: In order to present an applicative scheme of medical care through the analysis of the Rumenshiqin. Method: This research was done by analyze Zhanzihe's Medical Records and Thought in the Rumenshiqin. Results: 1. Zhanzihe's had recognized that vital-qi is recovered naturally by diaphoretic, purgative and emetic theraphy. 2. He had made an applicative scheme of psychotherapy in Oriental medicine. 3. Zhanzihe's Medical Records and Thought can contribute to madical care of neuropsychiatry 4. He had thought that the doctor's quality and consideration of infant's environment and individual grade is very important. Conclusion: Zhanzihe's Medical Records and Thought in the Rumenshiqin presents an applicative scheme of medical care of neuropsychiatric desease and we need to study more and more about this.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4445-4450
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• 2016

Background: This study explored perspectives of health-care providers on childhood cancer treatment in Kenya. Materials and Methods: A self-administered questionnaire was completed by 104 health-care providers in January and February 2013. Results: Seventy six percent of the health-care providers believed cancer to be curable. More doctors than other health-care providers had this positive opinion (p=0.037). The majority of health-care providers (92%) believed that most children with cancer will not be able to finish their treatment due to financial difficulties. They considered that prosperous highly-educated parents adhere better with treatment (88%) and that doctors adhere better with treatment for prosperous highly-educated parents (79%). According to 74% of health-care providers, quality of care is better for prosperous highly-educated parents (74%). Most health-care providers reported giving more explanation (71%), work with greater accuracy (70%) and use less difficult vocabulary (55%) to prosperous more educated families. Only 34% of health-care providers reported they feel more empathy towards patients from prosperous families. Reasons for non-adherence with the protocol according to health-care providers are: family refuses drugs (85%), inadequate supply of drugs at pharmacy (79%), child looks ill (75%), and financial difficulties of parents (69%). Conclusions: Health-care providers' health beliefs and attitudes differ for patients with families having high versus low socio-economic backgrounds.

• Korea Journal of Hospital Management
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• v.15 no.1
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• pp.1-12
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• 2010

This study was tried to evaluate the level of completeness and the accordance in electronic medical records by comparing paper-based medical record in doctor's admission records, discharge summary, and nursing information records. Medical records of inpatients of neurology department that the 100 paper-based medical records in 2004 and 100 electronic medical records in 2006 were targeted. Existence of record items and doctor-nurse record accordance were evaluated in doctor's admission record, discharge summary, admission nursing information record, and discharge nursing information record. There were not any differences between electronic medical records and paper-based medical records in doctor's admission record and discharge summary. Electronic medical records had less missing records than paper-based medical records in admission and discharge nursing information records. Electronic medical records showed higher accordance than the paper-based medical record in doctor-nurse record generally, but there were statistically differences in only medication, allergy, smoking, and drinking (p<0.05). In this study, it was verified that the quality of electronic medical records are better than paper-based records in nursing information record and doctor-nurse record agreement.