• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.261-280
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• 2013

Recently several hospitals have established a new nursing position so called, 'the nurse in charge of education (NCE).' The job description of NCE is to give a detail explanation on examination or test introduced to patients or a guide for those who are not familiar to hospital facilities at the out-patients level. The motivation of NCE position is the quality improvement in patient education on the sophisticated procedures or the follow up care for medical purposes to improve their compliances, as well in delivering services for outpatients or visitors in more informative and efficient way. The application of NCEA has been turned out positive and effective in patient satisfaction and unit management. However, special attention is brought to the scope and depth of the contents of education delivered by NCE which might overlap with the duty of physicians by the Medical Act. It is needed to clarify the role and job description of NCE in the context of Medical Act. The engagement of NCE to the Advanced Nursing Practitioner (ANP) is one of the possible solutions for a duty charge on patient education since ANP is a legislatively official position with higher license of RN at master level. Further discussion is needed to elaborate and arrange the details on the scope and content of patent education among health science professionals including RN, ANP and physicians.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.16-26
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• 1998

Background : As many previous studies proved, the quality of medical record is thought to reflect the quality of care. In this study, we analyzed the relationship between the quality of record and some factors influencing the quality of record, especially the commitment of the attending physician. Method : We developed checklist for evaluation of medical record with 36 criteria. 300 inpatient records of 10 attending physicians' patients were evaluated and the quality' of records were scored. The attending physician's commitment to medical records were scored by 34 residents. The relationship of the quality of records with physician's commitment to records, and some other factors were analyzed. Results : More than 75% of the immediate postoperative notes on the progress note were missed. More than 69% of the contents of explanation about the procedures on the consent form or on the other forms were also missed. The physician whose quality score of records was the highest(78.9) got the highest commitment score. The score of attending physician's commitment to the record, and his seniority were positively related with the quality score of his medical records when number of patients and department were adjusted. Conclusion : The quality of the 5 forms of the record reviewed were evaluated as moderate or excellent except 2 or 3 items. The quality of record was positively related with the attending physician's commitment to the record, and the seniority of the physician.

• Korean Journal of Applied Biomechanics
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• v.26 no.3
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• pp.285-292
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• 2016

Objective: This study collected data on muscle fatigue and ground reaction force during walking to provide a basis for development of custom-fitted outdoor walking shoes. The study analyzed an upright body exercise program using spine stabilization technique to determine the effect on foot plantar pressure in archers, demonstrate the effectiveness of upright body exercise, and develop a new, effective, and efficient training program. Method: A 12-week upright body exercise program was evaluated for the effect on plantar pressure in archers. Ten prize-winning archers (3 men, 7 women) in B metropolitan city, each with ${\geq}10years$ of experience, were given an explanation of the content and purpose of the program, and provided informed consent. Upright body exercise was performed 3 times a week for 12 weeks. A resistive pressure sensor was used to measure foot plantar pressure distribution and analyze quantitative information on variation in postural stability and weight shifting in dynamic balance during shooting, as well as plantar pressure in static balance with the eyes open and closed. Results: There were no significant differences in foot plantar pressure before and after participation in the exercise program. There was no statistically significant difference in foot plantar pressure in static balance with the eyes open or closed, or in foot plantar pressure in dynamic balance during shooting. Conclusion: An upright body exercise program had positive effects on foot plantar pressure in static and dynamic balance in archers by reducing body sway and physical imbalance during shooting and with eyes closed. This program is expected to help archers improve their posture and psychological state, and thereby improve performance.

• Women's Health Nursing
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• v.7 no.3
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• pp.393-406
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• 2001

The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.

• The Korean Society of Law and Medicine
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• v.22 no.4
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• pp.117-157
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• 2021

This research reviewed the HIPAA/HITECH, 21st Century Cures Act, Common Law, and private Guidances from the perspectives in protecting and utilitizing the medical data, while implications were followed. First, the standards for protection and utilization are relatively clearly regulated through single law on personal medical information in the United States. The HIPAA has been introduced in 1996 as fundamental act on protection of medical data. Medical data was divided into personally identifiable information, non-identifying information, and limited dataset under HIPAA. Regulations on de-identification measures for medical information, objects for deletion of limited data sets, and agreement on prohibition of data re-identification were stipulated. Moreover, in the 21st Century Cures Act regulated mutual compatibility for data sharing, prohibition of data blocking, and strengthening of accessibility of data subjects. Common Law introduced comprehensive consent system and clearly stipulates procedures. Second, the regulatory system is relatively simplified and clearly stipulated in the United States. To be specific, the expert consensus and the safe harbor system were introduced as an anonymity measure for identifiable medical information, which clearly defines the process while increasing trust. Third, the protection of the rights of the data subject is specified, the duty of explanation is specified in detail, while the information right of the consumer (opt-out procedure) for identification information is specified. For instance, the HHS rule and FDA regulations recognize the comprehensive consent system for human research, but the consent procedure, method, and requirements are stipulated through the common rule. Fourth, in the case of the United States, a trust-based system is being used throughout the health and medical data legislation. To be specific, Limited Data Sets are allowed to use in condition to the researcher's agreement to prohibit re-identification, and de-identification or consent process is simplified under the system.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4013-4016
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• 2012

Purpose: Breast cancer is the commonest malignancy of females throughout the world with one million new cases each year. In Pakistan, the burden of breast cancer disease is high with late stage presentation being a common feature, more than half being stage III or stage IV. The objective of this study was to study various aspects, patterns and risk factors in breast cancer patients of Balochistan. Method: Present study was performed on 134 patients of breast cancer who were registered in CENAR. The patients were interviewed by providing a questionnaire. Informed consent was taken from all the patients who took part in this study after explanation of the study aims. Body mass index (BMI) was calculated andbiopsy reports were obtained from patients files. All the cases were classified with respect to age, gender, ethnic group (Baloch, Pashtoon, Punjabi, Afghani, Hazara) BMI, cancer type, cancer grade, hormonal status, side of the cancer, fertility and marital status. Results: Out of 134 patients, the most common ethnic group was Pashtoon with a total of 42 and the common age group was 41-50 years with a total of 51. Invasive ductal carcinoma (IDC) was the most common type, accounting for in 128 patients (95.5%) followed by invasive lobular carcinoma (ILC). Conclusion: Pashtoon was the most common ethnic group, IDC was common type and most of the patients had an ER/PR positive hormonal status.

• Korean Journal of Applied Biomechanics
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• v.28 no.1
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• pp.9-18
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• 2018

Objective: This study aimed to analyze how the upright body type exercise program affected body balance and record of archers. This study aimed to prove the effectiveness of upright body type exercise, on this basis, in enhancing the performance of archery players. Method: A total of 14 archers (7 men and 7 women) in B Metropolitan City who had ${\geq}4years$ of career in archery and were given explanation of its contents and purpose before giving spontaneous consent to the experiment were enrolled in the study. The upright body type exercise program was implemented thrice a week for 12 weeks, with higher exercise intensity with time. A resistive pressure sensor, Gaitview AFA-50, was used to measure the foot plantar pressure distribution and analyze quantitative information concerning variation in posture stability and weight shift in dynamic balance of foot plantar pressure in shooting and static balance of plantar pressure with the eyes open and closed and the change in archery record accompanying the change in body balance. Results: As for the differences in foot plantar pressure between before and after participation in the upright body type exercise program, there was no significant difference in static balance of foot plantar pressure with the eyes open, and there was statistically significant difference at the ${\alpha}=.05$ significance level in static balance of foot plantar pressure with the eyes closed or in dynamic balance of foot plantar pressure in shooting. There was statistically significant difference at the ${\alpha}=.05$ significance level in archery record. Conclusion: The upright body type exercise program had positive effects on static and dynamic balance of foot plantar pressure by allowing archers to experience less body sway and physical imbalance in shooting with closed eyes and positive effects on archery record. Thus, the program is expected to help archers correct their posture and perform better.

• Journal of English Language & Literature
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• v.58 no.5
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• pp.903-941
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• 2012

This essay examines Edward Said's Culture and Imperialism focusing on the concepts of 'culture,' 'empire,' and 'nation'. The approach is critical, theoretical, and historical rather than explicatory. Consequently, the range of the essay is not limited to Said's own explanation and argument about Western imperialism and its culture presented in the book. In doing this, this essay finally purposes to be a discursive resistance to the current global empire, the United States, via a critical reading of Said's work. Said's notion of culture is set upon to disclose the function of culture as an apparatus of ideological consent of the dominated to the dominant. When applied to imperial practice, Western culture functions to subject the colonized to the colonizer. Said's geographical approach to imperialism complements the historical understanding of imperialism. Imperialism is not only the practice of Western-centered historicism but also the spatially mutual interaction between the West and the rest of the world. Along with European imperialism, Said poses the current global empire of the United States as his main target of criticism. Said's problem is that he takes the United States as a nation-state. When examined, the United States is not a nation-state, but today's empire. The empire in the appearance of the nation-state United States does not work for the interest of the American nation, that is, the American people. The empire is the transnational and postnational political and economic institution that works for the interest of global capital. In order to resist the current global empire, this essay suggests that the building or restoration of nation-states with its basic principle of people's sovereignty is in need.

• Child Health Nursing Research
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• v.5 no.3
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• pp.292-304
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• 1999

The lengthened average span of human life by virtue of recent developments in medicine has caused the Population of elders to increase. The development of modern industrial society has transformed family structure from the large family system to that of a nuclear family. Due to the shift in family structure, the problem of support for the aged has surfaced as a nursing problem as well as a social problem. With regard to this problem, this study aims to investigate the adolescent's understanding of elders and aging. By identifying their understanding and classifying their attitude patterns, this study will help the nursing assessment of the support of elders in the family. This study employed Q-methodology and the research was conducted from December 1998 to May 1999. One method of the research included deep interviews with elders, those who are in their 50's. 40's or 30's. and the adolescent. 183 Q-Populations taken from literary works such as poems or novels were also formed as another method. Finally. 36 Q-cards were made after consultation with Professors of the nursing department. The subjects of the P- sample were 30 high sohoolboys/girls - who were in first, second, and third years. The result showed that 3 factors provided an explanation for 59.14% of the whole variables: the first factor, 41.37%; the second factor. 11.49%, and the third factor. 6.28%. These three factors were analyzed and categorized as three types. Twenty subjects out of the 30 were included in Type 1: Respecting Elders. The statements which showed the most positive consent were as follows: 'The declining age is a perfect time to prosper completing a worthy life' ; 'Getting old. one needs financial stability' and 'Elders wish the best for their children' The statements showing the most negative response were as follows: 'It is better to die than to live as an older person' ; 'Elders are insignificant' ; and 'Getting old is the worst unhappiness that tortures human.' Four subjects were included in Type 2. Resenting Elders. The statements which showed the most positive consent were as follows: 'Aging is a process of dying that nobody can escape from'. 'Elders should be concerned about his health and try to maintain their health' ; and 'When you set older. you regret about the life in the Past.' The statements showing the most negative response were as follows: 'When You get older. You should stand aloof greed and worldly things' 'When You got older, You become generous and gentle' ; and 'When You set he gets old. You change to become a comfortable and warm person.' Six out of 30 subject were included in Type 3 Caring Elders. The statements which showed the most positive consent were as follows: 'Elders should be concerned about his health and try to maintain their health' ; 'Elders wish the best for their children' ; and 'Elders deserve to be treated with filial respects.' The statements showing the most negative response were as follows 'Elders are insignificant' ; 'Elders have freedom and plenty of free time.' and 'Elders are alienated form and drove out of the society.' The above-mentioned results show that most adolescents in Korea recognize aging as the time of fruition and development: it is a time of benefiting and giving back to society. Aging can also be seen as a time of generosity and magnanimity and the time of respect and favorable treatment from society. despite the change of modern society and the ostensible transformation of a family system. Their recognition seems deeply rooted in the traditional confucian values and the dual family system which is Peculiar especially to the Korea - one which maintains both the superficial form of nuclear family and the substantial mode of the enlarged family system. In sum, many Korean adolescents attribute the meaning of the elderly and aging to the type of the respect with the elderly and the type of the elderly's caretaking.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.163-199
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• 2005

Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.