• Title/Summary/Keyword: hospital physicians

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Sexual Discrimination towards Female Nurses in the Male Dominated Hospital Environment (간호사가 지각한 의료체계의 남성중심성)

  • Koh, Hyo-Jung;Jeong, Geum-Hee
    • Women's Health Nursing
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    • v.5 no.3
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    • pp.265-276
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    • 1999
  • Female nurses in Korea have historically experienced discrimination on the basis of their gender as part of the traditional society views on woman and as a result of the male dominated hospital environments. This discrimination may interfere with the ability of female nurses to promote the health of their patients. To better understand this bias, we collected and analyzed 16 cases of alleged sexual discrimination reported by female nurses with more than 5 years work experience. The cases were classified into 10 subjects and further into 4 categories: personnel administration, daily working environment, female gender bias, and health care delivery. There were 7 cases (11.3%) of unjust personnel changes consisting of demotion(1), termination(4), and reallocation of position(3). Twenty three (37.1%) of cases related to problems in the daily workplace including biases in communication between female nurses and male physicians(12), daily work(8), and responsibility for adverse outcomes(3). We noted 17 cases (27.4%) of female gender bias as reported by female nurses(7), female physicians(7), and female patients(3). Lastly, there were 15 (24.3%) cases of problems with health care delivery due to sexual discrimination, including enrollment in the health care system(4),and decisions regarding medical care(4). These results suggest that sexual discrimination towards women is pervasive in the Korea hospitals, not only towards female nurses but also towards female physicians and patients. More discriminatory practices in a timely fashion such that better nursing care can be provided to patients and their families.

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A Study on Main Issue and Supreme Court Decisions regarding the Duty of Interhospital Transfer of Patients - Focusing on the Supreme Court Decision 2010DO7070 Delivered on April 29, 2010 - (전원의무 관련 쟁점 및 대법원판례 고찰 - 대법원 2010. 4. 29. 선고 2009도7070 판결을 중심으로 -)

  • Kim, Young Tae
    • The Korean Society of Law and Medicine
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    • v.14 no.2
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    • pp.281-313
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    • 2013
  • A physician has to do his best for the better treatment of his patiensts. But, if a physician cannot remedy his patients because of the lack of hospital facilities, the lack of medical knowledge and etc., the physician must transfer his patients to another suitable hospital immediately. This is called the duty of interhospital transfer of patients. The necessity of interhospital transfer of patients is primarily ocurred in emergency medical care situations. The Supreme Court Decision 2010DO7070 delivered on April 29, 2010 is one of the important decisions related to the duty of interhospital transfer of patients. The Supreme Court ruled that there were the physician's medical malpractice and the causation between the physician's medical malpractice and the death of patient, as the physician has left the patient without due observations for 1 hour and 30 minutes after the caesarean operation inspite of mass bleeding during the operation, and has transferred the patient to another suitable hospital later. And the Supreme Court ruled that the transferring physician has to explain the situation of the patient in detail to the physician being transferred. I agree with the Supreme Court Decision. As decided by the Supreme Court, physicians will treat their patients more carefully and in case of necessity for transfer, physicians will transfer their patients with more caustion. However, the study for this issue should be continued hereafter because concrete standards are not given to lawers and physicians just by the Supreme Court Decisions itself.

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Prevalence of workplace violence against registered nurses and their perceptions of relevant management systems in acute care hospitals (병원간호사의 직장 폭력 경험 실태 및 대응 체계에 대한 인식)

  • Park, Seungmi;Kwak, Eunju;Lee, Ye-Won;Park, Eun-Jun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.3
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    • pp.319-334
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    • 2023
  • Purpose: This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals. Methods: One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems. Results: A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians' workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital's workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (p=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence. Conclusion: Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers' competency in managing workplace violence.

Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures

  • Jung, Cheol Hee;Ryu, Jae Sung;Baek, Seung Woo;Oh, Ji Hye;Woo, Nam Sik;Kim, Hae Kyoung;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.51-56
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    • 2013
  • Background: The C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures. Methods: This is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected. Results: Three hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians. Conclusions: In conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.

A Study on Illness Behavior of Panic Disorder Patients (공황장애 환자의 질환행동에 관한 연구)

  • Kim, Sang-Soo;Je, Young-Myo;Kim, Sang-Yeop;Lee, Dae-Soo;Lee, Sung-Ho;Choi, Eun-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.104-119
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    • 1998
  • This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

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Patient's Satisfaction with Medical Care Services in Hospital (병원 이용자의 의료서비스 만족도 조사)

  • Sung, Jung-Ae;Nam, Chul-Hyun;Kim, Soung-Woo;Kim, Gui-Suk;Koo, Hyun-Jin;Yoo, Eun-Joo
    • Journal of Society of Preventive Korean Medicine
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    • v.10 no.1
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    • pp.109-121
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    • 2006
  • The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

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Awareness of Doctors' Shared Decision-Making in Life-Sustaining Care Decisions

  • Kim, Dalyong;Lee, Hyun Jung;Yu, Soo-Young;Kwon, Jung Hye;Ahn, Hee Kyung;Kim, Jee Hyun;Seo, Seyoung;Maeng, Chi Hoon;Lim, Seungtaek;Kim, Do Yeun;Shin, Sung Joon
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.204-213
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    • 2021
  • Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

Factors associated with willingness to participate in clinical trials for cancer patients: an exploratory narrative review (암 환자의 임상시험 참여 의향과 연관된 요인: 탐색형 서술적 문헌고찰)

  • Kim, Kun Hyung;Hwang, Bo Yown;Son, Gyung Mo
    • Journal of Acupuncture Research
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    • v.33 no.3
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    • pp.145-152
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    • 2016
  • Objectives : This study aimed to investigate both cancer patients' willingness to participate (WTP) in clinical trials and its associated factors. Methods : We searched MEDLINE (PubMed) for studies that had investigated cancer patients' WTP in clinical trials. Search terms included 'willingness to participate', 'cancer' and 'trial'. Studies published within the last five years up to July 26, 2016 were potentially eligible. Results : Of 44 initial hits, 14 studies (12 quantitative and 2 qualitative) were included. Two out of the 14 studies investigated WTP in an acupuncture trial. Study designs, such as WTP measurement methods, investigation settings, and type of cancer, varied. The proportion of participants with a WTP was widely distributed between the studies (median 48.6 %, range 11.1 % to 88.3 %). Factors associated with WTP included various socio-demographic factors, clinical factors, participants' knowledge/attitudes toward clinical trials, travel distance, information from physicians, and trust toward physicians. Conclusion : WTP and its associated factors were variable across the reviewed studies, which might be due to different research methods and contexts. Whether or not common factors associated with cancer patients' WTP in clinical trials exist remains unclear and thus warrants further research.

Partial-thickness rotator cuff tears: a review of current literature on evaluation and management

  • Ramesh Radhakrishnan;Joshua Goh;Andrew Hwee Chye Tan
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.79-87
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    • 2024
  • Rotator cuff disease is a common cause of shoulder pain for which partial-thickness rotator cuff tears occupy a significant proportion. Such tears are often difficult to diagnose and manage in the general clinic setting. A review of the available literature from well-known databases was performed in this study to provide a concise overview of partial-thickness rotator cuff tears to aid physicians in their understanding and management.

Role of artificial intelligence in diagnosing Barrett's esophagus-related neoplasia

  • Michael Meinikheim;Helmut Messmann;Alanna Ebigbo
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.14-22
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    • 2023
  • Barrett's esophagus is associated with an increased risk of adenocarcinoma. Thorough screening during endoscopic surveillance is crucial to improve patient prognosis. Detecting and characterizing dysplastic or neoplastic Barrett's esophagus during routine endoscopy are challenging, even for expert endoscopists. Artificial intelligence-based clinical decision support systems have been developed to provide additional assistance to physicians performing diagnostic and therapeutic gastrointestinal endoscopy. In this article, we review the current role of artificial intelligence in the management of Barrett's esophagus and elaborate on potential artificial intelligence in the future.