• 제목/요약/키워드: medical collaboration

검색결과 280건 처리시간 0.033초

간호사의 상대적 권력과 대인갈등 (A Study on the Relationship between Nurses Relative Power and Interpersonal Conflicts)

  • 이명옥
    • 대한간호학회지
    • /
    • 제27권1호
    • /
    • pp.169-177
    • /
    • 1997
  • This study aims at empirically clarifying the relationship between power and the interpersonal conflict, including nurses' understanding of their relative power, the causes of interpersonal conflicts with the nurses, and strategies to resolve conflicts, in order to understand how nurses' relative power affect their conflicts. For the empirical survey, the population was defined as all the nurses working at a medical organization in Seoul, Korea. 1083 nurses were selected as the sample for the questionnaire survey and statistical analyses. For the sampling, 32 medical organizations were selected by a stratified random method and sub-samples were arbitrarily drawn from each organization to obtain the final sample of 1083 nurses who responded to the questionnaire designed by the reseacher. According to the result of the study, most nurses experience conflict more than once a month, and 70.4% of the respondents answered that interpersonal conflicts were directly or indirectly caused by power relations. which indicates that they perceive power relations as the main cause of interpersonal conflicts. Nurses experienced the most conflicts with interns and residents(29.7%), then patients and their families(24.3%), higher-positioned nurses(12.3%), nurse colleagues(7.7%), lower-positioned nurses(6.5%), and staff doctors(5.1%). If we classify these into three groups. the frequency of the conflicts, from most frequent to least. is in the order of doctors. nurses, and patients. In terms of relative power, nurses perceive that they have greater power than patients and their families, lower-positioned nurses, and nurse colleagues. In contrast, nurses perceive that they have less power than interns and residents, higher-positioned nurses. and staff doctors. Among these groups. nurses perceive that they have the most power over patients and the least over staff doctors. These results indicate that nurses tend to experience more conflicts with members of groups that are stronger than themselves in terms of relative power, Nurses use positive strategies such as the compromise strategy(32.3%) or the collaboration strategy (20.3%) to manage conflicts, more than other strategies. However, they use avoidance or competition strategy more at the earlier stage, compromise strategy more in the mid stage, and collaboration strategy more at the later stage of the interpersonal conflict. In relation to power, nurses use the collaboration strategy or the compromise strategy more when their perceived power is greater than or equal to their counterpart's, and they use the avoidance strategy or the accommodation strategy if their power is less. In terms of source of power, nurses' perceived relative power is greater in the order of referent power. expert power, reward power, legitimate power. and coercive power. where referent power is perceived as having the greatest power and coercive power is least. Most nurses(69.3%) used their power to resolve a conflict. with positive outcomes. Expert power was used most frequently. Overall. this study strongly indicates that the enhancement of power of nurses to have equal power relations with doctors would heighten the success of conflict resolution, since power is the main cause of conflicts. Specifcally. nurses experience most conflicts with doctors against whom they perceive the greatest gap in power. and the choice of a conflict management strategy depend upon their power relations.

  • PDF

Improving a newly adapted teaching and learning approach: Collaborative Learning Cases using an action research

  • Lee, Shuh Shing;Hooi, Shing Chuan;Pan, Terry;Fong, Chong Hui Ann;Samarasekera, Dujeepa D.
    • Korean journal of medical education
    • /
    • 제30권4호
    • /
    • pp.295-308
    • /
    • 2018
  • Purpose: Although medical curricula are now better structured for integration of biomedical sciences and clinical training, most teaching and learning activities still follow the older teacher-centric discipline-specific formats. A newer pedagogical approach, known as Collaborative Learning Cases (CLCs), was adopted in the medical school to facilitate integration and collaborative learning. Before incorporating CLCs into the curriculum of year 1 students, two pilot runs using the action research method was carried out to improve the design of CLCs. Methods: We employed the four-phase Kemmis and McTaggart's action research spiral in two cycles to improve the design of CLCs. A class of 300 first-year medical students (for both cycles), 11 tutors (first cycle), and 16 tutors (second cycle) were involved in this research. Data was collected using the 5-points Likert scale survey, open-ended questionnaire, and observation. Results: From the data collected, we learned that more effort was required to train the tutors to understand the principles of CLCs and their role in the CLCs sessions. Although action research enables the faculty to improve the design of CLCs, finding the right technology tools to support collaboration and enhance learning during the CLCs remains a challenge. Conclusion: The two cycles of action research was effective in helping us design a better learning environment during the CLCs by clarifying tutors' roles, improving group and time management, and meaningful use of technology.

Behavioural and Metabolic Risk Factors for Mortality from Colon and Rectum Cancer: Analysis of Data from the Asia-Pacific Cohort Studies Collaboration

  • Morrison, David Stewart;Parr, Christine Louise;Lam, Tai Hing;Ueshima, Hirotsugu;Kim, Hyeon Chang;Jee, Sun Ha;Murakami, Yoshitaka;Giles, Graham;Fang, Xianghua;Barzi, Federica;Batty, George David;Huxley, Rachel Rita;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권2호
    • /
    • pp.1083-1087
    • /
    • 2013
  • Background: Colorectal cancer has several modifiable behavioural risk factors but their relationship to the risk of colon and rectum cancer separately and between countries with high and low incidence is not clear. Methods: Data from participants in the Asia Pacific Cohort Studies Collaboration (APCSC) were used to estimate mortality from colon (International Classification of Diseases, revision 9 (ICD-9) 153, ICD-10 C18) and rectum (ICD-9 154, ICD-10 C19-20) cancers. Data on age, body mass index (BMI), serum cholesterol, height, smoking, physical activity, alcohol and diabetes mellitus were entered into Cox proportional hazards models. Results: 600,427 adults contributed 4,281,239 person-years follow-up. The mean ages (SD) for Asian and Australia/New Zealand cohorts were 44.0 (9.5) and 53.4 (14.5) years, respectively. 455 colon and 158 rectum cancer deaths were observed. Increasing age, BMI and attained adult height were associated with increased hazards of death from colorectal cancer, and physical activity was associated with a reduced hazard. After multiple adjustment, any physical activity was associated with a 28% lower hazard of colon cancer mortality (HR 0.72, 95%CI 0.53-0.96) and lower rectum cancer mortality (HR 0.75, 95%CI 0.45-1.27). A 2cm increase in height increased colon and all colorectal cancer mortality by 7% and 6% respectively. Conclusions: Physical inactivity and greater BMI are modifiable risk factors for colon cancer in both Western and Asian populations. Further efforts are needed to promote physical activity and reduce obesity while biological research is needed to understand the mechanisms by which they act to cause cancer mortality.

발전에 상응하는 교통안전 전략: 의료인의 참여 필요성 (Road Safety Strategy Corresponding to Development: The Need for Participation of Medical Professionals)

  • 이상완
    • 대한교통학회지
    • /
    • 제25권4호
    • /
    • pp.43-56
    • /
    • 2007
  • 한국은 70년대 이후 자동차의 증가와 함께 교통사고로 인한 인명피해가 점차 늘어나 90년대 초 이미 심각한 공중보건문제로 등장하였다. 그러나 역대 정부는 사고예방과 사상자감소를 위한 대책 마련에 소극적이었으며, 다양한 관련전문분야의 협조로 달성 가능한 효과적 안전전략을 이끌어내지 못하였다. 이 논문은 한국의 사회경제적 발전과 교통안전 수준을 밝히고, 특히 전문 의료인의 참여를 요하는 교통안전전략을 조명하는데 목적을 두었다. 사회경제적 발전을 위해 6 가지, 교통안전을 위한 2 가지 지표를 조사하여 외국의 사례들과 비교했으며, 발전수준에 상응하지 못하는 낙후된 교통안전상태가 지속되고 있음을 보였다. 사회경제적발전과 교통안전의 이러한 불균형은 정부로 하여금 장차 관련전문분야 특히 의료인의 협력과 공조를 요하는 보다 효과적인 교통안전전략을 모색토록 할 것이며, 이에 대비하여 1984년 이후 국제교통의학회지 및 동 학회 학술대회에 발표된 논문과 경험들을 성찰하고 그들 중 중진국 수준으로 발전한 한국에서 실행가능하고 시도될 수 있는 주요전략 및 대책들을 분류 제시했다.

Co-stimulation of TLR4 and Dectin-1 Induces the Production of Inflammatory Cytokines but not TGF-${\beta}$ for Th17 Cell Differentiation

  • Chang, JiHoon;Kim, Byeong Mo;Chang, Cheong-Hee
    • IMMUNE NETWORK
    • /
    • 제14권1호
    • /
    • pp.30-37
    • /
    • 2014
  • Collaboration of TLR and non-TLR pathways in innate immune cells, which acts in concert for the induction of inflammatory cytokines, can mount a specific adaptive immune response tailored to a pathogen. Here, we show that murine DC produced increased IL-23 and IL-6 when they were treated with LPS together with curdlan that activates TLR4 and dectin-1, respectively. We also found that the induction of the inflammatory cytokine production by LPS and curdlan requires activation of IKK. However, the same treatment did not induce DC to produce a sufficient amount of TGF-${\beta}$. As a result, the conditioned media from DC treated with LPS and curdlan was not able to direct $CD4^+$ T cells to Th17 cells. Addition of TGF-${\beta}$ but not IL-6 or IL-$1{\beta}$ was able to promote IL-17 production from $CD4^+$ T cells. Our results showed that although signaling mediated by LPS together with curdlan is a potent stimulator of DC to secrete many pro-inflammatory cytokines, TGF-${\beta}$ production is a limiting factor for promoting Th17 immunity.

의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과 (Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis)

  • 안양희
    • 한국보건간호학회지
    • /
    • 제28권1호
    • /
    • pp.32-45
    • /
    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

미래 의학교육을 위한 의과대학 신축의 건축디자인 방향성 (Architectural Design Approach of New Medical Education Building Fit for Pedagogy Changes)

  • 김남주
    • 의학교육논단
    • /
    • 제17권3호
    • /
    • pp.97-104
    • /
    • 2015
  • This literature review explores relevant research and evaluation on pedagogy and physical learning spaces. This study also is intended to encourage discussion among stakeholders on the best medical school developments, in light of emerging learning trends relevant to their institutions. The study has revealed that new environments for learning are being designed or reshaped in response to changing pedagogical approaches, to incorporate new information technology, and to accommodate the changing abilities of new generations of learners. Formal teaching spaces for large groups with a 'sage on a stage' are becoming less common than smaller lecture rooms, although classrooms form a large component of universities and will continue to dominate in the future. However, the traditional layout of these spaces is being transformed to incorporate multiple learning modes. Classrooms should be profound places of revelation and discovery. A well-designed space has the ability to elevate discourse, encourage creativity, and promote collaboration. Within the classroom walls, a learning space should be as flexible as possible, not only because different teachers and classes require different configurations, but because in order to fully engage in learning, students need to transition between lectures, group study, presentations, discussions, and individual work time.

The Role and Necessity of Public Health Services in a Remote Area

  • Lee-Seung KWON
    • 웰빙융합연구
    • /
    • 제6권4호
    • /
    • pp.63-68
    • /
    • 2023
  • Purpose: This study aims to investigate the national obligation of public health support for residents in medically vulnerable areas in Korea, and to propose a suitable model for public health institutions in this region. Research design, data, and methodology: A survey targeting residents was conducted from August 10 to August 17, 2021, with a sample size of 177 general citizens. The survey utilized a structured questionnaire administered online through Google, employing convenience random sampling. After an editing process to ensure data accuracy, the final dataset of 174 valid samples underwent encoding, coding, and cleaning using the IBM SPSS Statistics 22.0 program for analysis. Results: Health status revealed a moderate level, and 63.8% reported having chronic diseases, particularly prevalent among the elderly. External healthcare institutions were commonly utilized, with proximity and competence of doctors being primary reasons. Respondents expressed a need for improving the public health and medical system, emphasizing the establishment of a County Health Centre and expanding medical departments. Conclusions: In this region, the region's unique challenges, including education, employment, population decline, aging, and transportation, require multidimensional efforts and urgent intervention by public entities. Long-term strategies involve considering the establishment of a health and medical institute, adjusting health centre resources to local realities, and fostering a cooperative system for collaboration among residents and institutions.

국내 사람유두종바이러스백신 접종 후 자발적 이상반응 보고사례의 Brighton Collaboration 기준 활용 가능성 연구 (Patterns of Spontaneous Adverse Events Reporting on Human Papillomavirus Vaccines according to the Applicability of Brighton Collaboration Criteria in Korea from 2008 to 2017)

  • 김묘송;유승훈;박혜민;이민택;강예진;구현지;정선영
    • 한국임상약학회지
    • /
    • 제30권1호
    • /
    • pp.19-30
    • /
    • 2020
  • Objective: To describe patterns of spontaneous reporting on adverse events following immunization (AEFIs) using the human papilloma virus (HPV) vaccine according to the Brighton Collaboration (BC) criteria. Methods: We used the Korea Adverse Event Reporting System (KAERS) database including vaccinations between 2008 and 2017. To apply BC criteria, we classified 58 BC AEFIs into World Health Organization Adverse Reaction Terminology (WHO-ART) codes. We applied MedDRA standard medical queries that were pre-defined as five BC AEFIs. Terminology mapping between MedDRA and WHO-ART terms was performed by three researchers. Descriptive statistics of individual case safety reports were analyzed according to BC applicability. Disproportionality analyses were performed on each BC AEFI and each preferred AEFI term according to the case-noncase approach; reporting odds ratio (ROR) and 95% confidence intervals (CI) were calculated. Results: Among the 30,266 reports of vaccinations between 2008 and 2017, 2,845 reports included the HPV vaccine. Of these reports, 1,511 (53.1%) included at least one BC AEFI. Reports from physicians or manufacturers included more BC AEFIs than from other reporters. Injection site reactions and fever were frequently reported in BC AEFIs; spontaneous abortion and ectopic pregnancy (ROR, 14.29 [95% CI, 4.30-47.49]) and vasculitic peripheral neuropathy (ROR, 8.57 [95% CI, 2.61-28.10]) showed the highest ROR. Among non-BC AEFIs, dizziness or myalgia were frequently reported; exposure during pregnancy (ROR, 23.95 [95% CI, 16.27-35.25]) and inappropriate schedule of administration (ROR, 22.89 [95% CI, 16.74-31.31]) showed the highest ROR. Conclusion: BC criteria would be applicable for labeled AEFIs, whereas analyzing non-BC AEFIs would be useful for detecting unlabeled AEFIs.

보건계열 대학생의 환자 의료 정보 보호에 대한 인식과 수행 (Perception and Performance about Patients' Medical Information Protection in Allied Health College Students)

  • 최선영;임도연;고일선;문인오
    • 한국간호교육학회지
    • /
    • 제22권1호
    • /
    • pp.83-95
    • /
    • 2016
  • Purpose: This study aims to identify perception, performance, and the related factors of performance in regards to patients' medical information protection among allied health college students. Methods: Four hundred twelve subjects from three colleges located in Jeonbuk and Kyungbuk province consented to participate. Data was collected from November 28 to December 15, 2012. To assess perception and performance in regards to patients' medical information protection, a self-reporting questionnaire was used. Data was analyzed via SPSS 18.0 program. Results: The score of perception and performance about patients' medical information protection were 4.07 and 3.56, respectively. All item's scores of performance were significantly lower than those of perception. The perception score was significantly different according to recognition of hospital ethics code (t=1.95, p=.052), and recognition of association ethics code (t=2.88, p=.004). The performance score was significantly different according to gender (t=-3.32, p=001), major (F=14.41, p<.001), clinical practicum hospitals (F=8.22, p<.001), and method of electronic medical record access (F=3.23, p=.023). The factors influencing performance were perception(${\beta}=.46$, p<.001), duration of clinical practice(${\beta}=-.36$, p<.001), and gender(${\beta}=.09$, p=.033). Conclusion: In order to improve performance in regards to patients' medical information protection of allied health college students, we should develop ethical education programs and standardize them through multidisciplinary collaboration.