• Journal of Korean Biological Nursing Science
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• 제18권2호
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• pp.78-86
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• 2016

Purpose: Diabetic foot ulcers are significant problems in diabetes mellitus and often result in lower extremity amputation. This study was conducted to evaluate the effects of a self-care management program on Korean patient's self-efficacy, self-care behavior, size of the wound, and wound related pain. Methods: This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The intervention strategies of the self-care management program consisted of individual intervention (education, practice and demonstration), computer animation, and face-to-face counseling. There were thirty seven patients, and 20 were assigned to the experimental group while the other 17 were assigned to the control group. The experimental group was given a self-care management program. The control group received information on diabetic mellitus care by means of a leaflet. The data was analyzed using descriptive statistics, a chi-square test, an independent t-test, and a Mann-Whitney test. Results: There were significant differences in self-care behavior and wound related pain. Conclusion: A Self-care program is an effective way to increase patient's self-care ability. This program is highly applicable to diabetic foot ulcer patients in various settings.

• Journal of Hospice and Palliative Care
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• 제27권2호
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• pp.77-81
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• 2024

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

• 보건행정학회지
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• 제12권1호
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• pp.125-143
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• 2002

The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.

• 한국의료질향상학회지
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• 제5권1호
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• pp.2-14
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• 1998

The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patient satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7, 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those receiving free-care. There were, however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients. except for the dimension on sympathy and shape.

• 디지털융복합연구
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• 제17권12호
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• pp.565-573
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• 2019

본 연구는 치과위생사의 236명을 대상으로 예방진료 관심도와 예방관리지식 환자교육 정도를 알아보고 예방관련지식을 매개하여 환자교육에 미치는 영향을 파악함으로써 환자교육의 향상을 위한 방안을 모색하고자 시행하였다. 치위생사의 예방진료 관심도, 예방관리 지식, 환자교육은 변수 간 유의한 상관성을 가지며, 예방진료 관심도가 높을수록 예방관리 지식이 높고 환자교육을 잘하며, 예방관리 지식이 높을수록 환자교육을 잘하는 것을 알 수 있었다. 치과위생사의 예방진료 관심도가 환자교육에 미치는 영향에 예방관리지식의 매개효과를 알아보기 위해 회귀분석과 Sobel 검증을 실시한 결과 유의한 것으로 나타나(Z=5.96, p<.001) 예방진료 관심도가 환자교육 실시를 높이는 직접효과와 예방관리 지식을 높이고, 높아진 예방관리 지식으로 다시 환자교육이 잘 실시되는 간접효과를 동시에 가짐을 알 수 있었다. 이에 본 연구결과를 토대로 환자의 예방관련 교육효과를 높이기 위해서는 치과위생사의 예방업무에 대한 관심과 예방관련지식함량을 위한 교육과 함께 제도적 지지가 뒷받침이 된다면 환자의 예방교육 효과는 더욱 높아질 것으로 사료된다.

• 한국의료질향상학회지
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• 제25권2호
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• pp.26-43
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• 2019

Purpose:The objective of this study was to identify the conceptual constructs of patient centeredness from the perspective of patients and family members in Korea, and to compare them with those included in the Picker Institute framework. Methods: Two focus group discussions were conducted. Each focus group consisted of six participants who had experienced being either a patient or a caregiver. We carried out a thematic analysis, and then compared the contents of our focus group discussions with the components of patient-centered care outlined by the Picker Institute. Results: Six conceptual constructs of patient centeredness emerged from the focus group discussions. Five of these overlapped with those outlined by the Picker Institute: 1)respect for patients' values, preferences, and needs, 2) coordination and integration of care, 3) information, communication, and education, 4) physical comfort, and 5) emotional support and alleviation for fear and anxiety. A new component that was not mentioned in the Picker Institute framework emerged from this study: "ease of making a complaint." Currently, "involvement of family and friends" and "continuity and transition" were not prominent components of patient centeredness according to our focus group discussions. Conclusions: This study presents the conceptual constructs of patient centeredness, five of which overlap with those outlined by the Picker Institute, and provides a qualitative basis of the patient experience survey currently being implemented by the Health Insurance Review & Assessment Service in Korea.

• 한국병원경영학회지
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• 제26권3호
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• pp.68-83
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• 2021

Background: It is widely acknowledged that single bedrooms have many potential advantages compared to multiple bedrooms. However, Korea has a reimbursement system that patients have to pay the additional fee if they will use single bedroom or pay-bed (1-3 bedroom). There is little research on patients' bed selection and relationship between patient satisfaction and bed type in the Korean setting. Methods: Using the 2017 Korea Health Panel (KHP) Survey data, we modified bed type by two dichotomous variables: single bedroom vs. multiple bedroom (2+ bedrooms) and pay-bed (1-3 bedroom) vs. reimbursed bed (4+ bedroom). Multivariate logistic regression is performed to determine the factors affecting the patient's choice of room types. Multivariate regression analysis was conducted to examine how hospital room types are affecting patient satisfaction. Results: Single room and pay-bed (1-3 bedroom) use was influenced by patient age (19- years old), male, a person at work, hospitalizing in a clinic, and birth. After controlling variables of the behavioral model of medical utilization, the association between patient satisfaction and use of single bedroom & pay-bed (1-3 bedroom). Cause of hospitalization, major treatment, and recognition of unnecessary care are statistically significant variables on patient satisfaction. Conclusion: Although the single room is about the standard for newly built hospitals in western countries, it remains unclear that single room or pay-bed (1-3 bedroom) has positive effects on patient's outcomes and satisfaction. In this empirical study, the difference in patient satisfaction by bedroom type was not noticeable. In terms of bed management by hospital staff, securing patient credibility in hospital care is an important task. Patients' perception of whether medical staffs have encouraged unnecessary treatment or tests has a significant impact on patient's satisfaction.

• 한국의료질향상학회지
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• 제27권1호
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• pp.2-9
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• 2021

Patient safety remains one of the most important health care issues in Korea. To improve patient safety, we have introduced concepts from the field of safety science such as the Swiss cheese model, and adopted several methodologies previously used in other industries, including incident reporting systems, root cause analysis, and failure mode and effects analysis. This approach has enabled substantial progress in patient safety to be made through undertaking patient safety improvement activities in hospitals that are systems-based, rather than individual-based. However, these methods have the shared limitation of focusing on negative consequences of patient safety. Therefore, the paradigm shift from Safety I to Safety-II in safety science becomes the focus of our discussion. We believe that Safety-II will complement, rather than replace, Safety-I in the discipline of patient safety. In order to continuously advance patient safety practices in Korea, it is necessary that Korea keeps abreast of the recent global trends and development in safety science. In addition, more focus should be placed on testing the feasibility of new patient safety approaches in real-world situations.

• 보건행정학회지
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• 제12권1호
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• 한국병원경영학회지
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• 제6권3호
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• pp.25-45
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• 2001

The purpose of this study was to evaluate the environments of patient care, education, and research as indicators of university hospital performance. The objective data for this study were collected by secondary data. The subjective data were collected by a total of 523 questionnaire survey interviews conducted in C university hospital, of which 123 were students, interns, or residents, 76 were professors, and the remaining 324 were patients. The major statistical methods used for the analysis were t-test and ANOVA. We found that the environment of patient care is better than the environment of education and research in C university hospital. While the concern for patient care of C university hospital was about 60%, the equivalent figures for education and research were both 20%. And the patients' satisfaction level was higher than the others. The environment of education and research was found to be deficient in some aspects, especially in such areas as facilities, equipment, and investment. In particular for professors the time for research was very limited because of the demands of patient care. These findings clearly demonstrate that university hospitals need to pay greater attention to the areas of education and research, as well as to patient care. This article concludes with a discussion and summary and presents issues in need of further study.