• Title/Summary/Keyword: patient-physician communication

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A Study on factors affecting physician's acceptance of Electronic Health Record(EHR) System (의사들의 의료정보 시스템 수용도에 영향을 미치는 요인에 관한 연구)

  • Jung, Se-Young;Lee, Kee-Hyuck
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.19 no.6
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    • pp.117-125
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    • 2019
  • For successful EHR implementation, it is important to understand physicians's acceptance and attitude for EHR. This study aims to provide basic information for the overseas expansion of Korean EHR by studying Saudi Arabia's physicians' acceptance for the Korean EHR exported to Saudi Arabia. Except for physician autonomy and physician-patient relationship, Likert scales of physician involvement, adequate training, ease of use, usefulness, and attitude about EHR usage were over 3.5 points, which are relatively high. The Physicians' experience of Korean EHR may have influenced the EHR acceptance score. Based on the positive research results of this study, we can say that Korean EHR can be competitive in the overseas EHR business.

Effects of Hospital-based Home Care Demonstration Project on Physical and Emotional Problems and Cost - effectiveness of Patients having Arthritis (병원중심 가정간호 사업의 평가 연구 -외래 관절염 환자를 대상으로 -)

  • Lim, Nan-Young;Kim, Seong-Yoon;Lee, Eun-Ok;Lee, In-Sook
    • Journal of muscle and joint health
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    • v.3 no.1
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    • pp.4-22
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    • 1996
  • Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.

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Beyond Cognitive Empathy: Suggestions for Strengthening Medical Students' Empathy (인지적 공감을 넘어: 의과대학생의 공감능력 증진을 위한 제안)

  • Youngjoon Lee
    • Korean Medical Education Review
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    • v.26 no.2
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    • pp.140-154
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    • 2024
  • A physician's empathy plays a crucial role in patient-centered care, and in modern medicine, patients, their caregivers, and society demand a high level of empathy from healthcare providers. The conceptualization of clinical empathy, which has emphasized cognitive empathy since the mid-20th century, has been widely accepted in medical schools and the healthcare industry without much critical ref lection. This study provides an overview of the ongoing debates on empathy versus sympathy and cognitive empathy versus affective empathy to clarify the concept of empathy. Based on recent research findings, clinical empathy is proposed to encompass three components: cognitive empathy, affective empathy, and empathic motivation. It is suggested that fully demonstrating these components requires empathic communication skills. Additionally, the cognitive characteristics of medical students and the features of the academic environment demonstrate the need for education to strengthen their empathy skills. Considering this, proposed intervention methods that medical schools can consider include utilizing tutoring programs and debriefing processes for team activities, which can facilitate problem-solving as a coping strategy for stress. Learning communities can create an environment where students can receive social support and recover from stress. Medical schools can contribute to the development of students' professional identities as practicing clinicians who embody empathy and respect by cultivating professors as positive role models. Additionally, utilizing scales to assess the empathic nature of doctor-patient communication or incorporating patients and caregivers as evaluators can actively improve empathic communication skills.

Study on a Clinical Collaborative Communication System in Healthcare Organizations -Focused on Patient Education (보건의료 조직의 협업적 의료 커뮤니케이션 시스템에 대한 연구 - 환자교육을 중심으로)

  • Park, Hwagyoo
    • The Journal of Korean Association of Computer Education
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    • v.16 no.2
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    • pp.79-90
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    • 2013
  • Communication errors have severe consequences clinical quality and disputes in medical organizations. Thus, clinical communication has become a major practice recently, since clinical and managerial effectiveness can also be enhanced by improving the quality of the physician, medical staff, and laboratories interactions. Both medium and large-sized hospitals are increasingly adopting the philosophy to shorten clinical service time while enhancing higher medical service quality and lower healthcare service costs. From this motivation, this paper studies on the clinical collaborative communication concept and investigates approaches to the philosophy for implementation. The system has been theorized to improve communication and enhancing medical outcome qualities. In addition, to validate the system, the author analyzes the efficiency and effectiveness in S hospital, using statistical survey works.

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Classification of Nursing Activities and Workload Analysis in a New Open Hospital (환자중심 간호업무 향상을 위한 간호업무 측정에 관한 연구)

  • Lee, Young-Shin;Kwon, Young-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.123-136
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    • 1997
  • The purpose of this study was to confirm the classification of nursing activity and to analyze the time of nursing workload in a new open hospital. The data were collected from 20 nurses working in 6 general nursing units by 4 trained observers. The tools used for this study were an observation recording sheet and a classification sheet of nursing activity. The classification sheet was constructed to be adaptable to each hospital system based on the instrument described in the literature. The results of the study are as follows : The direct nursing activities consisted of 6 sections, 33 subsections and the indirect nursing activities consisted of 14 sections, 53 subsections. The direct nursing activities included medication, measuring and observation, care of therapies, care of physical comfort, laboratory and treatment. The indirect nursing activities included preparation of medical utensils, collection of information and assessment, recording, phone communication, professional interaction related to patients, personal time, assigning work to staff, patient eaucation and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. Nurses spent 127.6min for direct nursing activity during day duty. It was 24.5% of total nursing activity. Within that activity medication had the highest percentage of time(40.09%), followed by communication and education with patient(24.76%), measuring and observation (16.93%), laboratory and treatment (12.85%), care of therapies(3.21%) and care of physical comfort (2.16%). The time breakdown for indirect nursing activities is as follows ; the preparation of medical utensils 22.3%, collection of information and assessment 20.29%, recording 20.27%, phone communication 8.14%, professional interaction related to patients 7.33%, personal time 7.24%, with the remaining timeshared by staffing, patient education and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. In the analysis of the relationships between the working time and the work allocation characters of the nurses(including nurse's experiences. nurse-patients ratio, nurse-rooms ratio, and character of nursing unit) ; There were no significant differences in direct-indirect nursing times between nurse's career years. There was significant difference in direct nursing time between assigned patient numbers. The nurses assigned larger number of patients spent significantly more time in direct nursing care than that of the smaller. On the other hand, there was no significant difference in indirect nursing workload between the assigned patient numbers. There were no significant differences in direct-indirect nursing time between an allocated patient's room numbers. There was significant difference in working time between working places. The nurse in the medical unit spent more time in direct nursing care than her counterpart in the surgical unit. However there was no difference in direct nursing time between two groups. The study results indicate that nurses spent less time in the direct nursing care than in the previous studies even though the hospital system has been modernized. On the other hand they spent much more time for the coordinating role within the interdisciplinary team and for the overlapping paperwork. Therefore it is recommended that patient oriented job description and more efficient usage of modernized utilities be made.

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Nursing Students' Error and Recovery in Transfusion Simulation for Safety Competency (환자 안전 역량을 위한 수혈 시뮬레이션에서 간호학부생의 오류 발생과 복구 수준)

  • Kim, Eun Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.2
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    • pp.180-189
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    • 2015
  • Purpose: The purpose of this study was to identify the types of errors that occurred and were recovered in a simulated transfusion scenario by nursing students. Methods: Twenty-eight teams of a total of 89 nursing students participated in a transfusion simulation using a high fidelity simulator. Data were collected by observing rule based errors and built in errors recovered according to the framework of Eindhoven model. Reflective journaling was used to identify perceived safety-threatening errors and commitment to improvement. Data were analyzed using descriptive statistics. Results: All teams committed the rule based errors in the scenario. The most common errors occurred in the coordination category related to communication with physician. Most of students perceived the transfusion reaction as a safety-threatening error. Conclusion: The findings indicate that students lack patient safety competence. The simulation training to decrease errors and improve safe practice provides nursing students with an effective strategy to develop patient safety competence.

Home Health Care Service Using Routine Vital Sign Checkup and Electronic Health Questionnaires (주기적인 생리변수 측정과 전자건강설문을 이용한 재택건강관리서비스)

  • 박승훈;우응제;이광호;김종철
    • Journal of Biomedical Engineering Research
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    • v.22 no.5
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    • pp.469-477
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    • 2001
  • In this Paper. we describe a home health care service using electronic health questionnaires and routine checkup of vital signs Including ECG (Electrocardiography) , blood pressure. and SpO$_2$ (Oxygen Saturation) . This system is for patients at home with chronic diseases, discharged Patients, or any normal people for the Prevention of disease The service requires a home health care terminal and a PC with Interned connection installed at Patient home. The distance health care management center is equipped with a vital-sign and questionnaire interpreter as well as database, Web, and notification servers with UMS (Unified Messaging System). Participating Physician can access the servers at the center using a Web browser running on a PC available to them at any time. These components are linked together through various kinds of data and voice communication channels including PSTN (Public Switched Telephone Network) . CATV(Community Antenna TV) . Interned. and mobile communication network. Following the Physician's direction given to a Patient. he or she uses the home health care terminal to collect vital signs and fill out the questionnaire. When the terminal automatically transmits these data to the management center. the data interpreter and servers at the center process the information fo1lowing the Protocol implemented on the system. Physicians can retrieve and review data corresponding to their Patients and send back their diagnostic reports to the center. UMS at the center delivers the physician 's recommendation to the corresponding patient through the notification server. Patients can also reprieve and review their own records as well as diagnostic reports from physicians. The system Provides a new way of collecting diagnostic information and delivering doctor's recommendation to patients at home for their health management. Future works are needed in the development of new technology for measurements and interpretations of various vital signs .

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Informational Needs of Women with Breast Cancer Treated with Chemotherapy

  • Abi Nader, Elie;Kourie, Hampig Raphael;Ghosn, Marwan;El Karak, Fadi;Kattan, Joseph;Chahine, Georges;Nasr, Fadi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1797-1800
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    • 2016
  • Background: Research in the field of informational needs of breast cancer patients is scarce. In the few published articles, these needs were usually not satisfied. The main objective of this study was to evaluate satisfaction regarding informational needs in women with breast cancer. The long-term goal was to guide physician-patient communication to meet these needs. Materials and Methods: A survey with 21 questions was completed by 84 female patients receiving chemotherapy in a one-day hospital in Beirut, Lebanon. All patients were aware of their disease and agreed to participate in the survey. Results: The doctor was the major source of information for patients followed by media (radio and television). The level of knowledge of patients concerning their disease was proportional to the number of information sources. Women aged younger than 45 years, diagnosed during the last three months before the survey and certified from high school were less satisfied with information given by the oncologist. The missing information was in relation with the steps of the treatment after the chemotherapy regimen, the risk of a family member (sisters and daughters) of developing the disease and management of lymphedema. Conclusions: This study generated a scale for the degree of satisfaction of information received by women with breast cancer from their oncologist. The physician can use this scale to improve his or her skills of communication to patients and diminish their level of fear and anxiety.

Does Practicing Communication Skills with Standardized Patients or Completion of Elective Course of Communication Skills Affect the Scores of Clinical Performance Examination? (표준화환자와의 의사소통기술 훈련이나 선택과목 '의사소통기술' 이수가 임상수행평가 성적에 영향을 미쳤는가?)

  • Kim, Jong Hoon
    • Korean Medical Education Review
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    • v.13 no.1
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    • pp.35-43
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    • 2011
  • Purpose: Communication skills are considered as one of the essential requirements in medical education, and the training often involves exercising medical interviews with standardized patients(SP) or role play. This study investigated the helpfulness of the communication skills training programs for students' performance on the clinical performance examination (CPX). Methods: Fourth-year students who have taken one of two communication skills programs(exercising communication skills with SP or elective communication skill course with role play) completed a questionnaire on their evaluation of the helpfulness of communication skills programs immediately after finishing the CPX. Then, the programs were objectively assessed by comparing all fourth-year students' CPX scores between program participants and non-participants. Results: About 70% of participants answered that the programs were helpful to perform clinical clerkship and CPX. However, there was no difference in either the total CPX score or 2 categorical scores(integrated clinical encounter, communication and interpersonal skill) between program participants and non-participants. Conclusion: Although the students felt that the communication skills programs were helpful to their clinical activities, this study failed to find objective evidence of any effect of the programs on the CPX results. Communication skills training should be continued during clinical clerkship to maintain or enhance the skills, and it is necessary to introduce more effective methods for precise evaluation of students' communication skills.

The Public's Response to Communication between a Terminal Cancer Patient and Physicians: A Qualitative Study of Three Sets of Online News Comments (한 말기 암환자와 의사와의 의사소통에 대한 대중의 반응: 3개의 온라인 기사 댓글에 대한 질적 연구)

  • Park, Song Yi;Park, Kyung Hye
    • Korean Medical Education Review
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    • v.24 no.3
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    • pp.240-249
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    • 2022
  • This study explored the public's response to an incident involving publicity about how physicians broke bad news to a terminal cancer patient by analyzing 1,960 comments from three online news websites that reported on this event using Braun and Clarke's theme analysis methods. Three themes and 10 subthemes emerged from the public's responses to the way the physicians broke the bad news. Theme 1 (a physician is a person who tells the facts) contained the following subthemes: physicians are responsible for delivering facts, but it is a matter of consideration for patients to deliver bad news to them, empathy and consolation should be expected from people other than physicians, and physicians who say what patients want to hear are cheaters. Theme 2 (there is a problem with physicians) included the following subthemes: the physicians' empathy or personality and problems with their communication methods. Theme 3 (there are obstacles to communication with dying patients) had the following subthemes: physicians become emotionally dull and find it very stressful to break bad news, giving hope to dying patients can lead to medical disputes, and empathy and consolation are also costly. When breaking bad news, the physicians delivered factual information, but they did so inappropriately, and emotional support for the patient was insufficient. In medical communication education, it is necessary to emphasize training in emotional support. In the medical field, an environment should be created where physicians can communicate as they have learned.