Purpose: The purpose of this study was to develop a fundamental reference for the clinical implementation of Complementary and Alternative Therapy(CAT) by surveying and analyzing different perception and attitude between nurses and physicians. Method: A total of 167 nurses and 103 physicians from two C university health science centers participated in this survey, and SPSS program with version 10.0 was used to analyze the result of survey. Result: As results, 72.7% nurses and 57.1% physicians showed positive attitude for the concept of CAT, 60.6% nurses and 36.7% physicians responded positively while 2.6% nurses and 25.9% physicians responded negatively for the application of CAT to the clinical practice. There was a meaningful difference between two groups in the belief of therapeutic effectiveness of CAT. 67.7% nurses believed the therapeutic effectiveness of CAT while 38.8% physicians did. For attitudes of nurses and physicians toward CAT showed meaningful difference according to general characteristics: age, gender, marital status, a level of education, position in the organization, religion, and duration of health care service other than inpatient units. Conclusion: In this study, the attitudes of nurses and physicians about CAT showed meaningful difference that nurses were more positive than physicians in application.
The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.
Gang Myeong-gil(康命吉) wrote Jejung sinpyeon(濟衆新編), one of three major medical books produced in the latter half of the Joseon Period. Jejung sinpyeon, edited at the behest of King Jeongjo, was intended to overcome the shortcomings of the then best medical book, Donguibogam(東醫寶鑑), and to update medical knowledge in a bid to spread that knowledge widely to the general public. Jejung sinpyeon contains the life and medical theories of the physician Gang Myeong-gil. In order to examine Gang Myeong-gil's life and medical theories, which influenced the edition and characteristics of Jejung sinpyeon, this paper studies his family lineage, medical records and the editorial characteristics of Jejun sinpyeon. Gang Myeong-gil and his ancestors served in government medical offices for some 200 years, and Gang Myeong-gil himself served as a physician at Naeuiwon for thirty years. His descendants also served as physicians upon passing the state-administered examination. Gang Myeong-gil preferred to prescribe drugs, and this inclination led him to include Yakseongga in Jejung sinpyeon, and he took an open and practical attitude towards the editing of the book. This approach is supported by the chapter on experience-based prescriptions in Jejung sinpyeon and the prescriptions of the Royal Infirmary, thus revealing his humanitarian and open thinking on medicine.
Objectives : This paper aims to understand the meaning and utilitarian values of 'Jongyong(從容)' in medicine by studying its meaning in the 『Huangdineijing』. Methods : Examples of 'Jongyong(從容)' usages in Chinese literature and classical texts were studied first. Next, the similarities and characteristics of its contexts in discourses between Leigong and Huangdi were examined, followed by further examination of the overall meanings of the six chapters, 「Shicongronglunpian(示從容論篇)」, 「Zhuzhijiaolunpian(著至敎論篇)」, 「Shuwuguolunpian(疏五過論篇)」, 「Zhengsishilunpian(徵四失論篇)」, 「Yinyangleilunpian(陰陽類論篇)」, 「Jiejingweilunpian(解精微論篇)」 and the verses that include 'Jongyong(從容).' Results : Generally 'Jongyong(從容)' describes a resilient attitude that responds appropriately and calmly to difficult external situations while maintaining one's character, or refers to one's general behavior. In the 『Huangdineijing』, 'Jongyong(從容)' is only mentioned in discourses between Leigong and Huangdi, which talks about ancient East Asian clinical medicine in general, its transmission and education. Here, the meaning of 'Jongyong(從容)' could be summarized as an expansion of analogical thinking[引比類], medical work that involves the physician's commitment(人事), and detailed measurement of yinyang difference in the body(刑法, 陰陽, 治數). Discussion : In ancient East Asian medicine, the meaning of 'Jongyong(從容)' is closer to measurement of the yinyang difference rather than differentiation of the five element analogy. It is a medical practice that measures the shape, volume, length, area, height, concentration etc. of the human body in numerical figures to allow for the most subtle comparison, which was an important aspect of the physician's work that needed to be demonstrated, educated and transmitted to later generations to enable continuity of the medical profession.
Cyrus, Ali;Moghimi, Mehrdad;Jokar, Abolfazle;Rafeie, Mohammad;Moradi, Ali;Ghasemi, Parisa;Shahamat, Hanieh;Kabir, Ali
The Korean Journal of Pain
/
v.27
no.2
/
pp.152-161
/
2014
Background: According to the reports of the World Health Organization 20% of world population suffer from pain and 33% of them suffer to some extent that they cannot live independently. Methods: This is a cross-sectional study which was conducted in the emergency department (ED) of Valiasr Hospital of Arak, Iran, in order to determine the causes of delay in prescription of analgesics and to construct a model for prediction of circumstances that aggravate oligoanalgesia. Data were collected during a period of 7 days. Results: Totally, 952 patients participated in this study. In order to reduce their pain intensity, 392 patients (42%) were treated. Physicians and nurses recorded the intensity of pain for 66.3% and 41.37% of patients, respectively. The mean (SD) of pain intensity according to visual analogue scale (VAS) was 8.7 (1.5) which reached to 4.4 (2.3) thirty minutes after analgesics prescription. Median and mean (SD) of delay time in injection of analgesics after the physician's order were 60.0 and 45.6 (63.35) minutes, respectively. The linear regression model suggested that when the attending physician was male or intern and patient was from rural areas the delay was longer. Conclusions: We propose further studies about analgesics administration based on medical guidelines in the shortest possible time and also to train physicians and nurses about pain assessment methods and analgesic prescription.
A survey was conducted to study attitudes of physician, nurse and patient towards physician's and nurse's uniform, from March 1 to March 31, 1996. The study population was 130 physicians and 147 nurses engaged in Yeungnam University Medical Center and 211 inpatients of Yeungnam University Medical Center. A questionnaire method was used to collect data. The following are summaries of findings: In the respect of physician's uniform, both physicians and nurses preferred other type of gown to the traditional coat-typed one and especially, nurses preferred more than physicians. Patients showed no difference in the preference of the traditional one and other form of gown as a whole but those who had higher educational level preferred other form of gown(p<0.01). Regarding the color of physician's gown, 73.6% of physicians and nurses liked white color, and 86.3% of the patients also liked the white color. Male physicians preferred the white color more than female physicians and nurses(p<0.01). Patients showed no meaningful difference for the color. The opinion of insisting on wearing a necktie when physician see patients was given by male physicians, physicians of fifty or more, physicians working in the field of medicine and professors, which showed significantly higher percentage than other groups(p<0.01). In the group of patiens, the same opinion was given by female, the group of sixty or more, the group of elementary school graduates or less and people residing in other cities and counties more than male, the group of other ages, the group of having higher educational level and people of Taegu city(p<0.01). It tended to agree wearing casual wear of physician during the working time of weekend and holiday as a whole. Younger physicians showed significantly higher preference for it(p<0.05). Regarding the nurse's uniform, both physicians and nurses preferred trousers, and 96% of the nurses did. Especially, nurses who were forty years old or more and who served at outpatient department and administrative and aid parts expressed 100 percent partiality to trousers. For the patients, those who had lower educational level preferred skirt and those who had higher educational level preferred trousers. As to the color of nurse's gown, 46.7% of the physicians and nurses liked white color. The physicians preferred white and nurses preferred other color(p<0.01). Of the patients, 79.1% liked white color. Regarding the wearing cap, 95.9% of the nurses replied it didn't have to wear the cap. The nurses who were fifty or more and who served at outpatient department and special parts gave whole answers of not having to wear the cap. On the other hand, 77.7% of the patients answered nurse had to wear the cap. From the above findings, it would be advisable to give a change to the forms and colors of the gowns to match with the trend and sense of the time instead of insisting on the traditional typical ones.
Purpose: Influenza immunization among health personnel is of particular importance given their elevated risk of influenza infection, role in transmission and influence on patients' immunization status. The purpose of this study is to identify factors associated with the influenza vaccination intention among health personnel based on the theory of planned behavior. Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 131 health personnel in five general hospitals in two cities in South Korea. The data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with the SPSS 26.0 program. Results: There were statistically significant differences in influenza vaccination intention according to the high-risk group in the family, occupation, length of employment, and influenza vaccination status within a year. The influenza vaccination intention of these health personnel showed significant positive correlations with attitude, subjective norms, and perceived behavioral control towards influenza vaccination. Multiple regression analysis for influenza vaccination intention revealed that the significant predictors were attitude, subjective norms, influenza vaccination within a year and physician in occupation. These factors explained 41.4% of the variance. Conclusion: The results suggest a need to strengthen attitude and subjective norms. The findings also suggest that their characteristics through influenza vaccination status within a year and occupation should be considered for tailored interventions related to the intention. Furthermore, it is necessary to develop programs strengthening attitude and subjective norms to enhance influenza vaccination intention among health personnel.
Background: Cancer of the uterine cervix is one of the most common cancers among women worldwide. Industrialized countries have dramatically reduced the incidence of mortality from cervical carcinoma in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (Pap) smears but it still remains a major problem in the developing world. Objectives: This study was performed to determine knowledge, attitude and practice of Pap smear as a screening procedure among nurses in a tertiary hospital in north eastern India. Material and Methods: This cross sectional study was carried out with a questionnaire survey covering the socio demographic factors, knowledge, attitude and practices about Pap smear screening among 224 nurses in Regional Institute of Medical Sciences, Imphal, Manipur, India during December 2011. Results: Two hundred and twenty one participants (98.6%) had heard about cervical carcinoma but 18.3% lacked adequate knowledge regarding risk factors. Knowledge about the Pap smear was adequate in 88.8% of the respondents. Out of these, only 11.6% had Pap smear at least once previously. The most common reasons for non-participation in screening were lack of any symptoms (58.4%), lack of counselling (42.8%), physician does not request (29.9%) and fear of vaginal examination (20.5%). Conclusion: Although knowledge of Pap smear as a screening procedure for cervical cancer is high, practice is still low. The nurses who should be responsible for opportunistic screening of women they care for are not keen on getting screened themselves. If we can improve the practice of Pap smear screening in such experts, they should be able to readily provide appropriate and accurate information and motivate the general population to join screening programs.
Medical certificate is a document to demonstrate a patient's health status, made up and signed by a physician, dentist, or oriental physician who attended the patient. It serves as an evidence in many official process including civil or criminal law suit, especially for one's personal injury. The Korean legal system also acknowledges and protects the evidentiary function of medical certificate by mandating physicians etc. to issue medical certificate in good faith and only when they personally attended the patient, and by criminally punishing them when they do not comply with these legal requirements. There are some reasons, however, that medical certificates often do not reflect the true health status of the patient: When physicians attend the patient and collect information regarding the health status of the patient, their priority is and should be the most cost-effective way to meet the health needs of the patient. It does not necessarily correspond to the accurate examination of the health status of the patient. Even when the patient's report on the history of the illness or the injury seems suspicious, physicians might have to avoid disproving it because that kind of attitude might harm the rapport between the physician and the patient. All these can distort the perception of the physicians and this distortion can be reproduced in the medical certificate they made up. Some of these problems might be resolved or at least enhanced by introducing new form of medical certificate which would guide physicians to reveal the nature, factual and theoretical grounds, and the limit of their findings more accurately. Others, however, would not be able to address, because it stems from the conflict between the physician's primary duty, duty to be loyal to the patient's life and health, and his secondary duty to serve as a public or neutral witness on the health status of the patient, and when both values or duties conflict with each other, they should choose the duty to the patient sacrificing the duty to the public or the court.
Background: Our objective was to determine the knowledge and attitudes of Thai generalists (general physicians) toward palliative terminal cancer care (PC) in a primary care setting. Materials and Methods: We performed a cross-sectional descriptive survey using a self-administered questionnaire. The total number of completed and returned questionnaires was 63, giving a 56% response rate. Data analysis was based on these (Cronbach's alpha=0.82) and percentages and mean values were assessed using the Fisher's exact test to determine the correlation of variables. Results: Overall, attitude and knowledge levels were slightly satisfactory. Results indicated that general physicians had moderate scores in both attitudes (84.1%) and knowledge (55.7%) regarding palliative terminal cancer care. However, they had insufficient knowledge regarding truth telling, pain control and management with morphine, emergency management in terminal cancer care and treatment of fluid intake in terminal stages. Attitude and knowledge scores were statistically correlated (p=0.036). Knowledge scores were further positively associated with being taught palliative care in their medical curriculum (p=0.042). Conclusions: Formal education in palliative care and development of palliative care services are very much needed in Thailand to provide holistic care to terminally ill patients.
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