• Journal of Preventive Medicine and Public Health
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• 제47권5호
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• pp.273-280
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• 2014

Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

• 임상간호연구
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• 제19권1호
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• pp.20-32
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• 2013

Purpose: To present necessary data for improvement in communications between health professionals in as characterized by nurses' communications. Methods: This study was a descriptive survey research design with a survey of 1,510 registered nurses working in general hospitals (of at least 1,900 beds) in Seoul. A questionnaire on communication in the ICU, nurse-physician and nurse-nurse, was used. Data were collected from January 9 to 20, 2012, and the response rate was 85.0%. Results: Cronbach ${\alpha}$ values ranged from .75 to .89, except for .59 for accuracy (nurse-physician), with .89 overall. The highest mean score was for perception for timeliness [$3.83{\pm}.57$], followed by shift communication (nurse-nurse) [$3.64{\pm}.66$], openness (nurse-nurse) [$3.64{\pm}.65$], accuracy (nurse-nurse) [$3.14{\pm}.61$], openness (nurse-physician) [$2.90{\pm}.75$], understanding (nurse-physician) [$2.82{\pm}.65$], and accuracy (nurse-physician) [$2.70{\pm}.59$]. Subscales of openness, understanding, and shift communication were strongly associated with communication satisfaction. The general characteristics of nurses with different perceptions of communications included age, clinical experience, work pattern, and department. Conclusion: Proactive activities to improve accuracy, openness and mutual understanding between physicians and nurses are required for patient safety. Further studies are also needed to reassess communications and evaluate the relationship between patient outcomes and nurses' job satisfaction after application of strategies to improve communications.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.74-79
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• 2024

Patient-physician interaction (PPI) is an important area in medical education, but in-depth discussions on the content of the outcome of patient-doctor education are rare. Therefore, in this study, we will systematically analyze the research on PPI education in Korea. In this study, papers searched with keywords related to PPI education from Korea's academic journal service were targeted according to a systematic literature analysis method. The scope of the study was to include papers published in academic journals that are candidates for Korea Citation Index registration, excluding dissertations, research reports, posters, conference presentations, books, and internet materials. The content included papers targeting medical education and medical school students was set as the range. As a result of the analysis, although communication between PPI has many positive effects in the PPI in medical education at medical schools, obstacles do occur, and various ways to overcome them were suggested. Therefore, although medical interview training between patients and doctors in medical schools is necessary, it was analyzed as being based on overseas research or lacking in specific content. The core of PPI education appears to be medical interviews, and it seems necessary to discuss whether empathy or patient-centered medical care are appropriate as the main principles of PPI education in Korea. Therefore, education on the patient-doctor relationship is an important element in medical humanities and medical humanities education, and it is expected that research and education on this will progress more actively.

• 한국의료질향상학회지
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• 제5권2호
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• 보건행정학회지
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• 제13권3호
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• pp.21-34
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• 2003

Patient revisit to used hospital is a key factor in determining a health care organization's competitive advantage and survival. This article examines the relationship between customer's satisfaction and his/her revisit associated with three different methods which are the Chi Square Automatic Interaction Detection(CHAID) for segmenting the outpatient group, logistic regression and neural networks for addressing the outpatient's revisit. The main findings indicate that the important factors on outpatient's revisit are physician's kindness, nurse's skill, overall level of satisfaction, hospital reputation, recommendation, level of diagnoses and outpatient's age. Among these ones, physician's kindness is the most important factor as guidelines for decision of their revisit. The decision maker of hospital should select the strategy containing the variable amount of the level of revisit and size of outpatient's group under the constraint on the hospital's time, budget and manpower given. Finally, this study shows that neural networks, as non-parametric technique, appear to more correctly predict revisit than does logistic regression as a parametric estimation technique.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
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• pp.155-156
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• 2001

• 한국콘텐츠학회논문지
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• 제18권8호
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• pp.345-352
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• 2018

본 연구는 진료수행 시험 상황을 재연하여 실제 의사가 채점한 결과와 표준화 환자가 채점한 결과의 차이가 있는지, 첫째 날 응시한 학생과 정보가 노출된 둘째 날 응시한 학생의 점수 차이를 비교하고자 하였다. 의과대학 4학년 101명이 4가지 세트(본태성고혈압, 수면장애, 기분저하, 무월경)로 구성된 진료수행 시험에 응시하였다. 학생들은 첫째 날과 둘째 날 중 표준화환자 채점 세트와 의사 채점 세트로 구성된 평가 일정하나에 무작위로 배정되었다. 각 진료수행의 평가지침은 병력청취, 신체진찰, 환자교육, 환자의사관계, 진찰태도로 영역을 구분하여 구성하였다. 각 상황별, 영역별 성취점수를 표준점수로 변환하여 집단 간 차이를 비교하였다. 모든 영역에서 여학생의 성취점수가 남학생의 성취보다 유의하게 높았다(P=.001). 표준화 환자가 채점한 집단과 의사가 채점한 집단의 평균의 유의한 차이는 없었다(p=.425). 연속되는 시험일자 중 둘째 날 응시한 군이 병력청취와 신체진찰영역에서 유의한 차이를 보였다. 본 연구에서는 채점자의 신분에 따른 평가 결과에 차이가 없음을 다시 한 번 밝히면서 표준화 환자를 활용한 평가의 가능성을 확인하였다.

• 기본간호학회지
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• 제23권2호
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• pp.126-135
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• 2016

Purpose: This study was done to identify the influence of clinical learning environment and attitude toward physician-nurse collaboration on professionalism in nursing students. Method: The sample consisted of 317 nursing students. Data were collected from October 10 to December 20, 2014 and were analyzed using t-test, ANOVA, Pearson correlation and multiple linear regression with IBM SPSS statistics version 19. Results: The mean score for clinical learning environment was 3.15 out of 5. The mean score on the Jefferson scale attitude toward physician-nurse collaboration (JSAPNC) was 3.31 out of 4. The mean score for professionalism was 3.70 out of 5. The predictors of professionalism were major satisfaction, 'care vs cure' for the JSAPNC and 'patient relationship', 'student satisfaction' for clinical learning environment. Conclusions: Based on these results, educational programs to improve attitude toward physician-nurse collaboration and clinical learning environment should be developed.

• 의료법학
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• 제16권2호
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• pp.27-53
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• 2015

최근, 서울의 성형수술 병원에서 중국 여성 환자가 사망한 원인이 대리 의사의 무단 유령수술 때문이 아니냐는 의혹이 제기되었다. 사고가 발생한 후, 소비자시민모임과 한국환자단체연합회는 지난 3월 유령수술감시운동본부를 발족시켰다. 환자가 알지 못하는 상태에서 환자의 동의 없이 담당 의사를 교체하는 것은 사기행위이자 기본적인 윤리를 저해하는 행위이다. 환자는 1명의 인간으로서 자신을 치료할 의사를 선택할 권리가 있으며, 대리의사를 용인하거나 거부할 수 있는 권한도 환자에게 부여되어야 한다. 환자가 수술을 허락한 사람은 집도의라는 점을 유의해야 한다. 환자는 자신이 계약한 의사로부터 치료를 받을 권리가 있다. 환자를 치료하는 의사는 환자-의사 관계를 창출하는 계약이 허용하는 범위 내에서 자신의 능력껏 수술을 시행할 의무가 있다. 그는 환자로부터 부여 받은 수술 권한을 다른 사람에게 위임할 수 없다. '유령수술은 형법 제257조(상해, 존속상해)가 적용된다. 환자가 알지 못하는 상태에서 환자의 동의 없이 집도의를 교체하는 것은 상해행위이다. 이 부분이 쟁점인데, '유령 수술이 형법 제347조(사기)와도 연관이 있기 때문이다. 환자가 알지 못하는 상태에서 환자의 동의 없이 다른 의사가 수술을 대신하는 것이 사기 행위에 해당하는지 하는 문제도 쟁점이 될 수 있다. 뿐만 아니라, 유령 수술은 의료법 제27조(무면허 의료행위 등 금지), 제22조(진료기록부 등), 제33조(개설 등)와도 관련이 있다. 환자에 대한 의사의 의무는 (1) 수술 동의를 통해 자신에게 주어진 권한의 범위 내에서; (2) 계약 조건에 따라; (3) 수술의 필요성/진행과 관련된 모든 사실을 완전하게 공개하고, (4) 자신의 모든 역량을 발휘하면서 수술에 임하는 것이다.

• 한국병원경영학회지
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• 제21권1호
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• pp.51-61
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• 2016

This study attempted to investigate how mass media marketing of a hospital influences patient volume. Additionally, the association of patient volume with exposure time and the type of mass media was examined. Data from a university hospital in Bundang (from January 2014 to November 2014) were used. Degree of physicians' mass media marketing was measured by the number of media exposure. Linear mixed model for repeated measures data was run to identify the associations between the number of media exposure and patient volume. First, the number of hospital physician's mass media exposure and new patients and the first visit patients were positively associated. Second, broadcasting media which has relatively significant in patient volume is TV programs such as cultural programs and news. Third, hospital physicians with higher ranks who were exposed to press media receive more patient appointment. Also, nonsurgical hospital physicians who were exposed to press media receive more patients. Fourth, medical treatment activities for hospital staff who hold the rank of Professor in case of making an appearance at press media have relatively increased. Hospital physician's media exposure, particularly TV programs, was significantly related to patient volume for outpatients.