Othman, Nor Hayati;Zaki, Fatma Hariati Mohamad;Hussain, Nik Hazlina Nik;Yusoff, Wan Zahanim Wan;Ismail, Pazuddin
Asian Pacific Journal of Cancer Prevention
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제17권7호
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pp.3489-3494
/
2016
Background: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the coverage. Objective: We determined the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus samples collected by physicians (Physician sampling). Materials and Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of self-sampling was 71.9% (95% CI:70.9-72.8), the specificity was 86.6% (95% CI:85.7-87.5), the positive predictive value was 74.2% (95% CI:73.3-75.1) and the negative predictive value was 85.1% (95% CI: 84.2-86.0). Self-sampling smears (22.9%) allowed detection of micro-organisms better than physicians samples (18.5%). Conclusions: This study shows that samples taken by women themselves (self-sampling) and physicians have good diagnostic agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.
Copper T 380A intrauterine devices were inserted to nine thousand and nine hundred twenty women by 51 KAVS-member physicians since January 1, 1993 through December 31, 1993. This study was undertaken for the clinical analysis on a total of 9,920 women wearing Copper T 380A to grasp the effectivness as well as the expulsion rate due to a various side effects. The following features were the results of the study: 1. During the twelve months period, from January 1993 to December 1993, the largest number of IUD insertion per one physician is 740 cases and the smallest number 60 cases, the mean 195 cases. 2. After insertion of Copper T 380A, a total of 117 cases were removed the IUD;81 cases(0.8%) were due to extensive bleeding and 36 cases(O.36%) were due to pain. The pregnancy failure rate represented comparatively lower rate, 0.08% (8 cases) and the expulsion rate was 0.06%(6 cases). 3. The removal rate of Copper T 380A was different by physicians. The highest removal rate for bleeding was 3.13% and 13 physicians(25.5%) did not experience any bleeding cases. 4. For the removal rate for pain, 30 physicians(58.8%) did not experience any removal of IUD due to pain while 21 physicians(41.2%) removed IUD due to pain: 17 physiciansC33.4 %) had 0.1-1.5% of removal rate and 4 physiciansC7.0%) had 1.6-2.1% of removal rate. 5. A total of 43 physicians(84.3 %) did not experience any pregnancy failure case while 8 (15.7%) physicians was experienced pregnancy failure rate. Four physicians(7.8%) had 0.1-0.5% of pregnancy failure rate and 4 physicians had 0.6-1.0% of pregnancy failure rate. 6. Expulsion rate showed comparatively lower, 0.06% in this study. A total of 45 physicians (88.2%) did not experience any expulsion cases while 6 physicians(11.7%) had expulsion rate with the highest expulsion rate of 2.0%.
Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
Journal of Genetic Medicine
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제15권2호
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pp.72-78
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2018
Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.
There has been an increase in the number of female doctors worldwide. Women now represent half of all medical students, with almost the same numbers of men and women becoming physicians. There is a pool of talented women in our midst, and it is our responsibility as leaders to find those individuals and groom them for progress. However, residency training and academic education still resemble the historical model when there were few women in medicine. Gender differences in medical specialty choices can cause a maldistribution of doctors by specialty and geographical area, which could cause significant problems at the national health care system level. Major challenges facing female physicians include gender discrimination and sexual harassment, and work/family conflicts. Women are largely under-represented in academic medicine and experience discrimination in the academic environments. Recent issues about related to the "feminization of medicine" raise important questions forabout how academic medicine deals with gender issues. To better accommodate the needs of female doctors and ensure that they will have successful careers, structural and cultural changes to medical educations are needed.
Purpose: This study was designed to explore the attitudes of physicians and nurses. Method: Attitudes were measured by using the korean version of the SADP(Scale of Attitudes toward the Disabled Persons : Choi, G. H., & Lam, C. S., 2000). A korean version SADP consist of 24-item, six-point Likert-type scale(the points are -3, -2, -1, +1, +2, +3, where -3 is disagree very much and +3 is Agree very much), measuring general attitudes toward people with disabilities. The sample included 90 physicians, 114 nurses at a university hospital in Busan. The data were collected using questionnaires, and were analyzed using frequency, percentage, mean score, standard deviation, t-test and one-way ANOVA. Result: When studying the physicians group by itself, SADP scores tended to increase with women physicians, old age, married, higher educational level, more years of experience, medical unit. When studying the nurses group by itself, SADP scores tended to increase with the age of thirty, single, educational level, more years of experience, surgical unit. But not to a statistically significant degree. Conclusion: Findings suggest that the nurses had significantly higher score than the physicians(t=-4.63, p<.001). When studying the physicians group and the nurses group by itself, not to a statistically significant degree.
Lee, Sanghoon;Song, Jae Yun;Ku, Seung Yup;Kim, Sun Haeng;Kim, Tak
Clinical and Experimental Reproductive Medicine
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제39권2호
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pp.46-51
/
2012
Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.
Objectives: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. Methods: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians' demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. Results: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/vice-chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. Conclusions: A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.
Kim, Juyoung;Pyo, Jee-Hee;Choi, Eun-Young;Lee, Won;Jang, Seung-Gyeong;Ock, Min-Su;Lee, Sang-Il
한국의료질향상학회지
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제28권1호
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pp.34-44
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2022
Purpose:We investigated physicians' responses to a series of clinical vignettes consisting of patient safety incidents, with and without disclosure of patient safety incidents (DPSI). Methods: An anonymous survey was conducted to investigate physicians' responses to the DPSI via online communities of physicians, and additional participants were recruited using a snowballing sampling method. We evaluated physicians' responses to the DPSI using eight hypothetical scenarios (HS) from the following perspectives: thoughts regarding medical errors, revisiting the physician, recommendation, lawsuit, criminal prosecution, trust score, and compensation amounts. We used the chi-square test to evaluate the overall differences in response rates among the scenarios. Statistical analyses were performed using the Student's t-test to compare the trust scores and compensation amounts. Results: A total of 910 physicians participated in this survey. An overall comparison of trust scores among HS showed that HS 1 (unclear medical errors, minor harm, and DPSI) had the highest trust score. In contrast, in the opposite scenario, HS 8 (clear medical errors, major harm, and DPSI not conducted) received the lowest scores. Cases with minor harm to patients (HS 1, 2, 5, and 6) showed lower compensation amounts than the others (HS 3, 4, 7, and 8). Physicians were more likely to think of situations with DPSI as not having medical errors (53.1% vs. 55.2%). In addition, the scenarios with DPSI were evaluated favorably in terms of intention to revisit, recommend, suit, and engage in criminal proceedings. Physicians showed higher trust scores (6.2 vs 5.4) and gave lower compensation amounts ($27.7 million vs $28.1 million), although there was no significant difference in terms of compensation amounts to the physician conducting DPSI. Conclusion: Our study showed overall positive perceptions regarding DPSI among Korean physicians.
Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.
Female nurses in Korea have historically experienced discrimination on the basis of their gender as part of the traditional society views on woman and as a result of the male dominated hospital environments. This discrimination may interfere with the ability of female nurses to promote the health of their patients. To better understand this bias, we collected and analyzed 16 cases of alleged sexual discrimination reported by female nurses with more than 5 years work experience. The cases were classified into 10 subjects and further into 4 categories: personnel administration, daily working environment, female gender bias, and health care delivery. There were 7 cases (11.3%) of unjust personnel changes consisting of demotion(1), termination(4), and reallocation of position(3). Twenty three (37.1%) of cases related to problems in the daily workplace including biases in communication between female nurses and male physicians(12), daily work(8), and responsibility for adverse outcomes(3). We noted 17 cases (27.4%) of female gender bias as reported by female nurses(7), female physicians(7), and female patients(3). Lastly, there were 15 (24.3%) cases of problems with health care delivery due to sexual discrimination, including enrollment in the health care system(4),and decisions regarding medical care(4). These results suggest that sexual discrimination towards women is pervasive in the Korea hospitals, not only towards female nurses but also towards female physicians and patients. More discriminatory practices in a timely fashion such that better nursing care can be provided to patients and their families.
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