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이해원,조현선,김순화,Lee, Hae-Won,Cho, Hyun-Sun,Kim, Sun-Hwa 한국의료질향상학회 2011 한국의료질향상학회지 Vol.17 No.1
Background : The purpose of study in to grasp the level of perception of hospital workers on the patient safety culture, consider the difference in perception of patients safety culture according to medical service and finally find out a way to establish patient safety culture in hospital. Methods : As for the data, the analysis on frequency, t-test, ANOVA and tukey test were carried out by using SPSS 12.0. Result : The results of comparison among the positive response ratios on the patients culture of hospital workers showed that the subjects had perceived the teamwork within units most positively(74.1%), and perceived most negatively on the non-punitive response to error(16.2%)and the staffing(26.2%). 68.6% of subjects answered that the medical error were mostly of always reported. when daytime working hours are longer, perception of patient safety culture ranked low. In general, departments for direct medical service than departments for indirect medical service assessed patient safety culture high. Conclusion : Organizational learning and teamwork within units, communication openness, active support of hospital management for patient safety, and cooperation across the units would be crucial to promote the overall perceptions of patients safety of hospital workers and the level of patients safety in the units and to improve the quality of the event reporting system.
외상후 스트레스 장애 이외의 정신 장애에 대한 EMDR 전후의 치료 반응 및 증상 변화
이해원,김대호,배활립,최준호,오동훈,박용천,Lee, Hae-Won,Kim, Dae-Ho,Bae, Hwal-Lip,Choi, Joon-Ho,Oh, Dong-Hoon,Park, Yong-Chon 대한불안의학회 2008 대한불안의학회지 Vol.4 No.1
Objective : Eye movement desensitization and reprocessing (EMDR) has been established as an effective treatment for patients with posttraumatic stress disorder (PTSD). However, the literature is unclear as to whether EMDR is effective in the treatment of other psychiatric disorders. The purpose of this study was to evaluate the potential use of EMDR in the treatment of psychiatric disorders other than PTSD by using a clinician's impression of patient response and a subjective symptom evaluation. Methods : Seventeen diagnostically heterogenous patients without PTSD underwent an average of 4.3 sessions of EMDR. Symptom severity was assessed by the Clinical Global Impression-Change Scale (CGIC), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Checklist-90- Revised (SCL-90-R) before and after EMDR. Those whose CGI-C scores were 'very much improved' and 'much improved' after EMDR were classified as 'responders.' The patients' before and after treatment scores of symptom severity and group differences were compared. Results : Twelve of the 17 participants (12/17, 71%) were classified as 'responders.' The patients' scores on all of the scales, with the exception of the trait anxiety scale and obsession-compulsion scale of the SCL- 90-R, significantly decreased after treatment. There was no difference in sociodemographic and clinical variables between the responders and non-responders. Conclusion : The results of our study suggest that EMDR can be a promising candidate for the treatment of patients with psychiatric disorders other than PTSD, and thus further controlled studies are needed to determine whether EMDR can be applied to various psychiatric populations.
소아영양집중지원팀에서 진료과 참여 확대에 따른 정맥영양 자문 순응도 및 영양상태 비교 분석
이해원 ( Hae Won Lee ),정민재 ( Min Jae Jung ),박지은 ( Ji Eun Park ),권희 ( Hee Kwon ),김재송 ( Jae Song Kim ),고홍 ( Hong Go ),손은선 ( Eun Sun Son ) 한국정맥경장영양학회 2019 한국정맥경장영양학회지 Vol.11 No.2
Purpose: Malnutrition in hospitalized children has an impact on growth, morbidity, and mortality. For this reason, the implementation of pediatric nutrition support team (PNST) has been suggested. On April 2017, in Severance Hospital, more PNST physician’s departments participated in PNST, and a PNST physician assigning system was changed to be the same departments with the attending physician and PNST physician. This study performed a comparative analysis of the compliance and clinical outcomes after expanding the participation of the PNST physician’s department. Methods: Pediatric patients, who were referred to a PNST consultant, were divided into two groups: an unmatched group (different departments with the attending physician and PNST physician [154 patients, 233 consultations from May 2016 to October 2016]), and a matched group (same departments with the attending physician and PNST physician [169 patients, 302 consultations from May 2017 to October 2017]). The PNST compliance and clinical outcomes, such as the total delivered/required caloric and protein ratio, % ideal body weight (%IBW), serum total protein, and serum albumin, in the two groups were compared. Results: The compliance was significantly higher in the matched group than the unmatched group (63.4% vs. 47.3%, P=0.005). Although there was no significant difference, the total delivered/required caloric and protein ratio, and %IBW in the matched group tended to increase. The serum total protein (0.7±0.7 g/dL vs. -0.4±1.3 g/dL, P=0.004) and serum albumin (0.5±0.5 g/dL vs. -0.1±0.6 g/dL, P=0.003) were significantly higher in the matched group. Conclusion: After expanding the physician’s departments in PNST, the compliance was significantly higher in the matched group and the clinical outcomes tended to better. The physician assigning system to be matched with the departments between the attending physician and the PNST physician may help increase the compliance of NST consultations, resulting in an improvement of the patient’s clinical outcomes.