의료사고 및 의료분쟁에 관한 고찰

김현이 제주한라대학 1998 論文集 Vol.22 No.-

The general atmosphere for the medical customer's claiming his right more and more is rapidly spreading to the medical world with result that the patient is claiming his right strongly against physician. Nowaday, there is an increasing number of legal cases in which patients raise a lawsuit against doctors even for minor reasons. Also there is a trend that settles the medical dispute by means of unlawful method. This is the causes of disturbance of medical development and defensive medical services. Therefore this study reviewed causes of medical accident and increase of medical dispute and problems related increase of medical dispute and analized preventive means of medical accidents and amicable solution to medical dispute. The results of this study are summerised as follows. 1. The principal causes of medical accidents are the danger which is involved essentially in medical practice and the possibility of error by physician's discretion and emergency and experimental property of medical care. The lack of patient's understanding for medical properties as stated above and improvement of patient's cognition for medical information are causing increase of medical accidents. 2. The change of type of medical care and distrust between patients and physicians by deindividualization lead to increse of medical dispute cases. A social trend of mutual distrust and settlements by law affect increase of medical disputes. In addition, the lack of legal institution which inspect objectively and professionally medical accident and assess recompense and pay compensation for damage lead to increase of medical dispute. 3. The solution of medical dispute by unlawful acts like disturbance or riot is causing paralysis of hospital funtions and defensive medical services. Also incresed payment of compensation due to medical disputes makes worse financial condition of hospital. 4. To prevent medical disputes, physicians have to be faithful to their duties of explanation for medical care or treatment to patients and write minutely and completely medical records that are important evidence to clear medical malpractice. Also, medical practitioner must be careful not to develope medical accident due to negligence and an air of indifference. 5. The solution of medical disputes by arbitration is better than by litigation because the arbitration has advantage that can settle peacefully medical dispute. In order to settle medical dispute by arbitration, justice of jugement of medical accident must be guaranted. Therefore it is desirable that members of arbitration are constituted representative of medical provider and medical consumer, lawyer and related clerical employee.

Jovan Cvijic의 생애와 지리학 사상

金賢伊 祥明女子大學校 人文社會科學大學 地理學科 1995 地理學論考 Vol.13 No.-

코로나19 사태를 극복해 나가는 원장들의 경험에 관한 내러티브 탐구 -대구 지역을 중심으로-

김현이,백지혜 한국열린유아교육학회 2020 한국열린유아교육학회 학술대회 논문집 Vol.2020 No.11

본 연구는 대구지역 어린이집 원장들을 중심으로 코로나-19 사태를 극복해 나가는 경험의 의미를 알아보는 것을 목적으로 한다. 위기상황 속에서 기관장들의 노력과 적응과정을 살펴봄으로써 보육현장에 또 다시 위기가 찾아올 때 그들이 어떻게 대처할 수 있는지 알아보고 앞으로 어떤 협력과 지원이 함께 해야 하는지에 대해 논의해 보고자 하는 것이다. 이를 위해 대구지역 어린이집 원장 7명을 연구 참여자로 선정하였다. 자료 수집은 2020년 5월부터 2개월간 전화, 설문지, 개별면담, 집단면담 형식으로 진행되었으며 이외에도 보육통합시스템 공문, 뉴스 등을 수집하고 분석하였다. 연구결과 원장들은 교육책임자로써 언텍트 교육의 어려움을 경험하고 변화된 사회환경에 맞춘 새로운 교육의 필요성을 알 수 있었다. 또한 경염책임자로써 운영의 어려움을 경험하면서 장기적으로 보육통합시스템의 개선을 이야기하였다. 마지막으로 안전관리책임자로써 무거운 책임감을 느끼며 위기를 극복하는 과정을 통해 새로운 희망을 말한다는 것을 알 수 있었다.

요양보호사의 교육 전·후-취업 후 요양보호지식 및 직업의식 변화에 관한 연구 : 충남지역을 중심으로

김현이,유재옥,이형석 한국장기요양학회 2022 장기요양연구 Vol.10 No.2

본 연구의 목적은 예비요양보호사의 요양보호 지식 및 직업의식 변화를 교육 전·후, 취업 후로 나누어 살펴보고, 장기적으로 요양보호사의 직업에 대한 전문성 인식 및 근속 의지와 긍지를 제고하기 위한 기초자료를 제공하는 데 있다. 이를 위해, 충남 지역의 요양보호사학원 교육생 73명을 대상으로 교육 전·후 그리고 취업 후를 시계열 방식으로 설문조사 한 후, 요양보호 지식 및 직업의식의 변화를 분석하였다. 분석결과는 다음과 같다. 첫째, 요양보호사 교육과정 전·후 그리고 취업 후에 요양보호 지식에 대한 점수가 유의미하게 향상되었다. 둘째, 요양보호사 교육과정 전·후 그리고 취업 후에 요양보호사의 직업의식 점수는 유의미하게 증가하였다. 셋째, 요양보호 지식 및 직업의식은 연령 특성에 따라 유의미한 차이를 나타내었다. 이러한 분석결과를 통해 다음과 같은 정책적인 제언을 하고자 한다. 첫째, 연령대별 전문적인 교육프로그램의 개발 및 기타 인프라 구축이 필요하다. 둘째, 요양보호사의 직업의식을 고취시킬 수 있는 방안이 필요하다. 셋째, 요양보호사들이 돌봄 대상자들에게 지속적인 양질의 서비스를 제공할 수 있도록 근속의지를 높일 수 있는 환경개선이 필요하다.

생체 세라믹스의 응용과 개발 현황

김현이,공영민,Kim, Hyeon-Lee,Gong, Yeong-Min 재료연구소 1998 機械와 材料 Vol.10 No.2

병원 외래 방문 환자의 만족도에 대한 연구 : 제주시의 한 병원을 방문한 환자를 중심으로

김현이 제주한라대학 1997 論文集 Vol.21 No.-

Health care organigations are faced with serious competitive challenges from many directions in korea. Health care providers should learn what the consumer wants from the health care system in order to compete in the rapidly changing health care arena. Patient satisfaction and customer focus are increasingly important objectives set for health services. The patient satisfaction surfvey is becoming the main method of assessing this aspect of health care. The purposes of this study were to assess patient satisfaction with outpatient services in a hospital in Cheju City and to provide fundamental data to improve the quality of hospital services in Cheju. Using the method of self - 0administered questionnaires, patient satisfaction was measured in a hospital in Cheju City for outpatient visits and survey was conducted from Oct 1, 1997 to Nov 31, 1997. A total of respondants was 200. The data were analyzed by percentage and mean. The results were summerized as follows. 1. The important determinants that respondents selected a hospital were noted "reliability of medical care" (29.5%), "hospital was not far away home" (29.0%) and "reputaion of physician" (17%). 2. Of the means for the satisfaction with 7 specific dimensions of hospital services, the dimension of physician scored highest, 3.44, the dimensions of tests and nursing care scored 3.32, the dimension of hospital environment scored 2.94, the dimension of registration scored 2.92, the dimension of environment of medication scored 2.77, and the dimension of medical care scored lowest, 2.60. 3. The satisfaction of hospital outpatient services was evaluated for items of each dimension. The results indicated that respondents were satisfied with 4 items of physician, 3 items of nursing care and 6 items of tests but were dissatisfied with 5 items of environment of madication and 4 items of environment of medical care. 4. The mean score of the effect of medical treatment was 3.37 but the appropriateness of medical cost was 2.73. It showed that respondents were generally satisfied with treatment results but felt that medical cost were somewhat expensive. 5. The mean score of the overall satisfaction with hospital services was 3.05. It showed that respondents were generally satisfied with general hospital services.

〈동시대인〉지의 역사 속에서 살펴 본 고골과 뿌쉬낀

김현이 한국노어노문학회 2006 한국노어노문학회 학술대회 발표집 Vol.2006 No.11

제주시 여성의 자궁경부암 조기진단을 위한 세포진 검사 실태조사 및 추후관리 방안

김현이,김효실 대한보건협회 2000 대한보건연구 Vol.26 No.3

The purpose of this study was to examine the knowledge, attitudes and practices of Pap smear screening by women in Cheju City. It also investigated whether or not follow-up programs were offered and the way it was offered in 14 gynecological clinics. The results were summarized as follows: 1. A total of responses was 693. Respondents were predominantly married women with an age range from 25 to 44 years. The majority of respondents (83.7%) had the education level of over high school graduation. 43.9 percent of respondents indicated that their average income per month were less than one million won and more than 60 percent of them have had a job in some ways. 2. In investigation of the level of recognition about Pap smear screening, 94.8 percent of respondents answered that they have heard about it and the main sources for this information were Physicians and nurses (32.3%), Mass media (28.4%) and Family and friends (28.4%) respectively. 3. Out of 517 respondents (74.6%) who reported having had at least one screening in their lifetime, only 299(57.8%) reported that they took a routine Pap smear screening. In relation to screening intervals, 41.4 percent of them took Pap smear screening during last one year and 30 percent have taken it between last one and two years. The main enforcers to take Pap smear screening for respondents were to prevent themselves from cervical cancers (35.4%) and as part of routine health check (16.6%) . On the other hand, the main reasons for not being screened were embarrassing and unpleasant procedure (35.4%) , not enough information (19.5%) and lack of time (16.1%) . 4. The age group of 45 - 54 reported the highest screening rate and they were more likely to practice a routine Pap smear screening than any other age groups. There was no significant difference in screening rate among married women, divorcees and widows. However, interestingly, the screening rate of unmarried women recorded the highest in this study. Respondent with higher income, or with the lower level of education reported the higher Pap smear screening rate. 5. 93 percent of women experienced screening reported being satisfied with the test itself. Only 35.5 percent of all respondents in our study reported that Pap smear screening was publicized well. Therefore, there is a need for the better public education and publicity for Pap smear screening. 6. As a result of investigating 14 Gynecological clinics in Cheju city, there was no planned follow-up program for further screening and physicians didn't use recall methods such as phone calls and postcards.

노인의 자기효능감, 일상 스트레스, 건강행위가 자아통합감에 미치는 영향

김현이,김애리 한국자료분석학회 2012 Journal of the Korean Data Analysis Society Vol.14 No.6

Purpose: The purpose of this research was to provide basic data to develop nursing intervention program and to identify factors which influence on ego integrity for successful aging process for elders by recognizing the relation between the self efficacy, daily living stress, health behavior, and ego integrity. Methods: The study design was a cross sectional descriptive study. The data were collected with a structured questionnaire from 233 elders. Results: There were differences in age, education, standard of living, cohabitation, monthly money, health status, general & exercise self efficacy, daily living stress and health related behaviors. General & exercise self efficacy, daily living stress and health related behaviors influenced ego integrity and these variables explained 49.1% of ego integrity and daily living stress was the most explicable variable. Conclusion: There should be further development of professional nursing strategies which can enhance ego integrity, especially promoting self efficacy and health related behavior while reducing daily living stress. 본 연구는 노인의 자기효능감, 일상 스트레스, 건강행위와 자아통합감과의 관계를 확인하기 위함이다. 연구방법은 2010년 9월 20일부터 10월 9일까지 65세 이상의 재가노인 233명을 대상으로 하는 서술적 상관관계 분석연구로 연구결과 자아통합감에는 연령, 교육정도, 건강정도, 생활정도, 동거형태, 평균용돈에 따라 차이가 있었으며 일반적 자기효능감, 운동 자기효능감, 건강행위, 일상스트레스와 유의한 상관관계가 있었다. 자아통합감에 영향을 주는 변수로는 일반적 자기효능감, 운동 자기효능감, 일상 스트레스, 건강행위이었으며 이 변수들은 노인의 자아통합감을 49.1% 설명하였다. 이 중 일상 스트레스가 가장 영향력이 큰 변수였다. 따라서 일상 스트레스를 경감시키며 건강행위와 자기효능감를 증대시킬 수 있는 간호중재 프로그램을 개발하여 노인의 자아통합감을 증진해야 할 것이다.

한 종합병원의 계획에 없던 재입원률에 관한 연구

김현이 제주한라대학 1999 論文集 Vol.23 No.-

A reliable and valid assessment of the quality of medical interventions is an indispensable prerequisite for any initiatives targeting at quality improvement in health system. To date, quality assessment has relied on a leading indicator approach, which may miss important variations in care. Quality indicators are well suited tools for such tasks. An indicator is a well-defined, objective variable used to monitor the quality and/or appropriateness of an important aspect of patient care. Indicators can be derived with regard to structure, process and outcome. The indicators should be in a form which can be used within the individual department and for comparison between hospitals nationally and internationally. Especially clinical indicators are objective measures of process or outcome of patient care. An indiator can be a resource, process, clinical event, complication, or outcome about which data should be collected through monitoring activities. Examples of indicators include death, hospital-acquired infection, unplanned return to surgery, unplanned readmission. Unplanned hospital readmission within 28 days of discharge is considered a "sentinel event" for poor quality. This purposes of this study were to identify patient characteristics and risk factors at discharge associated with unplanned readmission within 28 days of hospital discharge and to provide information to reduce incidence of unplanned readmission. This study reviewed the medical records of 171 patients who had an unplanned readmission to a general hospital within 28 days of discharge from hospital during the period March 1, 1999 to May 31. The results were summerized as follows. 1. Overall unplanned readmission rate was 1.6%, sex specific unplanned readmission rate was higher men than women. 2. Percentage of unplanned readmission patients by previous admission department was noted pediatrics 20.5%, general surgery 16.4%, cardiology 14.0%, internal medicine 7.6%. 3. Of 171 unplanned readmission patients, 111(64.9%) underwent an operation and 60(35.1%) did'nt undergo an operation at previous admission. 4. Of unplanned readmission patients, 61.4% admitted through outpatient and 38.6% admitted through emergency room at previous admission. 5. The length of stay at previous admission was revealed 16 days over (43.9%), 1-5 days(21.6%), 6-10 days(21.6%) and 11-15 days(12.9%). 6. The reasons of unplanned readmission were recurrence of disease(56.7%), deterioration of existing disease(10.5), complication(31.6%), other(1.2%). Unplanned readmission should be analyzed preventable by better management of the previous admission.