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pISSN : 2005-8284 / eISSN : 2234-3598

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2015, Vol.18, No.2

  • 1.

    The Effect of Painful Experiences, Compassionate Competence, Caring Behaviors on the Terminal Care Performance of Clinical Nurses

    JO Kaehwa | 박애란 | Jin Ju Lee and 1other persons | 2015, 18(2) | pp.103~116 | number of Cited : 14
    Abstract PDF
    The purpose of this study was to identify the factors affecting the performance of clinical nurses in terminal care settings. The participants in this study were 150 nurses working in hospitals in and around the South Korean city of Daegu. Data were collected April 2015 by using self-report questionnaires and analyzed with the IBM SPSS WIN 19.0 program. Significant relations were found among humanistic knowledge (r=0.377, p<0.01), hospice perception (r=0.290, p<0.01), spirituality (r=0.481, p<0.01), and terminal care performance. The significant predictors of the terminal care performance of the hospital nurses were clinical working area, spirituality, and humanistic knowledge. These variables explained 32% of the variance in the terminal care performance of the hospital nurses. These results of this study suggest that the performance of hospital nurses in terminal care settings can be improved by enhancing their spirituality and humanistic knowledge.
  • 2.

    Ethical Values and Human Rights Sensitivity in Nursing Students

    Seongeun Kim | 2015, 18(2) | pp.117~128 | number of Cited : 12
    Abstract PDF
    Ethical Values and Human Rights Sensitivity in Nursing Students
  • 3.

    Study on the Recognition, Understanding, and Satisfaction about Surgical Informed Consent Terms among Surgical Patients in a Hospital

    Kim,Yeong-Kyeong | Jeong Ihnsook | 2015, 18(2) | pp.129~140 | number of Cited : 0
    Abstract PDF
    This cross-sectional study is designed to evaluate the recognition, subjective understanding (SU), and objective understanding (OU) of the terms used in obtaining informed consent for surgery and also the levels satisfaction with the explanations (ES) provided in the informed consent process. Data are collected using a structured self-report questionnaire answered by 243 patients who had orthopedic operations in South Korea in July to August, 2014. The mean number of terms recognized is 6.24, and lower in age over 50 years (F=11.46, p<0.001) and education level of elementary and middle school compared with college and higher (F=12.06, p<0.001). The mean SU was 73.90 out of 100 points and was lower in patients without a high school education than in those with a college education (F=12.39, p<0.001). The mean OU is 68.04 out of 100 points and lower in age over 50 years (F=5.91, p<0.001) and education level of elementary and middle school compared with college and higher (F=8.06, p=0.001). ES is positively correlated with both term recognition (r=0.168, p=0.009) and SU (r=0.135, p=0.035). The results of this study suggest that medical personnel should monitor patients’ recognition, understanding, and explanation satisfaction of the terms used in the consent process and give feedback to patients to enhance their understanding and explanation satisfaction.
  • 4.

    An Analysis of U.S. Guidance for Obtaining the Electronic Informed Consent in the Clinical Trial

    Eun-Ae Kim | 2015, 18(2) | pp.141~158 | number of Cited : 0
    Abstract PDF
    According to the international norms, the researcher who wants to conduct the clinical trial must obtain the informed consent from the research participant in order to protect their rights and welfare and to respect their autonomy. To obtain the informed consent appropriately, the researcher must provide the sufficient information and the detailed explanations about the research and allow adequate opportunity to ask questions before obtaining the informed consent. In Korea, these requirements are specified as the researcher’s legal liabilities both in the Pharmaceutical Affairs Act and in the Korean Good Clinical Practice. Recently, there has been a growing interest in the use of the electronic media and process for obtaining the informed consent since the electronic informed consent is convenient for delivering and storing the information. However, it is questionable whether the use of the electronic media and process for obtaining informed consent satisfies the legal and ethical requirements laid out in the domestic law and the international norms because these principles and standards within them are created on the premise that the informed consent could be obtained on paper. So, in this article, I identify the ethical issues surrounding the electronic informed consent that require the attention not only of the researcher but also of the Institutional Review Board. In particular, I analyze and comment on the guidance concerning the electronic informed consent prepared by the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration.
  • 5.

    The Roles of Patient Managers and Their Implications for Medical Ethics: An Ethnographic Study of a Plastic Surgery Clinic

    So Yeon Leem | 2015, 18(2) | pp.159~171 | number of Cited : 2
    Abstract PDF
    Based on long-term ethnographic fieldwork at a plastic surgery clinic, this article shows that non-medical professionals called “patient managers” have played mediating roles between patients and doctors and possibly challenged medical ethics and authorities. Unlike previous social studies of plastic surgery, rather than simply criticizing the unethical aspects of the private medical market, this study starts from their realities and considers them as resources for medical ethics. By taking the roles of non-medical professionals into both ethical and educational consideration, this study supplements current medical ethics, which is mainly concerned with medical professionals, and extends medical ethics education to include more common problems faced by patients. This study is a preliminary attempt to draw ethical implications from social studies of medicine. It demonstrates that medical ethics is a concern, not only for physicians, but for multiple agents including non-medical professionals. This kind of interdisciplinary approach can thus contribute to improving both the effectiveness of medical ethics and the social perception of doctors and medicine.
  • 6.

    The Role of a Patient’s Family When the Withdrawal of Life-Sustaining Treatment is Expected: A Narrative Analysis

    Won Kyung Chang | Kyongjin Ahn | 김민영 and 2other persons | 2015, 18(2) | pp.172~189 | number of Cited : 15
    Abstract PDF
    There are considerations both for and against allowing family members to decide whether to withdraw life-sustaining treatment from a terminal patient who is no longer able to communicate. On the one hand, a patient’s family members will often be the most suitable persons to speak for a patient’s values and interests and to make the best decision for the patient. On the other hand, family members may be influenced in their decision-making by a desire to rid themselves of the financial burden of the patient’s medical costs. Until now there has been a lack of in-depth research into the decision-making of family members caring for a terminally ill patient on life-sustaining treatment. This study investigates the suffering experienced by family members throughout the period of care, the changes in their relationships to the patient and/or other family members, and their attitudes toward the withdrawal of life-sustaining treatment by conducting in-depth interviews with six family members who have given primary care to a patient in the final stages of cancer. The study participants report their emotional suffering as a result of the patient’s condition, the substantial changes in their lives after the patient has been diagnosed with cancer, and the conflicts with the patient or other family members that have arisen in the process of caring for the patient. By analyzing the statements of these participants, this study suggests that in the discussions of life-sustaining treatment family members should be considered as multi-faceted individuals who sacrifice themselves in order to care for the patient while trying to maintain family bonds as well as fulfilling their own emotional, physical, economic, and relational needs.
  • 7.

    Ethical Considerations on the Financial Incentive Systems at Hospitals in Korea

    CHEONG Yoo-Seock | PARK Seokgun | 2015, 18(2) | pp.190~199 | number of Cited : 1
    Abstract PDF
    Many hospitals in Korea offer financial incentives to doctors based on the income they generate for the employers. These incentives encourage over-treatment and threaten professionalism by eroding the trust between physicians and patients. This article presents four cases that illustrate how these incentives can have adverse effects on institutional culture and pervert the delivery of medical services. This article also proposes the following guiding principles for an improved system of incentives: it should be designed with mandatory safe-guards to avoid harmful effects on patients; the overall purpose of the incentive system should be to improve the quality of medical care rather than to increase the income of hospitals; and the amount of money individual doctors can receive through financial incentives should remain modest so as to preserve institutional integrity. This article aims to promote more widespread discussions concerning the problems related to the incentive systems used by hospitals in Korea.
  • 8.

    Implications of Decision Coaching in Shared Decision Making

    LEE EUNYOUNG | 2015, 18(2) | pp.200~216 | number of Cited : 5
    Abstract PDF
    In shared decision-making, patients and physicians work together as decision-making partners. To overcome the imbalance of medical knowledge between physicians and patients and to assist patients in the shared decision-making process, patient decision aids (PtDAs) have been proposed. PtDAs improve patients’ knowledge, enhance their accurate perception of risks, help them achieve choices that match their values, and stimulate them to become more actively involved in the decision-making process. Nevertheless, many studies have reported that patients have difficulty in fully participating in shared-decision making. This in turn gives rise to the need for medical decision coaching, which aims to develop patients' confidence and skills in deliberating about options and helps to prepare them for making decisions with their practitioners. Medical decision coaching is provided by trained individuals, and the coach’s role has been described as that of a medical decision counsellor, educator, navigator, and facilitator. In this article, I describe a framework for medical decision coaching to support shared decisions. Additionally I discuss the implications of medical decision coaching in Korean society.