PURPOSE: The purpose of this study was to determine nurses' perceptions of the disclosure of patient safety incidents (DPSI), which is known to be effective in reducing medical litigation and improving the credibility of medical professionals. METHODS: Three focus group discussions were conducted with 20 nurses using semistructured guidelines. Transcribed content including a record of the progress of the focus group discussions and researchers' notes were analyzed using directed content analysis. RESULTS: Most participants thought that DPSI is necessary because of its effectiveness and for ethical justification. However, participants held varied opinions regarding the primary responsibility of DPSI. Participants agreed on the necessity of explaining the incident and expressing sympathy, apologizing, and promising appropriate compensation that are chief components of DPSI. However, they were concerned that it implies a definitive medical error. A closed organizational culture, fear of deteriorating relationships with patients, and concerns about additional work burdens were suggested as barriers to DPSI. However, the establishment of DPSI guidelines and improving the hospital organization culture were raised as facilitators of DPSI. CONCLUSION: Most nurse participants acknowledged the need for DPSI. To promote DPSI, it is necessary to develop guidelines for DPSI and provide the appropriate training. Improving the hospital organization culture is also critical to facilitate DPSI.
Compensation and Redress ; Disclosure ; Focus Groups ; Humans ; Jurisprudence ; Korea ; Medical Errors ; Organizational Culture ; Patient Rights ; Patient Safety

Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.

BACKGROUND/OBJECTIVES: In the Republic of Korea, “Healthy Restaurant for Sodium Reduction (HRSR)” project have been designated as one of the representative policies for sodium intake reduction. However, as of 2021, only 879 restaurants, less than 0.1% of all restaurants, had been designated. Therefore, to increase the participation of restaurants in this policy, it is necessary to examine the in-depth perception and experience of participants and non-participants in the HRSR.MATERIALS/METHODS: Two focus group discussions were conducted for HRSR project participants and non-participants. RESULTS: A total of 260 semantic units were derived from the 2 groups. The units were further classified into 5 upper categories and 11 subcategories. All the study participants knew the importance of low sodium intake, but they had little information on HRSR project.Various attempts have been made to encourage low sodium practice in restaurants, and the participants reported that the amount of salt used in their restaurants currently is reduced compared to that used in the past. However, they were worried about customers’ complaints about the low sodium in their diet and the insignificant beneficent associated with the policy, which makes restaurant owners reluctant to participate in this policy. All the participants agreed on the urgent need for the improvement of public awareness of low-sodium diets and for substantive government support for HRSR. CONCLUSION This study concluded that strategies such as more active publicity for the practice of sodium reduction in restaurants, identification of approaches to dispel the perception that low-salt diet is not tasty, and development of plans to increase the sale of food in of HRSR, are needed.

BACKGROUND: The objectives of this study were to identify the reasons of quitting smoking, to determine the factors that make it difficult or helpful to maintain smoking cessation and to confirm the changes after the smoking cessation. METHODS: This study was conducted an in-depth interview with people who participated in the smoking cessation treatment program. There were 10 participants and they were interviewed thoroughly for 14 times. Using the directed content analysis, we analyzed the transcript which was written by recording the interview and the researchers' note. RESULTS: The results of this study are summarized as ‘the experience while at the verge of smoking cessation and stepping over the verge of smoking cessation,’ ‘the changing experience due to smoking cessation,’ and ‘maintaining the changes through overcoming re-smoking.’ The smoking cessation treatment program induced the smokers to quit smoking. Participants mentioned drinking alcohol was the major obstacle to maintain smoking cessation. Also, they noted that the money and the time that were already spent to quit smoking helped their smoking cessation as well as the social relations which helped to prevent re-smoking. Participants felt well-cared through the smoking cessation treatment program and that it helped them to maintain smoking cessation. CONCLUSION: Smoking cessation treatment program has a positive effect on the smoking cessation trial and maintenance. In order for smokers to overcome re-smoking, educations regarding drinking problem, formation of supportive social relationship, and the applications for smoking cessation will be beneficial.
Drinking ; Korea ; Smoke ; Smoking Cessation ; Smoking

Objectives: The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS). Methods: We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations. Results: In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale. Conclusions While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.

Background: A methodology for comprehensively and reasonably measuring the burden of disease due to adverse events has yet to be clearly established. In this study, a new and systematic method for measuring the burden of disease due to adverse events was tested by utilizing the results of a medical record review, which is commonly used as a gold standard. Methods: Using the characteristics of preventable adverse events identified in the 2019 Patient Safety Incidents Inquiry (PSII), conducted to monitor the level of patient safety in Korea accurately, the resulting disability-adjusted life years (DALYs) and economic costs were estimated. DALYs were calculated as the sum of the years lived with a disability for patients who suffered permanent disability, or more, due to preventable adverse events, and the years of life lost due to premature mortality was calculated for patients who died due to preventable adverse events. The economic cost was calculated using the main diagnostic codes of patients who suffered preventable adverse events, identified as prolonged hospitalization in PSII, and the average medical cost by disease category and age group. Results: Estimates of DALYs due to preventable adverse events were 1,114.4 DALYs per 100,000 population for the minimum standard and 1,658.5 DALYs per 100,000 population for the maximum standard. Compared to the 2015 Korea Burden of Disease results, the ranking of DALYs due to preventable adverse events was sixth for the minimum standard and third for the maximum standard. The annual medical cost of adverse events in 2016 was estimated to be approximately Korean Republic Won (KRW) 870 billion (700 million US dollars). Medical expenses due to preventable adverse events were calculated to be approximately KRW 150 billion (120 million US dollars) as a minimum standard and approximately KRW 300 billion (240 million US dollars) as a maximum standard. Conclusion If this more standard method of systematically calculating the disease burden due to adverse events is used, it will be possible to compare the size of the patient safety problem with that of other diseases. The results of this study indicate that we still need to pay more attention to the issue of patient safety.

Background: The present study aimed to update the methodology to estimate cause-specific disability weight (DW) for the calculation of disability adjusted life year (DALY) and health-adjusted life expectancy (HALE) based on the opinion of medical professional experts. Furthermore, the study also aimed to compare and assess the size of DW according to two analytical methods and estimate the most valid DW from the perspective of years lost due to disability and HALE estimation. Methods: A self-administered web-based survey was conducted ranking five causes of disease. A total of 901 participants started the survey and response data of 806 participants were used in the analyses. In the process of rescaling predicted probability to DW on a scale from 0 to 1, two models were used for two groups: Group 1 (physicians and medical students) and Group 2 (nurses and oriental medical doctors). In Model 1, predicted probabilities were rescaled according to the normal distribution of DWs. In Model 2, the natural logarithms of predicted probabilities were rescaled according to the asymmetric distribution of DWs. Results: We estimated DWs for a total of 313 causes of disease in each model and group. The mean of DWs according to the models in each group was 0.490 (Model 1 in Group 1), 0.378 (Model 2 in Group 1), 0.506 (Model 1 in Group 2), and 0.459 (Model 2 in Group 2), respectively. About two-thirds of the causes of disease had DWs of 0.2 to 0.4 in Model 2 in Group 1. In Group 2, but not in Group 1, there were some cases where the DWs had a reversed order of severity. Conclusion We attempted to calculate DWs of 313 causes of disease based on the opinions of various types of medical professionals using the previous analysis methods as well as the revised analysis method. The DWs from this study can be used to accurately estimate DALY and health life expectancy, such as HALE, in the Korean population.

Background: Medical professionals must maintain their health to provide quality medical care to patients safely. However, the health-related quality of life of medical professionals is a complex issue that currently lacks a standardized evaluation approach. Therefore, the purpose of this study was to identify their perceptions of the health-related quality of life of medical professionals and explore ways to measure their quality of life as accurately. Methods: This study explored the subjective health status and well-being of Korean medical professionals by conducting three focus group discussions (FGDs) with 12 physicians and 6 nurses (November to December 2019). In the FGD, we elicited participants' opinions on existing health-related quality of life measurement tools. Also, we analyzed transcribed data through content analysis. Results: Participants in this study noted the ambiguity in the current definitions of health provided by the World Health Organization. They shared various problems of their health, mainly concerning fatigue and sleep disorders due to their work pattern. Also, participants shared anxiety, burden, and fear of negative consequences due to the complexity of their work. Participants voiced the necessity of a questionnaire on health-related quality of life that reflects the working lives of medical professionals. Conclusion Medical professionals in Korea were mainly criticizing about health-related quality of life problems caused by their work characteristics. The results of this study will provide valuable information for future health-related quality of life surveys targeting medical professionals in Korea, and also help to determine the method for monitoring the healthrelated quality of life for health professionals. In addition, the aspects and items identified by medical professionals as important for their health-related quality of life may be used as a basis for developing a new health-related quality of life measurement tools for medical professionals.

Background: To precisely build a healthcare delivery system at regional levels, local patients’ healthcare service utilization patterns must be examined. Hence, this study utilized trend analysis of the relevance index of each disease of each essential medical service field at the municipal and provincial levels. Methods: This study analyzed customized databases released by the National Health Insurance Service from 2016–2020. Diseases defined in the Korean National Burden of Disease (KNBD) study were categorized into the following essential medical service fields:trauma care, cardiocerebrovascular, maternal and neonatal, mental health, infection, cancer, older adults’ care and rehabilitation, and others. Relevance index, the percentage of medical service utilization in a region by the residents of that region relative to their total medical service utilization, was examined by region (17 municipal and provincial regions) and disease area. The relevance index was determined based on the number of patients and the total outof-pocket expenses.Result: Eight of the 17 regions showed over a 90.0% relevance index in the infection area. In the cancer area, 14 regions (not including Seoul, Daegu, and Busan) had a relevance index lower than 75.0%. Throughout the analysis period (2016–2020), there were no significant variations in the relevance index. Diseases such as bone and connective tissue cancer (39.0%), neural tube defects (16.7%), and autism (57.1%) had low relevance index in the essential medical service fields. In all 17 regions, the relevance index of inpatients was lower than that of outpatients, and that for out-of-pocket expenses was lower than that based on the number of patients. Conclusion The relevance index of major diseases of each essential medical service field calculated in this study can provide good indicators for monitoring the level of an independent regional healthcare delivery system.