Medical specialty systems were launched in 1951 by the National Medical Services Law. The following year, the specialty certifying examination had implemented in the form of portfolio evaluation. A paper-and-pencil type examination was implemented in 1960, and the 55th examination was carried out in January 2012. Currently, 26 specialties are represented, and the overall pass rate is over 90%. The examination consists of a step 1 paper-and-pencil test and step 2 skills test. In the step 1 test, the test items are multiple choice questions and short answer questions. Clinical performance examination is partially applied to the step 2 test. To cope with changes in the social situation and the growth of medical services, developmental changes are needed in the specialty certifying examinations. Performance assessment is an alternative worth considering. CPX should be a major part of the skill test. A computer-based test should be introduced as soon as possible, and it could eventually be developed into an adaptive test.
Educational Measurement ; Jurisprudence ; Phosphatidylethanolamines

Resilience refers to a person's ability to successfully adapt to acute stress, trauma or more chronic forms of adversity, maintaining psychological well-being. Recent years have seen a lot of research into the neurobiological factors and mechanism that characterize resilient individuals. It has shown that resilience is mediated by adaptive changes in several neural circuits involving numerous neurotransmitter and molecular pathways. Much more study is required to achieve a deeper understanding the genetic, biological, and psychological underpinnings of resilience, as well as the interactions between these factors.
Neurobiology ; Neurotransmitter Agents ; Phosphatidylethanolamines

PURPOSE: This study was done to identify factors (pain stress, perceived stress, pain disability, fatigue, depression) strategies used by elders to cope with pain based on their type of pain belief. METHOD: Data were collected from 314 elders in community settings in Seoul from September to December of 2007. Cluster analysis, t-test, and ANOVA were used to analyze data. Result: The types of pain belief were classified as the following groups: Self-blame, Enduring & Mysterious, and Short-term & Understandable. Perceived stress (t=2.36, p=.02), social support (t=2.24, p=.03), extent of pain relief (t=2.39, p=.02), and duration of pain relief (t=2.09, p=.04) were important factors for active and passive coping in the Self-blame group. Pain stress (t=2.39, p=.01) and depression (t=-3.99, p=.00) were significantly related to the active coping in the Enduring & Mysterious group. Perceived stress (t=2.55, p=.01) was an important factor in the passive coping in the Short-term & Understandable group. CONCLUSION: Considering different types of pain belief in elders and factors that are significantly related to different coping strategies, future nursing interventions should be population specific to encourage active coping strategies and to decrease passive coping strategies.
Adaptation, Psychological ; Depression ; Fatigue ; Phosphatidylethanolamines

PURPOSE: The purpose of this descriptive study was to compare ways of coping and physical symptoms of realistic optimist with unrealistic optimist in university students. METHODS: The participants for this study were students from three university, located in Seoul and Gangwon province. The data were collected by a questionnaire given to the students. RESULTS: The most frequently used coping skills of realistic/unrealistic optimist was the pursuit of social support. Realistic optimists are likely to use not only active coping skills but also passive coping skills, on the other hand unrealistic optimists tend to less use all coping skills. But in physical health, it doesn't show a significant differences except gastro-intestinal symptoms between two group. CONCLUSION: Based on the finding of this study, it is needed nursing intervention for strengthening realistic optimism for helping university students cope with stress and health.
Adaptation, Psychological ; Hand ; Humans ; Phosphatidylethanolamines ; Surveys and Questionnaires

PURPOSE: The purpose of this descriptive study was to compare ways of coping and physical symptoms of realistic optimist with unrealistic optimist in university students. METHODS: The participants for this study were students from three university, located in Seoul and Gangwon province. The data were collected by a questionnaire given to the students. RESULTS: The most frequently used coping skills of realistic/unrealistic optimist was the pursuit of social support. Realistic optimists are likely to use not only active coping skills but also passive coping skills, on the other hand unrealistic optimists tend to less use all coping skills. But in physical health, it doesn't show a significant differences except gastro-intestinal symptoms between two group. CONCLUSION: Based on the finding of this study, it is needed nursing intervention for strengthening realistic optimism for helping university students cope with stress and health.
Adaptation, Psychological ; Hand ; Humans ; Phosphatidylethanolamines ; Surveys and Questionnaires

With the increasing interest in endoscopy and the rising number of endoscopic examinations in hospitals, the importance of endoscopic reprocessing is also increasing. Cure facilities that are understaffed and ill-equipped are trying to cope with the problems of insufficient cleaning and high infection risks. To prevent endoscopy-associated infection, the endoscope cleaning, and disinfection guidelines prepared by the Korean Society of Gastrointestinal Endoscopy must be followed. In this review, the steps of endoscopic reprocessing and the equipments required in each step are discussed.
Disinfection ; Endoscopes ; Endoscopy ; Endoscopy, Gastrointestinal ; Phosphatidylethanolamines

PURPOSE: Childbirth self-efficacy plays an important role in women's ability to cope with labor and delivery. Coaching has been gaining popularity as a way to promote cognitive, emotional and behavioral change. This study aimed to test the effects of a Coaching-based childbirth program on anxiety and childbirth self-efficacy among primigravida women. METHODS: The study design was a quasi-experimental pre-post design. A coaching-based childbirth program was developed synthesizing concepts and techniques from the literature on coaching and was verified by an expert panel. It consisted of four weekly 2-hour small group sessions. Pregnant women were recruited from H hospital in Seoul. Childbirth self-efficacy and state anxiety were measured before and after the program. RESULTS: Although there was a no significant reduction in anxiety, there were statistically significant increase for childbirth self-efficacy in the experimental group when compared to the control group. CONCLUSION: The program appears to increase childbirth self-efficacy for pregnant women. Future studies may benefit from using mixed coaching modalities and consider measuring health behaviors and obstetric outcomes to gain insights on its long-term impact.
Anxiety ; Female ; Health Behavior ; Humans ; Parturition ; Phosphatidylethanolamines ; Pregnant Women

BACKGROUND: The Korean traditional national holidays commonly produce several physical symptoms related to stress. This study was performed to evaluate the degree of the stress from the married women during their Korean traditional biggest holidays. METHODS: The subjects were 99 married women who had visited the Health Promotion Center at a university hospital. For evaluating the stress of the Korean traditional biggest holidays, subjects were allowed to write in subjective stress score based on the Social Readjustment Rating Scale. The factors associated with the stress were investigated. RESULTS: The mean (+/- SD) score of the married women's stress of the Korean traditional biggest holidays was 38.7 (+/- 21.9). The score was widely distributed from the 0 to 100. The cases with hobbies to cope with stress showed significantly (P < 0.05) lower stress score than those without hobby. The stress score was inversely correlated with family APGAR score (r = -0.346, P < 0.01). In stepwise multiple regression model, the stress score was related to family APGAR score and hobby to cope with stress (overall R2 = 0.171, P < 0.001). CONCLUSION: The stress score of the Korean traditional biggest holidays was widely distributed from 0 to 100 in Korean married women. These results suggest that traditional biggest holidays act as a stressor for individual with a range of variable extent.
Apgar Score ; Female ; Health Promotion ; Hobbies ; Holidays ; Humans ; Phosphatidylethanolamines

PURPOSE: This study was done to examine differences in chronic pain, pain coping, and depression according to attributions of somatic symptoms among the elderly. METHOD: Data were collected by self-report questionnaires from 195 persons age 65 or over. Descriptive statistics, ANOVA, and Scheffe's test were used to analyze the data. RESULTS: There were statistically significant differences in chronic pain among the elders according to educational level and duration of pain, and in passive coping according to gender, physical function and duration of pain. There were statistically significant differences among the elders in active coping according to amount of spending money, in depression according to age, educational level, amount of spending money, and physical function. There also were statistically significant differences in chronic pain, pain coping, and depression according to attributions of somatic symptoms. CONCLUSION: The results of this study indicate that elders who have somatic attributions are incline to complain more severe chronic pain, to cope passively, and to manifest more severe depression than elders who have normalizing attributions. Continuous research is needed to improve effective nursing interventions for attributions of somatic symptoms among elders.
Aged ; Chronic Pain ; Depression ; Humans ; Phosphatidylethanolamines ; Surveys and Questionnaires

Gastroesophageal reflux disease (GERD) has a chronicity and its symptoms wax and wane by proton pump inhibitor (PPI) therapy. Chronic consumption of PPI in the patients with GERD is common, and we can cope with a PPI failure or refractory GERD. Therefore, we review various alternative modalities for chronic PPI treatment and an approach for refractory GERD. PPI has a potential for side effects. Many studies have been published the side effects of long-term PPI using. Mostly clinical level of evidence is weak and the absolute risk is low, however we may discuss the patients who need long-term PPI therapy about the controversial side effects, and manage those appropriately.
Gastroesophageal Reflux ; Humans ; Phosphatidylethanolamines ; Prescriptions ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Safety Management