Protecting and Utilizing Health and Medical Big Data: Policy Perspectives from Korea / 대한의료정보학회지

OBJECTIVES: We analyzed Korea's data privacy regime in the context of protecting and utilizing health and medical big data and tried to draw policy implications from the analyses. METHODS: We conducted comparative analyses of the legal and regulatory environments governing health and medical big data with a view to drawing policy implications for Korea. The legal and regulatory regimes considered include the following: the European Union, the United Kingdom, France, the United States, and Japan. We reviewed relevant statutory materials as well as various non-statutory materials and guidelines issued by public authorities. Where available, we also examined policy measures implemented by government agencies. RESULTS: In this study, we investigated how various jurisdictions deal with legal and regulatory issues that may arise from the use of health and medical information with regard to the protection of data subjects' rights and the protection of personal information. We compared and analyzed various forms of legislation in various jurisdictions and also considered technical methods, such as de-identification. The main findings include the following: there is a need to streamline the relationship between the general data privacy regime and the regulatory regime governing health and medical big data; the regulatory and institutional structure for data governance should be more clearly delineated; and regulation should encourage the development of suitable methodologies for the de-identification of data and, in doing so, a principle-based and risk-based approach should be taken. CONCLUSIONS: Following our comparative legal analyses, implications were drawn. The main conclusion is that the relationship between the legal requirements imposed for purposes of personal information protection and the regulatory requirements governing the use of health and medical data is complicated and multi-faceted and, as such, their relationship should be more clearly streamlined and delineated.

Relationship between Job Stress and Compassion Satisfaction, Compassion Fatigue, Burnout for Nurses in Children's Hospital

PURPOSE: Nurses experience burnout related to various factors. For this descriptive research job stress, compassion satisfaction, and compassion fatigue were examined as to their relationship to burnout in nurses from children's hospital. METHODS: The participants were 305 nurses working in children's hospital. Self-report questionnaires were used to measure job stress, compassion satisfaction, compassion fatigue and burnout. RESULTS: Nurses in children's hospital experienced a greater than moderate degree of job stress, compassion satisfaction, compassion fatigue and burnout, whereas differences existed according to general characteristics. Job stress, compassion fatigue and burnout showed a significant positive correlation and results of compassion fatigue and burnout were similar. Also, job stress, compassion satisfaction and compassion fatigue were associated with burnout in nurses working in children's hospital. CONCLUSION: Findings indicate that as longer work experience is accompanied by higher job stress and burnout, it is necessary to develop intervention programs to reduce burnout among career nurses exposed to greater job stress in children's hospital.

Infectious disease-related laws: prevention and control measures / 한국역학회지

OBJECTIVES: This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law. METHODS: The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency. RESULTS: When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease. CONCLUSIONS: To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

Infectious disease-related laws: prevention and control measures / 한국역학회지

OBJECTIVES: This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law.METHODS: The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency.RESULTS: When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease.CONCLUSIONS: To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

Effects of Social Support and Self-efficacy on Hope among Nursing Students / 한국간호교육학회지

PURPOSE: This study was conducted in order to explore the factors affecting the hope in nursing students. METHODS: A total of 166 nursing students participated in the study. Data was analyzed using SPSS WIN 18.0. RESULTS: The mean scores for social support, self-efficacy, and hope were above-average level. There were significant mean differences in hope according to religion, academic achievement, and satisfaction with nursing majors. Hope correlated positively with social support and self-efficacy. The significant predictors of hope included social support and satisfaction with the nursing major. The regression model explained 12.7% of hope. CONCLUSION: To improve hope in nursing students, nursing educators should focus on promoting their social support and satisfaction with the nursing major.

Factors Affecting Aggression in South Korean Middle School Students

PURPOSE: The study was undertaken to assess levels of aggression, and to determine factors affecting aggression among South Korean middle school students. METHODS: A descriptive study was conducted using self-report questionnaires. The participants were 340 girls and boys from two middle schools and 302 questionnaires were used for the final data analysis. Aggression, academic stress, depression, self esteem, decision-making competency, and happiness were measured. Data were analyzed using descriptive statistics including t tests, one-way analysis of variance, Pearson's correlation coefficients and multiple regressions. RESULTS: Aggression had significant correlations with academic stress (r = .21, p < .001), depression (r = .43, p < .001), self esteem (r = -.25, p < .001), decision-making competency (r = -.25, p < .001), and happiness (r = -.21, p < .001). Mean score for aggression was 2.49 out of 5. Significant explanatory variables for aggression were grade (t = 4.39, p < .001), academic stress (t = 2.78, p = .006), and depression (t = 5.03, p < .001). The explanatory power of these factors was 26.9%, and this was statistically significant (F = 16.06, p < .001). CONCLUSION: Findings indicate that depression, academic stress, and grade (second grade) influence aggression. To decrease aggressive behavior, it is necessary to provide systematic and political programs in schools and local communities that can ameliorate negative emotional factors like depression and academic stress. Additionally, development of positive factors such as self esteem, decision-making skills, and happiness in middle school students is important to reduce aggression.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.

Effects of Decision Making Competency, Nursing Professionalism, and Job Satisfaction on Turnover Impulse among Nurses / 간호행정학회지

PURPOSE: The study was undertaken to investigate effects of decision making competency, nursing professionalism and job satisfaction on turnover impulse, and identify factors contributing to turnover impulse among nurses. METHODS: The study was a descriptive study with 231 nurses from 4 general tertiary hospitals participating. Data were collected during March, 2013 using a structured self-report questionnaire. Decision making competency, nursing professionalism, and job satisfaction were measured with validated instruments, and turnover impulse was measured with one question using a 5-point Likert scale. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression. RESULTS: The significant predictors of turnover impulse among nurses were professionalism (beta=-0.18, p=.015) and job satisfaction (beta=-0.18, p=.009). These variables explained 12% of the variance in turnover impulse among nurses. CONCLUSION: The results indicate that nursing managers need to put efforts in improving nurses' job satisfaction and to develop plans to increase nursing professionalism in order to reduce nurses' turnover impulse.

Clinical Outcomes in HLA-Identical Living-related Donor Renal Transplants / 대한신장학회잡지

BACKGROUND: It has been well known that the degree of HLA matching in renal transplantation is important in graft and patient survival. Because HLA-identical living-related donor grafts are free from immunological attacks, they have benefits of one immunosuppressants or early withdrawal of steroids. However, there is acute rejection due to early withdrawal of immunosuppressants and graft loss due to recurrent glomerulonephritis following HLA- identical living-related renal transplantation. The purpose of this study is to determine the graft survival and the impact of recurrent glomerulonephritis on graft survival in HLA-identical living-related donor grafts. METHODS: From December 1984 to March 2004, 44 HLA-identical and 80 HLA-haploidentical living- related renal transplants in Bongsaeng Memorial Hospital were included in this study. We evaluated graft survivals, immunosuppressants and causes of graft failure. RESULTS: The mean graft survival for HLA-identical transplants is 198 months (16.5 years) and for HLA-haploidentical transplants is 166 months (13.8 years), respectively (p=NS). Acute rejection episodes occurred in 2 of the 44 (5%) identical transplants and 17 of the 80 (21%) haploidentical transplants, respectively (p=0.013). 6 grafts were lost in HLA- identical transplants and the causes are 4 recurrent glomerulonephritis (66.7%), 2 chronic rejections (33.4 %). 11 grafts were lost in HLA-haploidentical transplants and the causes are 6 chronic rejections (54.5 %), 1 acute rejection (9.1%), 1 drug toxicity (9.1%), 3 patient deaths (27.3%). Recurrent glomerulonephritis in HLA-identical transplants are three, but in HLA-haploidentical transplants are none. CONCLUSION: Our data revealed that there was no difference in graft survival between the two groups, but lower acute rejection rate in HLA-identical groups. Recurrent glomerulonephritis was the main cause of graft failure in HLA-identical groups and the impact of recurrent disease on graft survival needs to be investigated.