• Health Policy and Management
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• v.18 no.3
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• pp.1-17
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• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

• Korea Journal of Hospital Management
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• v.14 no.3
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• pp.132-153
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• 2009

The waiting time makes the customer be bored, and is the reason to obstruct the service quality evaluation. The managing waiting time appears to be the most important task, in accordance of physical inconvenience especially because the customers of the medical service are supplied in the unstabled status. Therefore, necessity and object of managing waiting time in the medical service were presented through the definition of waiting time and the consideration about preceding study, and the main cause of the waiting time was analyzed, furthermore the measure of actually indicated waiting time and various ideas for reducing the time were presented lastly as selecting a case study participative hospital for achieving the study object. This study will be one of role model as a solution to reduce the waiting time in each medical institution.

• Korean Journal of Health Education and Promotion
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• v.30 no.3
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• pp.75-84
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• 2013

Objectives: The purpose of this study was to identify the domestic research trends in health education published in journals and dissertations, and to provide recommendations for quality improvement. Methods: 277 papers published from 1960 to 2009 were reviewed using criteria of analysis. The results were displayed as frequencies and percentages. Results: The contents of the health education were very poor compared with the Health Promotion Act. In health education program developing and evaluation process, papers on the assessment stage occupied the largest portion. In research methodology; the survey study, school field, the questionnaire research tool and inferential statistics were the most applied. Master theses were the largest number. Conclusions: This review suggests that the published papers, in some instances, have been poorly done. However, this study may provide future guidelines for health education research, and it is hoped that higher level research can be accomplished.

• Therapeutic Science for Rehabilitation
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• v.12 no.3
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• pp.79-88
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• 2023

Objective : This study was to apply a cognitive rehabilitation group program based on sensory activity in patients with dementia living in a facility and to check its effectiveness on cognitive function, depression, and quality of life (QOL). Methods : Sensory-based cognitive rehabilitation group programs (20 sessions) were conducted for eight elderly with dementia over the age of 65 living in a nursing facility located in H-gun, Gangwon-do. The participants' cognitive function, depression level, and QOL were evaluated before and after the program. Results : The mean of Mini-Mental State Examination-Dementia Screening increased; however, there was no statistically significant difference. In contrast, the mean post-test score of the Subjective Memory Complaints Questionnaire decreased, and there was a statistically significant difference (p < .05). The mean post-evaluation score of Short Geriatric Depression Scale measured to confirm the decrease in depression compared to the pre-evaluation score, but there was no statistically significant difference. Finally, the mean post-evaluation score of the World Health Organization QOL assessment instrument-Brief confirmed the change in the QOL, and there was a statistically significant difference (p < .001). Conclusion : This study will provide the basis for suggesting the usefulness of developing a sensory activity-based cognitive rehabilitation group program for dementia patients living in facilities.

• Journal of the Korean Society of School Health
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• v.1 no.2
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• pp.50-65
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• 1988

This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

• Journal of Korean Physical Therapy Science
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• v.31 no.2
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• pp.15-29
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• 2024

Background: This study investigated the effects on the range of motion, pain, disability index, and quality of life when applying thoracic mobility exercise in middle-aged women with chronic back pain. Design: pretest-posttest control group design Methods: The study subjects were 32 patients with chronic back pain of 3 months or more among middle-aged women divided 2 groups. All groups were tested thrice a week for 30 minutes per session for four weeks. Each subject was evaluated using the thoracic rotation Range of Motion, the numerical pain rating scale and pressure pain threshold, Disability Index(Oswestry Disability Index), the Quality of Life(SF-36) before and after treatment. Results: As a result of the study, the range of motion at T1 and T2 of the exercise group to which thoracic mobility exercise was applied was significantly increased in both left and right rotations(p<0.05). In the evaluation of pain, the number pain rating scale(NPRS) score decreased significantly(p<0.05), and the pressure pain threshold was significantly increased (p<0.05), but there was no significant difference from the control group. In the evaluation of the disorder index, the Oswestry disorder index decreased significantly after the experiment (p<0.05), and there was a significant difference in group comparison with the control group (p<0.05). In quality of life, there was a significant increase in PCS of SF-36(p<0.05), but there was no significant difference from the control group. Conclusion: Through this study, thoracic mobility exercise can be used as an effective exercise therapy intervention method to improve and promote physical factors of range of motion, pain and disability index, and physical components of quality of life when treating middle-aged women with chronic back pain in the future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.6
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• pp.2672-2679
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• 2012

The study was done to provide basic data of medical quality evaluation after developing the comorbidity disease mortality measurement modeled on the severity-adjustment method of AMI. This study analyzed 699,701 cases of Hospital Discharge Injury Data of 2005 and 2008, provided by the Korea Centers for Disease Control and Prevention. We used logistic regression to compare the risk-adjustment model of the Charlson Comorbidity Index with the predictability and compatibility of our severity score model that is newly developed for calibration. The models severity method included age, sex, hospitalization path, PCI presence, CABG, and 12 variables of the comorbidity disease. Predictability of the newly developed severity models, which has statistical C level of 0.796(95%CI=0.771-0.821) is higher than Charlson Comorbidity Index. This proves that there are differences of mortality, prevalence rate by method of mortality model calibration. In the future, this study outcome should be utilized more to achieve an improvement of medical quality evaluation, and also models will be developed that are considered for clinical significance and statistical compatibility.

• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.8
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• pp.2134-2140
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• 2009

The purpose of this study is to compare relationship among pulmonary function, dyspnea, and health-related quality of life in patients with COPD. The instruments were used FEV1(%), the Baseline Dyspnea Index(BDI), the Medical Research Council Scale(MRCS), and the St. George's respiratory questionnaire(SGRQ). Dyspnea of patients with moderate and severe stage were deeper than one of patients with mild stage(BDI F=5.452, p=.007; MRCS F=4.925, p=.011). And health-related quality of life of patients with severe stage were poorer than one of patients with mild stage(F=3.778, p=.030). There were significant, but weak, correlations between scores of the BDI(r=.471), the MRCS(r=-.403), the SGRQ(r=-.476) and FEV1. There were strong correlations between scores of the BDI(r=-.752), the MRCS(r=.645) and the SGRQ. And FEV1 didn't correlated with the BDI, the MRCS, and the SGRQ scores in patient of moderate stage and severe stage. But there were also strong correlations between the BDI(r=-.719), the MRCS(r=.607) and the SGRQ in patient of moderate stage and severe stage. Specially, correlation between the BDI and the SGRQ were higher than one between the MRCS and the SGRQ. In conclusion, Using the BDI for evaluation of the subjective dyspnea with objective pulmonary functional test in patients with COPD, it will able to grasp the health-related quality of life.

• Korean Journal of Occupational Health Nursing
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• v.9 no.1
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• pp.39-48
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• 2000

Hyperlipemia is the most leading risk factor of cardiovascular disease which is the main cause of death in Korea. However, there is a tendency to neglect the prevention and treatment since it has no specific symptoms. It has been reported that the level of serum-lipid can be lowered by the improvement of eating habits. Therefore, it is highly likely that the development of programs on the improvement of eating habits through behavioral theory is required to the community nursing practice. The theory of planned behavior, which assumes that human behaviors are determined by one's intention to carry out the behavior, can be characterized by the point that behaviors are not only individual factors but also social behaviors relating to subjective norms. It is widely recognized that this theory has a high predictability on health behavior due to it's simplicity clearness, and measurability as well as high quality of being general. Thus, the theory of planned behavior could be useful in developing a model of a health promotion program to the change of behaviors of the risk group of cardiovascular disease. Consequently, based on the theory of planned behavior, the purpose of this study is to develop an intention promotion program of the diet, and then to testify the effects. The sample of this study consisted of 26 industrial workers who had proved hyperlipemia from a medical examination in 1996 (experimental group 13, control group 13). The intention promotion program, which includes education, monitoring, pressure, counselling on the level of individuals, families and organizations, was conducted for 10 weeks The purpose of this program was to promoting intention of the diet through changes of the prerequisite factors of intention such as behavioral belief, outcome evaluation, normative belief and control belief. When it came to data analysis, the ${\chi}^2$-test and Fisher's Exact test were used to compare the general characteristics between the experimental and the control group, an independent t-test for the other variables. ANOVA was used to the test hypothesis, and the Pearson correlation test for variable's correlation. The results of this study can be summarized as follows ; 1) There was a significant increase in the intention(F=18.51, p=.00) of diet in the experimental group. 2) Diets(F=32.51, p=.001) in the experimental group were better carried out than in the control group. 5) There was a moderate correlation between the intention of diet and performance (r=.587. p=.003). From the results, it can be concluded that the intention promotion program is very effective, leading to the change of health promotion behavior. Above all, it is really valuable that the intention promotion program in this study regards health promotion behavior as a social behavior and that intervention was done on the level of family and organization. Consequently, when performing a health promotion program, social approach elevating the intention should go hand in hand in order to make the program effective.