• International journal of advanced smart convergence
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• v.9 no.2
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• pp.1-7
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• 2020

As the demand for health screening increases, there is a need for efficient design of screening items. We build machine learning models for health screening and recommend screening items to provide personalized health care service. When offline, a synthetic data set is generated based on guidelines and clinical results from institutions, and a machine learning model for each screening item is generated. When online, the recommendation server provides a recommendation list of screening items in real time using the customer's health condition and machine learning models. As a result of the performance analysis, the accuracy of the learning model was close to 100%, and server response time was less than 1 second to serve 1,000 users simultaneously. This paper provides an adaptive and automatic recommendation in response to changes in the new screening environment.

• Health Policy and Management
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• v.22 no.1
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• pp.109-128
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• 2012

The purpose of this study is to analyze the performance difference between multi-hospitals and free-standing hospitals. Scholars in industrial economics argue that, due to economies of scale and integration, multi-hospital system may have a better performance compared to freestanding hospitals. The study overturned the hypothesis based on a theory. By analyzing 425 acute-care hospitals in Korea, this research shows that multi-hospital systems and market factors, which have been perceived to be strengths to hospitals, are negatively related to hospitals' financial performance. Specifically, the results showed a better performance of freestanding hospitals compared to multi-hospital systems. Higher labor and administrative cost by multi-hospital system may be the reason for the difference, and it means they are not more effective at cost control. Managers in multi-hospital system, therefore, should pay attention on cost-reducing issues to regain managerial efficiency of organizations.

• Korean Journal of Health Education and Promotion
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• v.24 no.3
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• pp.99-118
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• 2007

There are little program and services that have been developed to address the health and health care needs of vulnerable women. The access for their timely and appropriate health care and health promotion services have been a increasing concern. The purpose of this study was to suggest health promotion program for vulnerable women with collaboration of women's NGOs. At the first part of this study, we reviewed a conceptual framework for identifying vulnerable population, and issues regarding health problems, unmet needs, policies and programs that have been developed to address their need. In second part, we focused on investigating the role, subjects and activities of women's NGOs and their capacity for health promotion program. The last part of this study proposed health promotion programme with integrating above two parts of study. In describing what type of health promotion program available in women's NCOs, eight major programs and services were summarized. 1. Direct health promotion program and collaborating program with other services. 2. Education and training for empowerment of vulnerable women 3. Organizing mutual support system such as self-help group 4. Community supports. Vulnerable women living at home may benefit from linkage to community services as much as women living in facility 5. Organizing collaboration system with program for economic support and job training, social rehabilitation 6. Trainer's training for practitioners in NGOs 7. Technical, informational support from professional groups 8. A national coordinating policies for vulnerable population should be established at the central level. National support for NGOs' health promotion program are needed hi solving unmet needs of vulnerable women.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.30-44
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• 2021

Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

• Journal of Home Health Care Nursing
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• v.12 no.1
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• pp.1-40
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• 2005

This study investigated the relationship among home care nurses' perception of ethical values and conflicts and job satisfaction. The subjects of the study were 257 home care nurses working at 101 institutions involved in home care practice, the data were collected between December 28, 2004 February 14, 2005. The instruments were perception of ethical values, ethical conflicts, and job satisfaction and it was revised by the author. The reliability of Cronbach's a was .74, .93, .85, respectively. SAS 8.0 program was used to analyze the data, and frequency, percentage, unpaired t-test, ANOVA, $Scheff\`{e}$ test, and Pearson's Correlation Coefficient were calculated for data analysis. Followings are the results of the study: The scores of home care nurses' perception of ethical values were average 3.8points (5points scale). There was no significant difference between the groups according to general characteristics such as age (P=.001), religions (P=.001), ethical standard (P=.018), and current job satisfaction (P=.000). The scores of home care nurses' ethical conflicts were average 2.9points (5points scale). There was significant difference according to pay (P=.008) and employment status (P=.001) of general characteristics; conflicts was showed to go up with higher pay and temporary employment status. The scores of home care nurses' job satisfaction were average 3.3points (5points scale). There was significant difference among the groups according to age (P=.023), pay (P=.001), job career of home care (P=.030), and current job satisfaction (P=.000) of the general characteristics. There was significant positive correlation between subject's perception of ethical values and ethical conflicts (P=.004) and perception of ethical values and job satisfaction (P=.005). However, ethical conflicts and job satisfaction (P=.772) showed negative correlation, but it was not significant. With the results, home care nurses showed firm perception of ethical values and relatively higher job satisfaction. However, they showed ethical conflicts regarding the lack of administrative support and dignity of human life. In conclusion, It requires some alternative measures to solve the ethical conflicts and to enhance job satisfaction of home care nurses through the support in policy, continuous ethics education, rewarding system, and introducing laws to protect individual home care nurses.

• Korean Journal of Health Education and Promotion
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• v.22 no.2
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• pp.195-213
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• 2005

Objectives: This study aims to determine fostering stress and mental health state that mothers of handicapped children perceive as primary care givers and to analyze their demand for information assistance in order to release their stress so that it can provide materials that contribute to establishment of assistance system for families with handicapped children. Methods: The research subjects were 340 mothers whose children went to a nursery for special children, 3 general nurseries and 6 special schools in Daegu, and the data were collected using structures questionnaires. The survey analyzed mothers' fostering stress, their demand for fostering information assistance, children's daily activity abilities. Component concepts of each scale was validated by adopting confirmatory factor analysis, and factors affecting demand for fostering information assistance were analyzed by adopting covariance structural analysis. Results: Younger mothers tend to have higher demand for information, and mothers with younger children or children with double handicaps also have higher demand. Mothers under 30 have the lowest demand for public health and medical care assistance and for home and community life assistance, while mothers with children with physical handicaps have the highest. The validity of component concepts was verified by categorizing as cognitive structure models fostering stress, information demand, children's daily activity abilities, and their appropriateness was evaluated through confirmatory factor analysis using structural equation modelling. And then, GFI (more than 0.9), CFI (more than 0.9), TLI (more than 0.9) and RMSAE (less than 0.08) were used to evaluate the appropriateness. It was found that all the component concepts are valid, as every item is within appropriate range. The result of analyzing information demand demonstrated that children's handicap levels significantly affect their mothers' mental health, while fostering stress significantly affect mothers' metal health, information demand. As well, it was confirmed that mothers' mental health has a significant effect on information demand. Conclusions: Therefore, to reduce special children's mothers' uncertainty, helplessness and fostering burden, it is necessary to provide them with information on children's challenges, development and fostering and to offer them quality public health, medical care and welfare assistance along with family and local community life assistance.

• Perspectives in Nursing Science
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• v.4 no.1
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• pp.1-8
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• 2007

Aim: The purpose of this paper is to present the importance of multidisciplinary strategies in cancer prevention and control, especially comprehensive breast cancer care. Background: Worldwide, breast cancer is the most common cancer diagnosed among women and is the leading cause of cancer deaths. Although the incidence of breast cancer in Asian countries is still lower than in Western countries, the rate of increase for the last two decades is striking. Methods: Data on cancer mortality, incidence, and risk factors were summarized by using the most recent data available from population-based cancer registries affiliated with the International Union Against Cancer, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the CDC's National Program of Cancer Registries (NPCR). Results: Global differences in breast cancer incidence and fluctuations in rates within a country still exist. The incidence of breast cancer in Asian countries was lower than in Western countries. Breast cancer incidence in the United States decreased each year during 1999-2003. On the other hand, morbidity and mortality related to breast cancer in Asia has increased significantly. Conclusion: Multidisciplinary strategies to reduce breast cancer mortality and promote breast cancer awareness are addressed. Lessons learned from multidisciplinary approaches to cancer treatment and control will be valuable in implementing future breast cancer research in the fields of basic, clinical, and population research in Asia.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.516-539
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• 1998

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

• Journal of Korean Academy of Nursing
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• v.40 no.5
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• pp.662-675
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• 2010

Purpose: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. Methods: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. Results: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. Conclusion: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.239-253
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• 2002

Health care for women regularly focuses on the reproductive system to the exclusion of other health needs. The lack of research focusing on women's common health issues is a major problem to the enhanced optimal level of women's health. Health care providers have to recognize biological and social differences between men and women. This study was conducted to identify the baseline data and their correlation of health perception, health behavior, and health status of adult women for developing nursing intervention. The study was a descriptive correlational design. A convenient sampling method was used for collecting data from 103 adult women, over 18 years of age, during the period from Sep 1 to Nov 30, 2001. The study's subjects were interviewed using a structured questionnaire. The instruments for this study were the health perception scale modified by Lee(1985) based on the tool developed by Ware(1977) and Jenkins (1966), and the health behavior scale by Ko, Kumja(1987). Health status was measured by the short form Cornell Medical Index(CMI) modified by Nam, Hochang(1965). The data were analyzed SPSS PC+, by frequency, mean, t-test, ANOVA, and Pearson correlation coefficients. Also, the Duncan test was utilized for a post hoc test of ANOVA. The results of this study are as follows: 1. The mean score for health perception was 3.02(S.D=0.39) on a 5 point scale. 2. The mean score for health behavior was 3.08(S.D=0.43) on a 5 point scale. 3. The mean score for health status was 18.54 on 58 items. The mean score for physical symptoms of a subscale of health status was 11.30 on 36 items and the mean score for psychological symptoms was 7.37 on 22 items. 4. The relationship of sociodemographic variables to health perception. health behavior, and health status of women.: 1) There were significant differences in the scores of health perception by disease experience(t=-3.37, p=0.00). 2) There were significant differences in the scores of health behavior by age(F=10.52, p=0.00), height(F=4.73, p=0.01), marital status(t=-5.56, p=0.00), educational background(t=2.90, p=0.00), and drinking or non-drinking(t=2.17, p=0.03). 3) There were significant differences in the scores of health status by educational background(t=2.28, p=0.02) and disease experience(t=2.61, p=0.01). 5. Health perception showed significant positive correlation with health behavior(r=0.39, p=0.00). Health perception showed significant negative correlation with health status(r=-0.44, p=0.00), that is, the more women perceived health, the less she complained about unhealthy symptoms. Health behavior had no significant correlation with health status but showed a positive correlation with psychological symptoms of a subscale of health status(r=-0.19, p=0.05). Many of the leading causes of disease are preventable through changes in health perception and behavior. The need to increase individual awareness of relationships among health perception, health behavior, and health status and to enhance knowledge regarding the long-term effects of positive health behaviors, is an important nursing strategy for women's health promotion.