• Journal of Korean Biological Nursing Science
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• v.23 no.3
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• pp.237-246
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• 2021

Purpose: To determine effects of family conflict mitigation documentary programs on conflicts, autonomic nerve activation (ANA), and happiness of elderly in long-term care hospitals. Methods: This study used a non-equivalent control group with a pretest-posttest design. It was conducted on 39 elderly patients (19 in the experimental group and 20 in the control group) in long-term care hospitals. The experimental group (n=19) received family conflict mitigation documentary programs. The family conflict mitigation documentary programs consisted of four sessions (40-50 minutes per session). These programs were implemented in small groups, with each group having five elderly. Data were analyzed by sing the conflict checklist, the Oxford Happiness Questionnaire, Chi-square test with Fisher's exact test, independent t-test, paired t-test, and repeated measure ANOVA using the SPSS/WIN 21.0 program. Results: The participants in the experimental group showed significantly decreased scores of conflict (t=-2.31, p=.028) and the value of sympathetic nervous system activity (t=8.36, p=.007) compared with those of the control group. The participants in the experimental group showed significantly increased the value of parasympathetic nervous system activity (t=-2.91, p=.008) and scores of happiness (t=5.46, p<.001). Conclusion: The family conflict mitigation documentary programs on conflicts, ANA, and happiness of the elderly in long-term care hospitals are effective intervention programs for mitigating conflicts between elderlies and their families and for improving happiness of the elderly in long-term care hospitals.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.56-65
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• 1994

Total quality management has been a focus of concern in recent years since some dissatisfaction with the results from implementation of quality assurance programs in the U.S. Many managerial methodologies and innovation guidelines from academic disciplines have been applied to promote TQM programs in the health field. This paper consists of two folds of aspects: firstly to examine TQM's managerial philosophy by comparing with the newly introduced managerial concepts in Business Reengineering; and then to introduce a method for an integrative way of process analysis, Entity Life-Cycle Diagram (ELCD) modeling. The analysis method was compared with Process Map, which is a well-known method for BR applications. To show effectiveness of ELCD modeling, a case of application was introduced using 'drug' as a target entity. With having TQM issues in mind, the result was reflected in designing Entity Relation Diagrams. The results of ELCD modeling turn out to be helpful in designing database related to quality monitoring, in that many monitoring check points can be identified in a systematic way and that queries cross-sectional over organizational boundaries can be generated with a consistent view focusing on the drug use as a single process. Full evaluation of the analysis method remains to be studied until the completion of the information system under construction. But as long as TQM is based on a process-oriented view and needs supports from information system, ELCD can be one of the appropriate choice as a tool for the process analysis.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.345-358
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• 1996

All human health behavior is deeply rooted one's beliefs or value system usually encompassed within the culture in which they live. The Taegyo, based on Oriental folk medicine, is defined as the behavior and self care of pregnant women administered for herself and her fetus(unborn child). Taegyo is believed to be desirable, effective, and healthy behavior by most of Korean pregnant women. It is essential in our contemporary culture, to ascertain what the components of Taegyo are and to integrate them into current, western nursing care, particularly in the area of prenatal care. 910 Korean women were the subjects of this study, who were in a gestation period of pregnancy between 10 weeks to three months postpartum. The subjects were selected by clustered smpling from 10 representative cities in Korea. Data was collected from February 10 to March 30 1995 by a constructed Questionnaire which consisted of 95 items. The questionnaire was developed through three steps such as content analysis, calculation of content validity index, and pretest. Data was analyzed by descriptive statistics and rotated matrix factor analysis with pc-SAS. The mean age of the subjects was 28.9 years : 36.5％ of them were employed and the mean income per month was about 2000 dollars. The component of Taegyo was clustered into five factors such as fetus psychological stability(equity), fetus personality development, maternal-fetal interaction, fetus intellectual development and physical health promotion. The variance of each factor were 23.7％, 8.3％, 4. 7％, 4.1％, and 3.3％ respectively in that order. The Eigen value of each factor was 13.03, 4.57, 2.60, 2.23, and l.83 respectively. It was found that the Taegyo is an unique and holistic self care behavior of Korean pregnant women. Therefore it has been concluded that this study has broadened the understandability of the implications the Taegyo. It is suggested that further studies on the effects of the Taegyo are needed to provide a scientific basis for professional maternity nursing.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.74-89
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• 2002

Background : The purpose of this study was to investigate the incidence of unplanned endotracheal extubation and to identify the influencing factor of unplanned extubation in ICUs for providing baseline data in developing prevention strategies and administrative standards. the medical records and hospital information system. In order to analyze factors related to unplanned extubation, the subjects of this study were divided by unplanned extubation group and planned extubation group and were matched by its sex, age, and disease groups in a ratio of one to two. The data were analyzed by descriptive statistics, ${\chi}^2$- test, t-test, Fisher's exact test, and logistic regression analysis with SPSSWIN 10.0 program. Result : 1) Forty-seven(4.99%) of 942 intubated patients experienced unplanned extubation 65 times during the twelve-month period. Thirtyfour( 72.34%) of 47 unplanned extubated patients required reintubation, whereas thirteen patients(27.66%) did not. 2) About half of unplanned extubation(46.8%) occurred during the night shift. 3) As for the nursing activity, respiratory nursing activity score(P=.0.06) and total nursing activity score(P=.011) showed statistically significant differences between unplanned extubation group and planned extubation group. 4) As for the patient status, unplanned extubation group showed more lower consciousness level(P=.000), more irritable or agitated behavior(P=.000), and had more applied physical restraints(P=.000) than planned extubation group. 5) As for the intubation related variables, unplanned extubation group revealed more intubated with respiratory failure(P=.000), more dependent on mechanical ventilation(P=.015) than planned extubation group. 6) Factors affecting unplanned extubations in intensive care unit patients were irritable or agitated behavior(odds ratio=13.757), night shift(odds ratio=7.166), and mechanical ventilation(odds ratio=6.257) from conditional logistic regression analysis. Conclusion : The most affecting factor of unplanned extubation was agitated or irritable behavior. Therefore the results of this study could be helpful to ICU nurses for meticulous care, decision making, timely intervention, and development of intervention strategies for preventing unplanned extubation.

• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.201-210
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• 2014

Purpose: To provide an in-depth analysis of the physical changes in and marital experiences of immigrant women in Korea, considering the differences in their cultural backgrounds. Methods: A qualitative research methodology with a phenomenology perspective was used. Data were collected through interviews from four focus groups and through in-depth interviews from five individuals. Data analysis was carried out using Colaizzi's phenomenological analysis method. Results: Twenty-four participants from nine different nations were interviewed. Three phenomenological theme clusters were identified and six sub-themes were derived. These comprise: "emergence of physical changes", "experienced symptom with negative result", and "coping with my body". The derived themes comprise: "struggling for my body to survive", "changed body after pregnancy and delivery", "diagnosed as normal but", "neglected my health", "using familiar care", and "unfamiliar health service system". Conclusion: Immigrant women by marriage in Korea are new subjects of nursing care. Their physical changes and experiences in coping with marriage at an early stage of immigration as described by themselves provide valuable information for nursing professionals. Cultural differences, problems specific to women, and our social conditions regarding minorities and our patriarchal tradition that discriminates against women affect their health problems. We strongly recommend that nurses should actively determine and engage in the health problems of immigrant women.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.86-109
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• 1995

Clinical trials of drugs on humans is the final and most important stage in evaluating the safety and efficacy of the drugs. Good Clinical Practice(GCP) standards were announced in 1987 to protect testees' rights as well as to ensure validity of the clinical trial results, but its implementation has been delayed until now. The purpose of this study is to evaluate the preparedness of the designated institutions to abide by GCP standards during clinical trials, and thereby to determine GCP implementability at the institutions. Survey on the status of clinical trials was conducted for the designated 83 clinical trial hospitals. Response rate was 95.2%. Donabedian's quality assessment model was applied as the basic framework for the study. And the relative - weights for the evaluation items were determined by expert's evaluation. Among the designated 83 hospitals, 39 conducted clinical trials to obtain drug manufacturing approval from 1990 to 1994. Only 19 institutions are found to be able to meet the requirements of KGCP. Structure variables - manpower, organization, and facility -, which are the basic elements for GCP, are evaluated as unsatisfied in many hospitals. Institutions which established IRB accounted for 41 or 51.9%, but those who have a protocol evaluation guideline, or Adverse Drug Reaction(ADR) reporting system were only 12 and 21 institutions, respectively. Also, the institutions providing educational programs on conducting clinical trials are few - 20. The study results indicates that the level of conducting KGCP is unsatisfactory. However, more institutions are expected to be able to meet the standards soon because GCP standards does not require so much regulation on facilities, but stress importance on research methodology and human right. At present as the institutions for clinical trials are primarily training hospitals with residency programs, such efforts as education will accelerate the implementability of GCP in Korea. Institutions must build the appropriate infrastructure and government must prepare to strongly enforce KGCP before it can successfully take place.

• Health Policy and Management
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• v.22 no.4
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.2
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• pp.97-107
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• 1996

Nursing standards determine the type and extent of services that are delivered to the patients and define quality care and communicate the institution's expectations of care. Thus, taking the standard of care and incorporating it into a welldefined indicator of excellent patient care becomes one of the first activities in setting up the nursing service's quality assurance process. The purpose of this study was to determine the impact of using a nursing care standards for the quality of nursing care in gastrectomy patients. The subjects were composed of fourty-two under going gastrectomy patients with stomach cancer in general surgery nursing care unit of K University Hospital in Pusan. The data was collected from January 3 to April 13,1996. The subjects were divided into a control group - those admitted from Jan.3 to Feb.12 and an experimental group those admitted from Feb.18 to April 13. The instruments used for this study were a nursing care standards in gastrectomy patients developed by the investigator and an evaluation tool for the quality of nursing care in abdominal surgery patients developed by Byoung-Sook Lee in 1995. The data was analized by means of chi-square test, t-test and Cronbach-alpha test with the SAS System. The result was as follows : The hypothesis, that scores of the quality of nursing care in the experimental group would be higher than that of the control group. was supported(t=-6.12, p=0.00). The detailed results of each standards of evaluation tool were as follows : The mean score of the experimental group was significantly higher than that of the control group in audit standard 1:'Collection of basic data of the patients', (t=-3.76, p=0.00). The mean score of the experimental group was significantly higher than that of the control group in audit standard 2 : 'Defining nursing diagnoses(or nursing problems)', (t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit standard 3:'Estabilishment of nursing care plan according to nursing diagnoses(or nursing problems)',(t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit stndard 4:'Implimentation of nursing care plan', (t=-2.38, p=0.01). The mean score of the experimental group was significantly higher than that of the control group in audit standard 8 : 'Increase of the knowledge of health related to surgery',(t=-2.40, p=0.01). No significant differences between the mean scores of the experimental group and that of the control group in audit standard 5 : 'Recover and maintain of the physical function', audit standard 6:'Prevention of the post-operative complication', audit standard 7 : 'Decrease of discomfort caused by operation', and audit standard 9 : 'Patient satisfaction in nursing care' were found. The standards of evaluation tool were devided into two dimension. One was process dimension which contains four standards(audit standard 1 to 4), the other was outcome dimension which contains five standards(audit standard 5 to 9). The mean score of the experimental group was significantly higher than that of the control group in process dimension (t=-12.30, p=0.00), but no significant difference between the mean scores of the experimental group and that of the control group in outcome dimension was found. From these results, it is concluded that using a nursing care standards in gastrectomy patients promotes quality of nursing care and nursing care standards of various fields are necessary for effective nursing care.

• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.68-83
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• 2021

Background: It is widely acknowledged that single bedrooms have many potential advantages compared to multiple bedrooms. However, Korea has a reimbursement system that patients have to pay the additional fee if they will use single bedroom or pay-bed (1-3 bedroom). There is little research on patients' bed selection and relationship between patient satisfaction and bed type in the Korean setting. Methods: Using the 2017 Korea Health Panel (KHP) Survey data, we modified bed type by two dichotomous variables: single bedroom vs. multiple bedroom (2+ bedrooms) and pay-bed (1-3 bedroom) vs. reimbursed bed (4+ bedroom). Multivariate logistic regression is performed to determine the factors affecting the patient's choice of room types. Multivariate regression analysis was conducted to examine how hospital room types are affecting patient satisfaction. Results: Single room and pay-bed (1-3 bedroom) use was influenced by patient age (19- years old), male, a person at work, hospitalizing in a clinic, and birth. After controlling variables of the behavioral model of medical utilization, the association between patient satisfaction and use of single bedroom & pay-bed (1-3 bedroom). Cause of hospitalization, major treatment, and recognition of unnecessary care are statistically significant variables on patient satisfaction. Conclusion: Although the single room is about the standard for newly built hospitals in western countries, it remains unclear that single room or pay-bed (1-3 bedroom) has positive effects on patient's outcomes and satisfaction. In this empirical study, the difference in patient satisfaction by bedroom type was not noticeable. In terms of bed management by hospital staff, securing patient credibility in hospital care is an important task. Patients' perception of whether medical staffs have encouraged unnecessary treatment or tests has a significant impact on patient's satisfaction.

• The Korean Journal of Emergency Medical Services
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• v.11 no.3
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• pp.17-30
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• 2007

Accidents occur frequently and that the date of the emergency situation and the people a good quality of life to actively respond to the emergency scene in the line of business activities and given their lives silently. 1st EMT's is currently the most jobs in the ability to work within a hospital that can be verified by expanding employment opportunities than the rate of youth unemployment and a sharp alleviate part of the current emergency medical institution performing the duties within the contents of this communication in a Emergency patients reflected in the rates for schools that can be revitalized as part of the emergency medical system(part of the emergency medical workers) for the completion of the law concerning emergency care, if you want the current laws and enforcement rules are to be improving. Under the current provisions in law concerning emergency care, and enforceable rules on enforcement issues and identify practical issues for consideration and improvements to enumerate the reasons for the demotion, the following conclusions can be sure until they improve. In addition, the National Assembly recently passed a bill AED use, and enforceable rules to enforce party that can teach AED necessarily a grade, including 1st EMT's to protect people's lives and to actively deal with the emergency situation so that it can be. Resolving these issues in the country where the emergency medical system can create a foundation for the advancement of emergency patients can get a good length of life, opens.