• Journal of Genetic Medicine
• /
• v.8 no.2
• /
• pp.89-99
• /
• 2011

Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

• Child Health Nursing Research
• /
• v.8 no.3
• /
• pp.302-312
• /
• 2002

This descriptive exploratory study was conducted to analyze the results of developmental screening test using DDST and the follow-up diagnostic evaluation in one public health center, and to evaluate the feasibility of developmental screening in nursing. Samples were 373 children under 6 years who visited the public health center. Mothers' satisfaction on the developmental clinic was also determined. Summaries of the results were as follows:v 1. 0.5% of children in height and 1.9% of children in weight were included in below 3 percentile of Korean children's growth chart, but none of them showed developmental delay. 2. The results of DDST showed 92.1% of subjects were classified as normal, 3.7% as abnormal, and 4.2% as questionable among 354 children. 3. Most of children who showed the abnormal development at the first DDST were confirmed having the developmental delay at the follow-up diagnostic evaluation. On the other hand, most of children who showed the questionable development at the first DDST revealed having the normal development in follow-up screening test. 4. The result of the DDST was influenced by the birth order of the subject and delivery type. 5.The mean satisfaction score by mothers on developmental clinic was 4.35 in 5 Likert scale. In conclusion, we could certain the feasibility and usefulness of developmental screening in community and child care nursing. To fulfil the increasing needs of mothers with infants on the child development, nurses have to provide anticipatory guidance and parent education in addition to the developmental screening test. We hope to expand the developmental screening in nursing field not only of clinical setting but also of community.

• Quality Improvement in Health Care
• /
• v.1 no.1
• /
• pp.96-108
• /
• 1994

Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

• The Journal of the Korea Contents Association
• /
• v.18 no.1
• /
• pp.504-516
• /
• 2018

Many countries have tried to reform financing systems toward UHC and paid attention to the function of strategic purchasing. This study was performed to examine theoretical foundations and the function of strategic purchasing. And we examined the functions of strategic purchasing in Korea based on the framework proposed by Preker(2005). For this purpose, we reviewed literature related to purchasing. we defined the strategic purchasing as strategic activities to provide health care services people need within a given budget, which is carried out by certain organizations, purchasing organizations. These activities include selecting appropriate providers, designing and operating the payment system, setting the price, and determining the target populations and their needs etc. The relationships among government, purchasers and healthcare providers can be explained by the principal-agent theory. In addition to Preker's framework, we emphasized the importance of the infrastructure such as decision making support systems, information systems, health care resource management systems, or expenditure monitoring systems. The National Health Insurance Service and the Health Insurance Review & Assessment Service play major roles in performing strategic purchasing.

• Journal of Korean Academy of Nursing
• /
• v.23 no.4
• /
• pp.544-554
• /
• 1993

The study was designed to identify the attitude of nursing students to clinical education through Q-methodology. A C sample was developed through a review of the literature and interviews. Twenty - seven statements made up the finalized Q- sample. This was out of an initial 143 statements developed through consultation with eight professors. The P sample consisted of 25 nursing students in S Health Junior College.0 statements were written on seperate cards and were given to the 25 subjects to sort according to degree of agreement or disagreement. The Q-sorts by each subject were coded and analyzed with QUANL PC Program. The analysis discovered three major attitudes, namely “amicable adaptation” 〈type 1), “Nightingale social service” (type 2), and “realistic occupation pursuit” (type 3). The correlation was .465 between type 1 and type 2, .293 between type 1 and type 3, and .273 between type 2 and type 3. The characteristics of each type were as follows ; Type 1 (amicable adaptation) They satisfied in interpersonal relationships in the clinical setting. They would not dream of becoming Nightingale, but thought of nursing care affirmatively and performed their works faithfully and adapted themselves to the new circumstances easily, Fourteen subjects were classified as type 1. Type 2 (Nightingale: social service) They often dreamed as a child that they would be Nightingale with a white uniform and think that nursing is a gift from heaven. They have an aptitude for nursing care by nature and selected nursing science them-selves. They give care to the sick with pleasure. Seven subjects were classified as type 2. Type 3 (realistic occupation pursuit) They were not satisfied with their nursing practice. First of all they want a stable job, therefore they selected nursing science. They had conflicts in clinical practice, but were responsible for nursing and studied hard. Four subjects were classified as type 3. Through the results of this study, the attitude of nursing students to clinical education could be classified into three types. Therefore it is suggested that clinical education would be more valuable, if it was planned according to an understanding of the attitudes of nursing students to clinical education.

• Journal of Korean Clinical Nursing Research
• /
• v.21 no.2
• /
• pp.196-206
• /
• 2015

Purpose: This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.

• Safety and Health at Work
• /
• v.7 no.3
• /
• pp.213-217
• /
• 2016

Background: The objective of this study is to identify high-risk groups for industrial accidents by setting up 2003 as the base year and conducting an in-depth analysis of the trends of major industrial accident indexes the index of industrial accident rate, the index of occupational injury rate, the index of occupational illness and disease rate per 10,000 people, and the index of occupational injury fatality rate per 10,000 people for the past 10 years. Methods: This study selected industrial accident victims, who died or received more than 4 days of medical care benefits, due to occupational accidents and diseases occurring at workplaces, subject to the Industrial Accident Compensation Insurance Act, as the study population. Results: According to the trends of four major indexes by workplace characteristics, the whole industry has shown a decreasing tendency in all four major indexes since the base year (2003); as of 2012, the index of industrial accident rate was 67, while the index of occupational injury fatality rate per 10,000 people was 59. Conclusion: The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of < 3 years and newly hired workers with a relatively shorter working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

• Health Policy and Management
• /
• v.20 no.2
• /
• pp.69-88
• /
• 2010

The effective administration of hospital with innovation and human resource practices is a matter of grave concern because hospitals are becoming bigger and more specialized. Biomedical engineers who manage medical machineries and tools used to deliver healthcare services in a hospital setting play an important role in providing customers good quality services. Maintaining job satisfaction of biomedical engineers is, thus, important in the delivery of quality care. This is a descriptive cross-sectional study aiming to determine factors affecting job satisfaction of biomedical engineers working in general hospitals. The study population consisted of biomedical engineers at 79 general hospitals of 26 regions based on the registry of the Korea Medical Engineering Association (KMEA). The data were collected using a self-administerd questionnaire between May and July of 2009. Job satisfaction was assessed with 19 items covering 3 dimensions of work-external, work-internal, and organizational aspects (Cronbach's ${\alpha}=0.884$), resulting in an average summary score. Statistical analysis was conducted with SPSS for Windows version 15.0. The mean score of job satisfaction was 3.50 (${\pm}0.04$). There were statistically significant differences in job satisfaction according to age, health status, job position, duration of work as a biomedical engineer, years in the current workplace, difficulty at work, intent to change job, and the amount of support from superiors and colleagues. In multiple regression analysis, the factors affecting job satisfaction of biomedical engineers were salary, health status, and support of superiors and colleagues ($r^2=0.512$). Effective motivation-plans, taking into account organizational characteristics and the working environment of the hospital, may help to improve the job satisfaction of biomedical engineers.

• Safety and Health at Work
• /
• v.9 no.4
• /
• pp.381-387
• /
• 2018

Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

• Journal of Music and Human Behavior
• /
• v.13 no.1
• /
• pp.19-40
• /
• 2016

This study provides numerical data on the status of music therapy practices in 54 hospice and palliative care settings in Korea. Two different questionnaires for music therapists and coordinators were sent to 54 coordinators via email, and 47 (87%) hospitals and centers replied by email or post. The survey period was October 30 through December 5, 2014. Music therapists were asked to respond to 65 questionnaire items regarding working conditions, environment, session process, and personal competence. Coordinators were asked to complete 28 questionnaire items regarding the status of music therapy in their perspective setting. Twenty-two (46.8%) hospitals and centers were running music therapy programs with 28 music therapists, and 19 (67.9%) of these music therapists majored in music therapy. There was a significant difference between music therapists (M= 3.43, SD = 0.96) and coordinators (M= 2.73, SD = 0.77) regarding conditions and environment of music therapy sessions (p < .05). The circumstances and conditions for music therapy are inad quate for optimal implementation of music therapy practice. However, the perceived benefits of music therapy by coordinators suggest that music therapists do play an important role in hospice and palliative care. This research provides the first quantitative baseline data of music therapy status in hospice and palliative care settings in Korea.