• Title/Summary/Keyword: Medical care services

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Factors Influencing on Selection of Specialty Hospital among Inpatients with Loyalty (전문병원 충성고객의 병원 선택에 영향을 미치는 요인)

  • Kim, Bokmi;Hahm, Myung-Il;Min, In Soon;Kim, Sun Jung
    • Korea Journal of Hospital Management
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    • v.23 no.4
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    • pp.1-14
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    • 2018
  • Purpose : Customers with loyalty are very important to hospitals for sustainable growth in their medical market. Individuals with loyalty are likely to visit same hospital repeatedly when they need medical services. This study was to identify factors associated with selection of specialty hospitals among customers with loyalty. Methods : The subjects of this study were 735 inpatients in 22 specialty hospitals in 6 designated fields(joints, spine, colorectal-anal, obstetrics and gynecology, ophthalmology, otolaryngology). Customer types classified as customers with high loyalty, neutral customers, and customers with low loyalty according to net promoter score(NPS). Factor analysis was conducted to classify 22 hospital selection factors into some similar properties. Logistic regression analysis was conducted to confirm the selection factors related to loyal customers. Findings : Most of specialty hospitals received high NPS of 8 points or higher in all the designated fields. Five factors associated with selection of specialty hospital are (1) hospital facilities and convenience, (2) trust in doctor and hospital, (3) rapidness of treatment, (4) hospital awareness, and (5) accessibility. As a result of logistic regression analysis, selection factors related to loyal customers were 'hospital facilities and convenience', 'trust in doctor and hospital' and 'rapidness of treatment'. Differences in the degree of importance of three selection factors by customer types appeared for each designated field. Practical Implications : This study confirms the high level of patient experience among inpatients of specialty hospitals. Factors associated with selection of hospital among inpatients with loyalty are 'facilities and convenience of hospitals', 'trust of doctor and hospital' and 'rapidness of treatment'. This study will be meaningful as basic data to systematically enhance the roles and functions of the health care system and to provide securing competitiveness according to designated fields in the management aspect of specialty hospitals.

Derivation of professional ethics application criteria for dental hygienists using the Delphi method (델파이 기법을 이용한 치과위생사 직업윤리 적용기준 도출)

  • Hwang, Yoon-Sook;Lee, Sun-Mi;Jang, Jong-Hwa;Jeung, Da-Yee
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.4
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    • pp.427-440
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    • 2021
  • Objectives: We classified items required for dental hygienists' ethics training by domains. We administered a survey on experts using the Delphi method to collect opinions for guiding future trainings. Methods: 33 participants were selected and analyzed using the Delphi method thrice. Results: For relationships with patients, the item "1.3.1.1 I can keep the confidentiality of the information obtained from patients, including mature minors, related to their specific disease and treatment during medical care as well as other personal information of the patients." had the highest mean value (mean=4.88). For medical and social relations, "2.3.2.2 I can understand how staff provide dental services as a team and explain a dental hygienist's roles and responsibilities that enable a team to function effectively." had the highest mean value (mean=4.85). For individual specialized fields, "3.1.1.1 I can explain the roles and responsibilities in public health of individuals, the public, the state and professional dental hygienist." showed the highest mean value (mean=4.82). Conclusions: We identified 3 categories, 14 sub-categories, and 53 items on the scope of training and standards for ethical competencies for practical applications in professional ethics training of dental hygienists.

Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department (응급실 간호사와 응급구조사의 외상성 사건의 경험, 외상후 스트레스장애에 대한 지식, 태도 및 회복탄력성)

  • Hong, Sun-Woo;Bang, Kyung-Sook;Bang, Hwal Lan;Hyun, Hye Jin;Lee, Miyoung;Jung, Yu Na
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.1
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    • pp.86-97
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    • 2023
  • Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé's test. Results: Compared with emergency room nurses, paramedics were more positive about the government's spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). Conclusion: The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

Comparisons of Maternal Perceptions between Rooming-in and Non Rooming-in Postpartum Women (신생아간호 운영체계에 대한 산모의 인식과 이용에 따른 차이)

  • Kim, Yun Mi;Park, Kwang Ok;Jang, Hae Ryung;Jung, Eun Ja;Kim, Ji Soo;Kim, Eun Young
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.77-89
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    • 2009
  • Purpose: The purpose of this study was to compare maternal perceptions between two groups of postpartum women, women who chose to have their babies room-in and women who did not (non rooming-in group). Methods: Data collection was conducted in 37 hospitals from August 10 to September 20, 2008. The participants were 209 mothers opting for rooming-in and 128 mothers for non rooming-in. The women completed a questionnaire which included the Edinburgh postpartum depression scale, maternal attachment inventory, and postpartum self-evaluation questionnaire. Results: There were significant differences in education level, income and antenatal education between the rooming-in and non rooming-in groups. The rooming-in group also showed higher levels of satisfaction with medical services. More important, the rate of breast feeding for the rooming-in group was higher than for the non rooming-in group. There was no difference between the two groups for postpartum depression, maternal attachment and mothers' confidence with infant care tasks. Conclusion: These findings suggest that rooming-in system has more advantages compared to non rooming-in and that it can help to promote breast feeding. The authors recommend that the rooming-in system be expanded nationwide. The results of this research can be used to assist the development of future rooming-in system expansion strategy.

One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series

  • Ji Wool Ko;Giho Moon;Jin Geun Kwon;Kyoung Eun Kim;Hankaram Jeon;Kyungwon Lee
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.376-384
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    • 2023
  • Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

Vaccine hesitancy: acceptance of COVID-19 vaccine in Pakistan

  • Sheze Haroon Qazi;Saba Masoud;Miss Ayesha Usmani
    • Clinical and Experimental Vaccine Research
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    • v.12 no.3
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    • pp.209-215
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    • 2023
  • Purpose: The delay in acceptance or refusal to get vaccinated despite the availability of services is called vaccine hesitancy. The Global Polio Eradication Initiative in Pakistan faced consistent barriers preventing the eradication of the disease in the country. Similarly with the advent of the coronavirus disease 2019 (COVID-19) pandemic mass vaccination drives were initiated to a vaccine hesitant population. The aim of this study is to explore the prevalence and reasons for COVID-19 vaccine hesitancy in the Pakistani population. Materials and Methods: Cross-sectional study conducted during July to September 2021 using a snowball sampling technique targeting the adult population of Pakistan. The modified version of the vaccine hesitancy questionnaire related to the Strategic Advisory Group of Experts on Immunization Vaccine Hesitancy matrix was distributed online. Results: Out of 973 participants, 52.4% were immediately willing to take the vaccine and constituted the acceptance group whereas the remaining 47.6% who were still not sure formed the hesitant group. Support from leaders was found to be statistically significant for the difference between the hesitant and acceptance groups (p-value=0.027). Hesitant people were concerned about the effectiveness of the vaccine (60.9%) and potential side effects (57.9%) as it was not sufficiently tested prior to launch (44.7%). Age and education were significant factors affecting the acceptance of vaccination. The most trusted source of information regarding vaccination was health care workers (43.8%). Conclusion: A moderately high prevalence of vaccine hesitancy was reported in Pakistan. To overcome it, policymakers need to address the reasons for it. Leaders, celebrities, and healthcare workers can play an instrumental role in dispelling conspiracy theories regarding vaccines and making the vaccination drive a success.

A Study on Performance and Achievement of Village Health Workers in Rural Primary Health Care Program (농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구)

  • Hur, Dal-Young;Lee, Myoung-Sook;Yum, Yong-Tae;Kim, Soon-Duck
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.36-53
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    • 1987
  • It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

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The Evaluation on the Effectiveness of Inter-Agencies in Community Welfare Practice -The Attitudes of Practitioners and Clients of Community Welfare Association- (지역사회복지실천에 있어서 기관간 연계의 효과성 평가 -'지역사회복지협의체' 사업의 참여자와 수혜자의 태도-)

  • Han, Cheol-Ho
    • Korean Journal of Social Welfare
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    • v.55
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    • pp.309-339
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    • 2003
  • This study was made in order to evaluate the effectiveness on the activities of Community Welfare Association through the inter-agencies, carried out in 14 regions in our country as the examples. I'd like to emphasize the two main points in this study. One is whether the community practitioners have positive thoughts or not, about the evaluation on the activities through the inter-agencies. The other is how the receivers react to the inter-agency services. In order to find the solutions for two questions, the survey data of Korea Institute for Health and Social Affairs were reanalyzed. First, the attitudes of the practitioners are as follows; that is, the directors of the organizations have negative opinions about the communication, while practitioners have positive evaluations. About the performance of its roles, 68.2 percent of practitioners showed positive reactions, and 77.8 percent answered it's necessary to manage the community association continuously. The receivers have positive evaluations in general about the inter-agency services. In the comparison of the community activities between before and after, domiciliary services were improved because there was a meaningful statistical difference, however, other services such as medical care service were not bettered. And there was no difference between before and after in the CSQ.

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Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients (지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로)

  • Lee, Hyun-Ji;Park, You-Hyun;Cho, Hyung-Kyung;Seol, Jin-Ju;Kwak, Jin-Mi;So, Ye-Kyeong;Park, Su-Jin;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.94-102
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    • 2020
  • Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

The Impact of Childhood Cancer on The Korean Family (암 환아 발생이 가족에게 미치는 영향에 관한 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.636-652
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    • 1992
  • This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

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