• 한국노년학
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• v.34 no.2
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• pp.369-386
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• 2014

The purpose of this study was to develop the classification of home-based long-term care activities and to test its validity. In this study, the taxonomy of long-term care activities was structured according to the service domain and process. Two expert groups participated in making a draft of the taxonomy that was composed of 7 service domains, 22 care needs, 22 service objectives, and 114 activities. Reliability and validity of the taxonomy was tested in a sample of 152 elderly subjects who used the home-based long-term care services. Based on the factor analysis of 114 activities, 21 factors were extracted from 114 activities. Internal consistency of the factors was high. Content validity was confirmed by the CVI. Long-term care insurance grade was used to assess the criterion validity. Among 21 care needs, 12 cares needs were significantly different from their grade. The classification of home-based long-term care activities demonstrated reliability and validity. In conclusion, the use of this classification is recommended while communicating with the elderly subjects, service providers, and the 3rd party payers.

• 한국노년학
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• v.39 no.3
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• pp.531-548
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• 2019

The purpose of this study is to provide basic data in order to improve service quality based on empirical analyses about a relationship among positive psychological capitals, service quality, and job satisfaction of professional care workers under the Long-Term Care Insurance in South Korea. In this study, total 430 numbers of the workers who were currently working in nursing homes for the elderly at the cities of Ansan, Anyang, Bucheon, and Kwangmyeong in Gyeonggi Province, South Korea, participated in self-report questionnaires. Only 393 questionnaires were used for the final analyses after excluding the ones that neither were not returned nor didn't completed it all. These are major results. First, positive psychological capitals affect positively on service quality. Second, job satisfaction works as a mediating effect in the process of positive psychological capitals affect on service quality. Based on above results, it is possible to suggest it as down below. First, it is required to have policies that will be helpful for both positive psychological capitals and capacity building through human resource management in systematic approaches. Second, it is also required to acknowledge that having positive psychological capitals is effective to improve both their job satisfaction and service quality. Therefore, it is necessary to change environmental circumstances in relevant institutions where this acknowledgement will be applied.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.41-63
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• 2002

The purpose of this study is to analyze the interrelation of influential factors in organizational conflict and organizational commitment. The data for this study were collected through a self-administered survey with a structured Questionnaire to 1,167 subjects from several nursing staff members, administration staff members and medical technicians of six hospitals. In this analysis frequency test, t-test, ANOVA, hierarchical multiple regression and structural equation model were used. The main findings of this study are as follows. 1. Factors which influence organizational conflict were analyzed. The type of occupation and the year of service were socio-demographic variables which influenced organizational conflict positively. Adjusted R square was 0.03. Perceptions on organizational structure and organizational culture were analyzed with two- level variables that were added. The findings were as follows. Adjusted R square increased to 0.25. The year of service, internal process culture and rational goal culture were positive variables. The design of organizational structure, human relations culture and open system culture were negative variables. 2. Variables which influence organizational commitment were analyzed. Age and the year of service were positive variables, while academic background based on high school education was a negative variable. Adjusted R square was 0.16. Perceptions on organizational structure and organizational culture were analyzed with two-level variables that were added. The findings were as follows. The characteristics of organizational structure, human relations culture and organizational culture were positive variables. Adjusted R square increased to 0.55. The variables of organizational conflict were added in 3 steps. Findings were as follows. The variables of hierarchical conflict showed negative influence and were included in two-level influential variables. Adjusted R square increased to 0.56. 3. Structural equation model was analyzed in order to examine the relation between organizational structure and the variables of organizational culture, organizational conflict and organizational commitment. Thirteen path coefficients out of seventeen path coefficients were significant. Age had negative influence on organizational conflict and positive influence on organizational commitment. The year of service had positive influence on organizational conflict and organizational commitment. The design of organizational structure, human relations culture and open system culture had negative influence on organizational. conflict. They had positive influence on organizational commitment. Internal process culture and rational goal culture had positive influence on organizational conflict. Organizational conflict had negative influence on organizational commitment. The squared multiple correlation of this model was 25.1% in organizational conflict and 52.7% in organizational commitment. The conclusion of this study is as follows. Factors in organizational structure and organizational culture, rather than socio-demographic factors, had a stronger influence on the organizational conflict and organizational commitment of hospitals. In order to decrease organizational conflict, to increase organizational commitment and to maximize the effectiveness of hospital management, it is necessary to understand the overall relation between organizational structure, organizational culture, organizational conflict and organizational commitment, with the effort of improving personalized factors and individual factors of organization management.

• Journal of the Korean Society of School Health
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• v.11 no.2
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• pp.171-187
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• 1998

In recent years, adolescent issues including smoking, drinking, drug abuse, juvenile delinquency, deviant sexual behavior, mental health problems, high suicide rate, juvenile delinquency and absence without due notice, etc are emerging as serious social problems and the debate on these controversial issues is heating up. The previous studies on adolescent health behavior and social juvenile delinquency such as run-away from home and absence without due notice have been conducted mostly by cause analysis utilizing social demographic factors or biological factors. In other words, the main factors analyzed were demographic and economic factors or parent's educational level, etc, which were the fixed environmental ones that were unable to cause the change in the health behavior. Accordingly, the purpose of this study is to analyze factors which are changeable and fixable among the factors influencing the adolescent's health behavior and misconducts and, eventually influencing factors which can be used as the basis to establish health policies and health promotion program to reduce the health risk behavior and misconducts of adolescents. The study subjects were selected by dividing senior high school student in Seoul by region and through random sampling. The 890 subjects were selected from 10 schools including the preparatory school, vocational schools and institutional schools. The duration of the study was for July 1-5, 1997 for the first survey and the second one, for August 25-September 10. Regarding the analysis method, the SAS program was used. The adoptablity of theoretical model was tested through covariance structural analysis utilizing PC-LISREL 8.12 Program. The major findings of the study are as follows: As a result of establishing the model of factors influencing health behavior and juvenile delinquency, in case of male students as the health behavior self-efficacy, education level of fathers, economic level, self-control and the health interest of parent were higher, students were more likely to practice the health promoting behavior. Juvenile delinquency and health risk behavior were prevalent among those with the less shyness, the lower health behavior self-efficacy, lower self-control, lower self-assertiveness, lower economic level. The self-control was the most powerful factor. In case of female students, those with higher health behavior self-efficacy were more likely to practice the health promoting behavior whereas those with lower health behavior self-efficacy, lower self-control, lower self- assertiveness, less shyness were more likely to practice health risk behavior and juvenile delinquency. In case of prep schools, those with higher health behavior self-efficacy and better perceived health status were more likely to practice the health promoting behavior while those with less shyness, lower health behavior self-efficacy and lower academic achievement were more likely to engage in health risk behavior and juvenile delinquency. In case of vocational schools, as health behavior self-efficacy and economic level were higher, the practice rate of health promoting behavior was higher. As the self-control, shyness, self-assertiveness, health behavior self-efficacy were lower, the rate of health risk behavior and juvenile delinquency were higher. In case of social institutional schools, as, the health behavior self-efficacy, social support and economic level, health interest of parents were higher, the rate of health promoting behavior were higher. As the self-control, shyness, self-assertiveness, health behavior self-efficacy and social support were lower, the rate of health risk behavior and juvenile delinquency were higher. So the health promoting behavior was positively related to the health behavior self-efficacy, health interest of parents, social support, education level of fathers, level of perceived health status, economic level. The health risk behavior and juvenile delinquency were higher with the lower health behavior self-efficacy, self-control and self-assertiveness, lower health locus control, less shyness and loneliness, lower economic level and academic achievement. In conclusion, the health risk behavior and juvenile delinquency can be reduced by enhancing self-control, self-assertiveness, health behavior self-efficacy and social support. According to the final model drawn by connecting health behavior and juvenile delinquency, the reduction of health risk behavior can greatly contribute to decreasing social juvenile delinquency as the process of juvenile delinquency was extended from common behaviors to problem behaviors and further into juvenile delinquency.

• Journal of the Korean Society of School Health
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• v.14 no.2
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• pp.249-268
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• 2001

This study was carried out to identify the effects of an art therapy program based on reality therapy on the weight control, body image, and self-esteem of college students. The program was developed by the authors. The design was a pretest-post test control group design. The subjects were college students attending M college : 8 in experimental group A, 6 in experimental group 2, who wanted to control their body weight and 16 in the control group who didn't attend the program those in the experimental group attended the program once (group A) or twice (group B) per week meeting a total of six times. The data were analyzed by quantity method (SPSS 10.0 program) and quality method(process analysis). The results were as follows : 1. The average obesity index of pre-test, post-test, and a follow-up test decreased from 8.9% to 6.1%, 3.7%. And the rate of decrease both pre-post and post-follow up were statistically significant 2. The average obesity index of group A decreased from 9.6% to 6.3%, 4.1% and the rate of decrease between pre and post were statistically significant. But the rate of decrease between post and follow-up were statistically not significant 3. The average obesity index of group B decreased from 7.8% to 5.8%, 3.1% and the rate of decrease between pre and post were not significant statistically. But the rate of decrease between post and follow-up were statistically significant 4. The average scores of pre and post body image increased and were statistically significant : group A from 129.0 to 153.5, group B from 127.7 to 155.2. 5. The average scores of pre and post semantic differential method increased and were statistically significant: group A from 38.1 to 44.1, group B from 38.0 to 45.0. 6. The average scores of pre and post self-esteem increased: group A increased from 37.3 to 40.3 and were statistically significant, group B increased from 36.5 to 39.5 but was statistically insignificant 7. The average scores of pre and post obesity rate, body image, semantic differential method and self-esteem in the control group were not statistically significant 8. The pre and post scores of body image(p=.001), semantic differential method(p=.001) and self-esteem(p=.039) between experimental and control group were statistically significant. 9. In Duncan multiple comparison, it was not statistically significant between group A and B, but statistically significant between group A and the control group, group B and the control group in obesity index, body image, semantic differential method. There was no statistically significance among the three groups in self esteem 10. In Duncan multiple comparison, group A gained higher scores than group B in obesity index(-1.2%), and self esteem(0. 3). Group B gained higher scores than group A in body image(3. 0), and semantic differential method(1. 0). So it is difficult to conclude whether group A or B is more effective. In conclusion, the art therapy program based on reality therapy was effective in weight the control program of college students: obesity was decreased, the scores of body image and semantic differential method and self-esteem were increased. The scores of group A were increased more than group Band were statistically significant, The time interval was a very important factor in this program. The recommendation is : the validity of this program has to be tested through various subjects and in various areas. And also this program has to be tested in other topics.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.66-74
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• 2014

Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.388-400
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• 2006

The time 18 months after birth is very important for the prevention of early childhood caries because this time is proper to assure the completion of weaning and to perform the diet counseling, and caries process is initiated or actively aggravated under the total influence of feeding pattern from this period. For the purpose of examining the infection status of Streptococcus mutans and Lactobacillus of 18 month old infants and their mothers, and analyzing the correlation between infection status versus various caries-risk factors, this study was performed on the 60 infants of 18 months old and their mothers through the microbiological screening of saliva samples and direct questionnaire to mothers about the caries risk factors. And the results were as follows, 1. The higher the mother's infection level of S. muntans, the higher the infant's infection level and transmission rate. 2. Compared with non-caries group, higher infection level of S. mutans in both infants and mothers and transmission rate were revealed in caries group. 3. The higher the infant's infection level of S. mutans, the higher the caries prevalence and deft values, the less the monthly income of the parents, the longer the period of breast feeding, and the higher the consumption rate of sugared snacks. 4. Most of Lactobacillus infected infants were revealed to be infected also with S. mutans and to have caries. 5. The higher deft value, less parents' monthly income, more frequent daily nursing and more irregular snacking patterns were found among Lactobacillus infected group compared with not-infected group.

• Health Policy and Management
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• v.12 no.2
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• pp.23-42
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• 2002

The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.10-19
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• 2013

Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.83-104
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• 1981

Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance（P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.