• Journal of Digital Convergence
• /
• v.18 no.2
• /
• pp.333-342
• /
• 2020

The purpose of this study was to identify factors influencing elderly care burden of a working family. Methods: A descriptive correlational design was used. Participants was 153 family member of elderly at five nursing facilities. Data were collected through self-reported questionnaires from July to October 2019. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 25.0 program. Analysis result, explaining 20,8% of the variance, which indicated that subjects for giving care, monthly admission fee, burden of expenses, and satisfaction for fee service were significant predictors of working family's care burden. Various individual characteristics significantly influenced working family's care burden in aspects of emotional, social, economical, and physical burdens. Therefore, interventions to decrease working family's care burden must focus on their individual factors.

• Journal of Korean Clinical Nursing Research
• /
• v.30 no.3
• /
• pp.178-192
• /
• 2024

Purpose: This study aimed to improve the reimbursement policies in the service of Korean Advanced Practice Nurses (APNs) to enhance their utilization in practice. Methods: The study was conducted in three stages: 1) reviewing other countries' APN systems; 2) conducting focus group interviews and online surveys with APNs to gather opinions on their roles, practices, and reimbursement status; and 3) proposal for improving reimbursement policies based on expert consultations. The data was collected between March and June 2023. Results: In the United States, APNs can be reimbursed at 85~100 % of physician fees for services provided under the Balanced Budget Act of 1997. In Japan, reimbursement is only available for 38 tasks performed among specially trained Certified Nurses. Master's level APN education has been created but not nationally legislated. The results of focus group interviews reveal low awareness and legal limitations of Korean APNs' roles. The results of online surveys indicate high professional pride but low satisfaction with little reimbursement system, and 71.4% of respondents denote the APN field's integration. Also, expansion of current reimbursement to other APN fields and regular evaluation of roles and reimbursement were recommended. Conclusion: In this study, it is necessary to clarify APNs' roles, and scope of practice, and establish benefits and reimbursement systems for professional APNs' health services. This study suggests improvements to enhance the Korean APN system and healthcare quality in Korea.

• Women's Health Nursing
• /
• v.6 no.2
• /
• pp.234-257
• /
• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Quality Improvement in Health Care
• /
• v.3 no.1
• /
• pp.104-124
• /
• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• Journal of agricultural medicine and community health
• /
• v.39 no.2
• /
• pp.94-103
• /
• 2014

Objective: The purpose of this research was to define the factors influencing turnover intention of customized home health care nurses. Methods: Research participants were 237 nurses who worked in the customized home health care of 33 public health centers in Daegu city and Gyeong-Buk Province. The data were collected by self report questionnaires from July, 1 to August, 30, 2011. The data were analyzed by t-test, ANOVA, correlation coefficient, multiple stepwise regression using the SPSS program. Results: The average score for turnover intention was 3.12 (5 score) and job satisfaction was 2.41 (4 score). The scores for sub-categories of job satisfaction were operational factors, 1.99, personnel factors, 2.03, work factors, 2.64 and relationship factors, 3.04. Marital status, religion, visiting nurses career, employment status, work area were the significant factors related to turnover intention in these subjects. There was a significant negative correlation between job satisfaction and turnover intention (r=-0.354, p<0.001). Significant factors were job satisfaction, marital status, employment status (Cum $R^2$=0.198, F=17.179, p<0.001) that explained 19.8% of turnover intention. Conclusions: Customized home health care nurses management policy which includes job satisfaction and general characteristics of visiting nurses should be established to enhance of quality of customized home health care service.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.10
• /
• pp.336-343
• /
• 2017

In this study, we analyze the relationship between long-term care workers' emotional labor, professional quality of life, and service quality. The subjects of this study were 211 long-term care workers working in long-term care facilities. Self-administered questionnaires were used. In the research model, emotional labor(surface behavior, internal behavior) was verified using independent variables, with professional quality of life (compassion satisfaction, compassion fatigue) as the parameters and service quality as the dependent variables. The results of this study are as follows. First, the fit of the model was good. Second, the direct effects of emotional labor on service quality were not significant. However, there was a positive correlation between internal behavior and service quality, and a negative correlation between surface behavior and service quality. Third, professional quality of life(empathy satisfaction) was the most influential variable in terms of service quality. The results of this study demonstrate the necessity to payclinical and academic attention to long-term care workers' emotional labor and quality of life.

• Research in Community and Public Health Nursing
• /
• v.11 no.1
• /
• pp.21-36
• /
• 2000

The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

• Korea Journal of Hospital Management
• /
• v.22 no.4
• /
• pp.1-15
• /
• 2017

This study was designed to analyze the effect of servicescape and human service quality on patients' internal response and their behavioral intention in dental care organizations. Self-administered survey questionnaires with structured instruments were developed, and a total of 226 responses were used for statistical analyses using SPSS Windows version 18.0 program and AMOS 18.0 program. Major findings of the study are as follows. First, among other servicescape components, air condition environment was found to have a positive effect on patients' cognitive and physiological responses, while signals and symbols had a positive effect on cognitive and emotional responses. Second, the competence, among other factors of the human service quality, had positive influence on cognitive and emotional responses, while customer understanding affected positively on emotional response. Third, none of the servicescape components showed a direct effect on patients' behavioral intention, but their influence was mediated by internal responses. However, customer understanding, among other human service quality factors, had a direct effect on patients' behavioral intention. Fourth, emotional response, among other internal response factors, proved to have positive influence on behavioral intention. Results from this study suggest that dental care service providers can increase their competitiveness and customer satisfaction by understanding and improving the most important areas of servicescape and human service quality.

• Journal of Korean Public Health Nursing
• /
• v.4 no.2
• /
• pp.35-57
• /
• 1990

This study was conducted to provide information useful in developing a nursing curriculum. The sample consisted of 158 nursing students in Hanyang University and 34 faculty members who has taught them in their college & the practical area. Data were collected by using a structured questionnaire, which consisted of general characteristics of the students & their self-concept, teacher's perception of student's professional roles. The results are summarized as follows; 1. General characteristics of the students When the students applied for the university, they decided what they would specialized in. Because the motive of application for their major was simply based on their high school records, they were admitted to their university without previous knowledge of their major. The reason why they wanted to tranfer to another course after the admission was the same as above. The level of satisfaction of their major was the highest in Freshman, but in other grades the higher the;, grades were, the more they satisfied with their major and they had a better prospects about their speciality. 2. Self-concept in profermance for their major Self-concept in horne aspects was more positive perception than in social aspects & self control aspects. It resulted from tile fact that all students were females and the nursing uniqueness was based on the spirit of humanity & service. The students who had graduated from the high school in rural area wanted to tranfer to another course and taken counsel their personal problems with their parents had higher self-concept in horne aspects. As their grades were higher, the self-concept in social aspects bacame higher. The students who were satisfied with their major and took counsel their personal problems with their parents had more positive self - concept in social aspects. Self-concept in self control aspects was lower than other aspects. The students who didn't take counsel their problems with their parents, were burdened with their educational expenses and their curriculum had more negative self-concept in self control aspects. Therefore the university should be concerned about student's welfare and provide detailed orientation about their curriculum. 3. Teacher's perception about learner's professional role The role model of democratic group leader, role models for learners facilitator in a students' reach for knowledge and teaching based on soundly researched theory showed more positive perception than other factors. Their mean values were over 4. 32. The professionalism of allnurshing area, reinforcement with reinforcement for learning, nursing as part of the meaningful context of the whole showed nagative perception. Their mean values were below 3. 00. Therefore the nurse as a teacher should try to promote the locus of nursing profession and participate in their research actively.

• Journal of Hospice and Palliative Care
• /
• v.12 no.1
• /
• pp.5-13
• /
• 2009

Purpose: This exploratory study was undertaken to analyze the information needs of family members of terminal cancer patients, collected through the telephone counselling service by National Cancer Information Center. Methods: The study included 113 family members of terminal cancer patients who had enrolled at the National Cancer Information Center for the period from June, 2007 through March, 2008 and had agreed to the survey. Results: The subjects (n=113) consisted of grown-up children (n=82) and spouses (n=8) of patients'. Those in their 40's (n=40) and 30's (n=36) accounted for the majority of the sample. The questions raised most were about the information on treatment methods (n=117), management of terminal cancer patients (n=46), terminal cancer patients' life (n=27), deathbed and prediction of remaining life (n=18), hospitalization (n=16), and financial support (n=15). Most of the subjects were satisfied with the telephone counseling services, and 69% of the subjects had come to know about the telephone counseling service via Internet, and 10.6% of them stated that the PR for the service was poor. Conclusion: It is deemed essential for the government to use the mass media for PR of the hospice services, since family members of terminal cancer patients' are less aware of the hospice conducive to enhancement of patients' remaining quality of life, being involued too deeply in their treatment.