• 보건행정학회지
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• 제24권1호
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• pp.13-23
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• 2014

Background: A need arises to efficiently control health expenditure for medical aid due to a sharp increase in medical aid expenditure. This study experimently analyzes the impact of physician behavior on medical use for medical aid beneficiaries using supplier induced demand (SID) theory. Methods: This study looks into analyze SID effect using expenditure factor analysis of medical aid for the years between 2003 and 2010 in comparison with health insurance. Moreover, this study analyzes the existence and scale of SID using econometrics modeling with panel data on 16 cities and provinces's health expenditure data for medical aid from 2003 1/4 to 2010 4/4. Results: This study finds that the growth rate of visit days per capita and treatment amount per visit days for medical aid is higher than health insurance. Furthermore, the result of econometrics modeling analysis shows the existence of SID in general hospital, hospital, clinic, oriental clinic. Conclusion: In order to efficiently control expenditure for medical aid, it is required to reinforce macro polices such as the introduction of 'target management' and micro policies such as the strengthen of management on medical institutes in the perspective of suppliers as well as regulations of demanders.

• 지역사회간호학회지
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• 제15권1호
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• pp.155-164
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• 2004

Purpose: The purpose of this study was to identify factors affecting early detection behaviors of breast cancer such as breast self examination(BSE), breast physical examination, mammography. Method: The subjects were 141 women on an island and materials were collected through an organized questionnaire from March, to August 2002. The data were analyzed by using descriptive statistics, $x^2$ and logistic analysis by SAS program. Results: 52.7% of the subjects performed breast self examination, 67.2% did breast physical examination and 67.7% did mammography. That is, about 60% of the subjects performed early detection behavior to find the breast cancer. Practice of breast self examination was significantly correlated with experience of physician examination and mammography. The most significant factor on BSE was a normal salted diet, and the most significant factor on physical examination and mammography was the high education level of subjects. Conclusions: According to the results of this study, it suggests that intensive education and information strategies for breast cancer early detection need to be developed. In particular, early detection programs for lower educated women should be activated.

• 수면정신생리
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• 제2권1호
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• pp.13-22
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• 1995

To provide the physician with adequate information to diagnose and treat sleepwalking and sleep terrors, the author reviewed clinical features, epidemiology, causative and precipitating factors, polysomnography, diagnosis, differential diagnosis, and treatment for these disorders. Sleepwalking and sleep terrors have been defined as disorders of arousal that occur early in the night and have their onset during stage 3 or 4 sleep. In both disorders, patients are difficult to arouse, and complete amnesia or minimal recall of the episode is frequent. Genetic, developmental, and psychological factors have been identified as causes of both sleepwalking and sleep terrors. Sleepwalking and sleep terrors typically begin in childhood or early adolescence and are usually outgrown by the end of adolescence. When sleepwalking or sleep terrors have a post-pubertal onset or continue to adulthood, psychopathology is a more significant causative factors. The behavior that occur from deep slow-wave sleep can be painful or dangerous to the individual and/or disturbing to those close to that individual. The assessment of patients suspected of having these conditions requires a thorough medical and sleep history. The most important consideration in managing patients with sleepwalking or sleep terrors episodes is protection from injury.

• 성인간호학회지
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• 제20권2호
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• pp.296-310
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• 2008

Purpose: The purpose of this study was to compare the importance and performance of nursing interventions linked to five nursing diagnoses in CVA patients. Methods: First, total 37 nursing diagnoses were identified from the analysis of 78 nursing records of CVA patients, and then top 5 diagnoses were mapped with nursing interventions. Second, each intervention was compared in terms of importance and performance by 80 nurses working at neurosurgical units from 5 general hospitals. Data were analyzed using mean, SD, and t-test using the SPSS program. Results: Selected the top five nursing diagnoses were Acute Pain, Risk for Disuse Syndrome, Decreased Intracranial Adaptive Capacity, Ineffective Cerebral Tissue Perfusion and Acute Confusion. In general, most of the interventions were scored higher in importance than performance and most of independent interventions were not performed as frequently as it perceived in importance. The interventions which scored high in performance were the interventions ordered by physician or interventions related to medication behavior. Conclusion: We identified which nursing interventions should be performed more frequently and more critically important to nursing diagnoses. We recommend further research that enhances the performance of nursing interventions to provide better quality of nursing services to the patients in practice.

• 한국문헌정보학회지
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• 제14권
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• pp.93-130
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• 1987

Scientific communication is an information exchange activity between scientists. Scientific communication is carried out in a variety of informal and formal ways. Basically, informal communication takes place by word of mouth, whereas formal communication occurs via the written word. Science is a highly interdependent activity in which each scientist builds upon the work of colleagues past and present. Consequently, science depends heavily on scientific communication. In this study, three mathematical models, namly Brillouin measure, logistic equation, and Markov chain are examined. These models provide one with a means of describing and predicting the behavior of scientific communication process. These mathematical models can be applied to construct quality filtering algorithms for subject literature which identify synthesized elements (authors, papers, and journals). Each suggests a different type of application. Quality filtering for authors can be useful to funding agencies in terms of identifying individuals doing the best work in a given area or subarea. Quality filtering with respect to papers can be useful in constructing information retrieval and dissemination systems for the community of scientists interested m the field. The quality filtering of journals can be a basis for the establishment of small quality libraries based on local interests in a variety of situations, ranging from the collection of an individual scientist or physician to research centers to developing countries. The objective of this study is to establish the theoretical framework for informetrics which is defined as the quantitative analysis of scientific communication, by investigating mathematical models of scientific communication.

• 지역사회간호학회지
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• 제23권4호
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• pp.438-445
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• 2012

Purpose: Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not. Methods: A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system. Results: After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not. Conclusion: This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

• 성인간호학회지
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• 제18권1호
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• pp.146-156
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• 2006

Purpose: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. Method: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). Results: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. Conclusion: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.

• 성인간호학회지
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• 제14권2호
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• pp.265-275
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• 2002

Pursose: The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. Method: The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky & Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. Result: The results of this study are as follows. 1. The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2. Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3. Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. Conclusion: The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.

• 대한간호학회지
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• 제31권2호
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• pp.340-350
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• 2001

The purpose of this study was to investigate the factors influencing social adaptation of chronic mental illness. The subjects of this study were 190 patients, over the age of 20 with chronic mental illness diagnosed by a physician, and living in Seoul, Korea during May, 2000 to December 2000. The instruments for this study were the social adaptation scale by Wallace (1979), the self-esteem scale by Rogenberg (1965), social support scale by ParkJiWon (1985), coping behavior scale by Shirley Zeitlin (1978), self efficacy scale by Sherer et. al (1982), and Rand mental health inventory(1979). The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. The results of this study are as follows: 1. The level of social adaptation showed moderate (M=3.43). 2. The social adaptation showed significant positive correlation with self-esteem (r=0.39, p=0.00), self-efficacy (r=0.31, p=0.00), social support (r=0.47, p=0.00), self-productive coping (r=0.14, p=0.05), self-flexible coping (r=0.22, p=0.00), environment-active coping (r=0.21, p=0.00), and environment-flexible coping (r=0.14, p=0.04). The social adaptation showed significant negative correlation with anxiety (r=-0.16, p=0.02), and emotional problems (r=-0.18, p=-0.00). 3. The stepwise multiple regression analysis revealed that the most powerful predictor of social adaptation was social support (21%). A combination of social support, depression, behavioral controllability, self-efficacy, and environmental coping behavior accounted for 39% of the variance in social adaptation in chronic mental illness. From the results of this study, it is suggested to develop and apply a social adaptation training program for chronic mental illness.

• 한국의료질향상학회지
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• 제21권1호
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• pp.52-61
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• 2015

Objectives: Because recently hospital had to faced with financial hardship, we have to have more effective hospital management. The purpose of this study was to reduce loss costs of the hospital through the systematic management of medical supplies and increase operational efficiency. Methods: The team was composed of outpatient nursing staff, medical record administrator, nurses in medical insurance, medical computer center, dermatologists for this study. We surveyed for 114 people including outpatient nursing staff, nurse aids, medical assistant, physician assistant. Pre-survey period was 2013.03.11 ~ 03.30(2 weeks), and post-survey period was 2013.09.03 ~ 09.17(2 weeks). Result: We improved this way through the computational improvement, conservation campaigns, inventory management, staff training, replaced by low-cost medical supplies. The finding of this study were as follows: Comparing before and after the activity of outpatient nursing staff's degree of knowledge, performance, economic consciousness, the degree of knowledge, performance was increased, but there was no significant change in economic consciousness. Performance of Married person is higher than the unmarried, In addition, the high-position people were more the degree of knowleage, economic consciousness. After activity, correlation of goods and treatment, examinations is increasing, but statistically there was no mean. Conclusion: This study revealed that knowledge in a short period of activity, but also can improve, perform the same change in behavior is not easy. This one shows the intensive training required to sustained and systematic behavioral changes, such as changes in behavior, perform rituals to help the economy. Expensive medical supplies to replace a similar effect as the cost of materials just to have a lot of cost savings. Therefore, more medical supplies change is necessary to develop alternative treatment and cost cutting.