• Title/Summary/Keyword: Quality of Health Care

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Institutionalization of a Patient-Sitter Program in Acute Care Hospitals (보호자 없는 병원 제도화 방안)

  • You, Sun-Ju;Choi, Yun-Kyoung
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.370-379
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    • 2013
  • In an effort to resolve the burden of patients hiring patient sitters, this study sought to review the Ministry-of-Health-and-Welfare-initiated pilot program of running hospitals without patient-sitter to identify its background, operation method, performance results, and limitations. Based on the review, the study derived the necessity of introducing a hospital system without patient-sitter as well as its operation and systemization methods. The ministry-initiated pilot programs were conducted twice: in 2007, and in 2010. A review of the 2007 pilot program revealed that the patients and families' satisfaction score with nursing services was 9.1 points (on a 10-point scale), their intention to reuse the service was 97.8%, and their intention to recommend the service was 98.0%, all high scores. Appropriate nursing manpower, derived from the 2007 pilot project, indicated 2.3 patients per nurse and 4.0 patients per nurse aid. The 2010 pilot project results indicated that the patients and families' satisfaction was high at 8.0-9.1 points (on a 10-point scale), and that the intention to reuse and recommend the service was also high. Compared with the 2007 pilot project, however, the types of medical institutions and the nurse to patient ratios were diverse, offering limitations. In conclusion, to systemize hospitals without patient-sitter, it is necessary to develop policies designed to establish criteria for the appropriate nurse to patient ratio and skill-mix, to standardize the work, to prepare finances for securing nursing staff, to evaluate the nursing demands, and to monitor the quality management.

Analyses of Brand Community Characteristics, Members' Behavioral Patterns & Participation Experiences, and Quality of Relationship according to Community Formation Orientation: Comparisons between Maker Oriented Community and Customer Oriented Community (브랜드 커뮤니티 형성과정에 따른 커뮤니티의 특징, 구성원의 행태와 참여경험 및 관계의 질에 대한 분석)

  • Yoo, Chang-Jo;Jung, Hye-Eun
    • Proceedings of the Korean Association for Survey Research Conference
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    • 2005.12a
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    • pp.187-220
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    • 2005
  • The purpose of this study is to analyze supporters' community formation motives/ Process/consumption experiences and community characteristics. For this purpose, this study collected the data using ethnographic interview. participant observation, documents and media reports. The results of this study show that supporters communities' formation and diffusion process were influenced by individual characteristics(e.g., personality, hobby and etc.), community characteristics(e.g.,team performance, star player, facilities and etc.) and external factors(ex: media movement etc.) and supporters have experienced various emotions such as intimacy. cohesion, pride and so on through various activities at on-line and off-line site. Community characteristics were classified into we-ness, rituals/traditions, moral responsibility. We found that we-ness influenced emotional dimensions such as joy, pleasure, fun and excitement. rituals and traditions made members feel passion. hope. love and vitality. and moral responsibility provided satisfaction. enthusiasm anxiety. regret and so on. Also, emotional attachment and brand loyalty were increased by these experiential aspects of community consumption.

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A Study on the Nurses' Contingent Employment and Related Factors (간호사의 비정규직 고용실태 및 관련요인에 관한 연구)

  • Choi, Sook-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.477-500
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    • 1999
  • Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

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Food Habits and Nutrition Knowledge of College Students Residing in the Dormitory in Ulsan Area (울산지역 기숙사 거주 대학생의 식생활 습관과 영양지식)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.9
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    • pp.1388-1397
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    • 2005
  • This study has been carried out to obtain information regarding to the food habits including health-related behaviors, the nutrition knowledge and the satisfaction on the dormitory food service. The subjects of this study were 758 college students (580 male and 178 female) residing in the dormitory in Ulsan. The data were obtained through questionnaire and interview, and were analyzed using the SPSS package program. the results of this study are as follows: The average age of the subjects was $20.7\pm2.3$ years old. The average height and weight of male were $175.2\pm5.0\;cm\;and\;69.4\pm9.6\;kg$, respectively. Those of female were $162.6\pm4.1\;cm\;and\;51.8\pm5.9\;kg$, respectively. The BMI value of male was $22.6\pm0.1$ which ranged within normal level, but that of female was $19.6\pm0.2$ which ranged underweight level. In the case of food habits, $26.0\%$ of total subjects always skipped a meal (especially breakfast). The main reasons for skipping meals were no time to eat, no appetite, and weight control. Most of subjects ($69.3\%$) have usually eaten snack after dinner, their most favorite food was noodle (ramen), and the next was pizza. With regard to the health care, there was a significant difference between male and female respect to smoking (p<0.001), drinking (p<0.01) and exercise level (p< 0.001). The mean food habit score of the subjects was $59.9\pm11.1$. Male students had a higher food habit score than female students (male: $60.6\pm10.9$, female: $57.7\pm11.4$), and the group residing longer period had a higher food habit score than the one residing shorter period. Average nutrition knowledge score of subjects was $7.8\pm1.8$. Gender, residing periods, monthly pocket money influenced on the nutrition knowledge score. Female had a higher score than that of male (P<0.001), and the group residing longer period had a higher score than the one residing shorter period (p<0.01), and the group who had more monthly pocket money had a higher score than the one who had less. No significant correlation was found between food habit score and nutrition knowledge score. In the case of dormitory food service, the total subjects showed high satisfaction scores for the sanitation and the atmosphere, while low scores for the menu and the quality of food service. This study may provide basic information on the eating habits and health-related behaviors of college students in dormitory. However, further studies and nutrition counseling are needed to improve food habits and nutrition knowledge.

The Physiologic change associated with aging, essential nutrients and their diseases in senior or geriatric dogs (노령견의 생리적 변화에 따른 필요 영양소 및 질병에 관한 연구)

  • Jung, Hyung-hak
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.4
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    • pp.1456-1471
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    • 2018
  • This article discusses the nutritional requirements, reviews senior or geriatric dog nutritional evaluation, and then addresses some common nutrition-related problems in older dogs. The purpose of this study was to investigate the Physiologic change associated with aging, essential nutrients and their diseases in senior or geriatric dog subjects. According to a 2002 market research, 30% to 40% of dogs raisedin the United States are 7 years of age. In Europe the number of dogs considered to be "senior or geriatric" (>7 years of age) increased by approximately 50% between 1983 and 1995. A 2012 e-mail survey of 50,347 respondents revealed that 33.2% of dogs were 6 to 10 years of age and 14.7% were older than 11 years in the United States. The average life expectancy of dogs raised in the home is affected by health care, aging and nutrition.And, the aging process is influenced by breed size, genetics, nutrition, environment, and other factors. Although many pets remain active and youthful well into their teens, most dogs start to slow down and may show signs of aging beginning as early as 5 or 6 years of age. Improvements in the control of various diseases and in the nutrition of dogs have resulted in a gradual increase in the average lifespan of companion dogs. Nutritional goals for aging dogs include supporting health and vitality, preventing the onset or slowing the progression of age-related health disorders, and enhancing the dog's quality of life and, if possible, life expectancy. Aging brings with its physiologicchanges. Some changes are obvious, such as whitening of hair, a general decline in body and coat condition, and failing senses including sight and hearing. Other changes are less obvious, however, and these include alterations in the physiology of the digestive tract, immune system, kidneys, and other organs. Nutritional requirements can change with age. In addition, many diseases common in older dogs may be nutrient-sensitive, meaning that diet can play an important role in the management of the condition.

Role accomplishment and job satisfaction of hospice nurse (호스피스간호사의 역할수행 정도와 직무만족도)

  • Han, Hyoung-Suk;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.29-48
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    • 2008
  • Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.

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The Death Orientation of nursing students in Korea and China (한국과 중국 간호대학생의 죽음에 대한 의식)

  • Li, Zhen-Shu;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.1-12
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    • 2008
  • Perpose: The purpose of this study was to investigate the perception of death between Korean and Chinese nursing students. And it will help develop curriculum for preparing death, the quality of hospice care, as well as nursing education and practice. Methods: Data was collected from 492 nursing students participated(248 Korean and 244 Chinese) by questionnaire designed for examining Death Orientation (Thorson & Powell, 1988). They were analyzed using Cronbach's Alpha coefficients, factor analysis, t-test, ANOVA and regression analysis (SPSS; win 12.0 version) Results: More than half of the Korean nursing students followed a religion (58.5%) while the majority of Chinese nursing students did not follow a religion (93.9%). In the view of the afterlife, nursing students in China had two views. 'I really don't know what happens after a person dies (30.3%)' and ‘There is no afterlife and death is the end (29.5%)’. On the other hand the Korean nursing students’ answer were, 'After dying, a person goes to heaven or hell (27.3%)' and 'I really don't know what happens after a person dies. (22.9%)' The study also found that the average of 25 items in Death Orientation is 2.36points of nursing students in Korea and 2.50points of nursing students in China. This means that the concern, anxiety and fear were of the middle level for the Chinese Students and were higher than Korean students (t=3.51, p=.000). In the low factor of death orientation, those in Korea had higher 'anxiety of burden to family' than those in China (t=-3.50, p=.001). The nursing students in China had higher 'anxiety of the unknown (t=4.96, p=.000)', 'fear of suffering (t=6.88, p=.000), 'fear of extinction body and life (t=5.20, p=.000), 'fear of lost self-control(t=2.12, p=.034)', and 'anxiety of future existence and nonexistence (t=2.33, p=.020)' than those in Korea. There was no statistically significant difference for the 'concern of body and fear of identity lost' category. The death orientation of Korean nursing students had statistically significant differences according to age (t=3.20, p=.002), religion (t=2.56, p=.011), and afterlife (F=4.64, p=.000). The contribution of Death Orientation had a statistically significant difference, the afterlife variable (0.735, p=0.001). The death orientation of Chinese nursing students did not have any statistically significant differences. Conclusion: In conclusion, there were differences in death orientation between Korean and Chinese nursing students. In particular, those who believed in afterlife showed acceptance of death. The results of this study suggest that nursing curricula should include education program on death and spiritual nursing. Additional studies are needed to establish death education in China with careful considerations on Chinese policies, cultures and social systems.

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Malignant Bowel Obstruction in Terminal Cancer Patients (말기암 환자의 악성 장 폐색)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.214-220
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    • 2004
  • Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.

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Database for Hospice Nursing in Electronic Medical Record (호스피스 전자기록을 위한 데이터베이스 개발)

  • Kim, Young-Soon;Lee, Chang-Geol;Lee, Kyoung-Ok;Kim, Ok-Kyum;Kim, In-Hye;Kim, Mi-Jeong;Hwang, Ae-Ran;Lee, Won-Hee
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.200-213
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    • 2004
  • Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

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The Study of Structural Relationship among the Customers' Service Recovery of Complaint and After Behavioral Intention in the Service Industry (서비스 산업에서 고객 서비스 불평 회복과 사후행동의 구조적 관계 연구)

  • Heo, Seon Hee;Youn, Chun Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.1
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    • pp.165-176
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    • 2014
  • This study is directed to examine the most useful restoration strategies for turning the customers' dissatisfaction caused by unsuccessful spa service to the satisfaction through each fair factors and tries to suggest the practical schemes to cope with complaints and dissatisfaction of spa service customers by establishing the system dealing with customers' complaints. And this verifies the relationship between the alternative attraction and the intention of conversion as the action after the restoration from the unsuccessful services. Moreover, it analyzes the mediation effect that a formation of reliance through the restoration of unsuccessful services has. To achieve the purpose of this study, the subject got decided as women who are customers of private spa facilities situated in Seoul and Gyeonggi-do region for the purpose of skin care in 1 year recently. After understanding their experiences of complaining about the services, this study investigates the alternative attraction and the intention of conversion as the next action and the perception of fairness and trust in the efforts of Spa service business for recovery. As the result of verifying hypothesis, it is shown that the recovery satisfaction increases when the 3 points of the distributive justice, procedural justice, and interactional justice, which are the fairness factors of the effort to restore services according to the quality of service, are more positive. In the relation among recovery satisfaction, trust, the alternative attraction, and the intention of conversion, the result was that recovery satisfaction affects trust in positive way and alternative attraction in negative way. However, the positive and meaningful result came out in contrast with the hypothesis which predicted the negative effect of recovery satisfaction on the intention of conversion. Furthermore, it means that indirect effectiveness which carries trust and alternative attraction should be considered instead of the direct effectiveness that the recovery satisfaction affects on the intention of conversion. In this study, it can be interpreted that the combined increase of the trust and the alternative attraction makes the intention of conversion higher rather than the higher intention of conversion following the decrease of the recovery satisfaction in view of the result that the indirect effectiveness is high between the recovery effort and the intention of conversion. In the relation among the intention of conversion, trust, and alternative attraction, the intention of conversion got influenced in positive way and negative way by trust and alternative attraction respectively and trust influenced the alternative attraction negatively as well. It means the high quality of services or the recovery of services has a direct causation which carries conviction to the customers' intention of action.

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