• Journal of Preventive Medicine and Public Health
• /
• v.31 no.4 s.63
• /
• pp.857-874
• /
• 1998

The objective of this study is to collect the opinions on the present condition and the improvement directions of urban health centers from and to make a comparison. Samples were drawn from the various sources of a district in seoul. 53 persons involved in district health's administration(the Members of a District Parliament, the senior officials of a District office, village chief) and 84 health center workers were surveyed with anonymous postal questionaires and 427 district private medical personnels with postal questionaires and 625 users of a health center with direct questionaires, from November 18 to 25, 1996. Additionally, 12,151 households were surveyed with self-reported questionaires including priorities on special district health services of health center, from September 1 to 7, 1996. The major findings were as follows : 1) Although the persons involved in district health administration tend to put lower priority on health service over other community activities, they well acknowledged the importance of health center. But health center workers strongly acknowledged the importance of both health service and heath center. 2) As to the level of human resoureces, equipments and ammenities of Health Center commpared with private medical institute, the persons involved in district health's administration and health center workers responded that health center was higher in following order : 54.9%, 41.6%, 36.5% and 88.0%, 80.7%, 44.1%. 3) Concerning the priorities of health center's improvement, the persons involved in district health's administration replied in the order of reinforcement of proffesional health workers (43.3%), improvement of equipments and ammenities(28.3%), and the health center workers replied in the order of reconstruction of organization(24.1%), public health education and promotion(22.8%), reinforcement of proffesional health workers(21.0%). 4) Both the persons involved in district health's administration and health center workers replied that Ministry Health and Welfare, District office, health center were essential as the most critical organizations in the activation of Health Center's Function. 5) Persons involved in district health's administration and health center workers chose, as the most important health center's Function, medical treatment and prevention of infectious disease, and prevention of acute and chrone disease control and special district health service, respectively. Both Groups replied that fammily planning and parasite control are no longer in need. 6) As the future health service requiring reinforcement, every human resources parties considered health conselling, health line, sex education as the most imortant elements in public health education. Concerning the reinforement of other health services such as medical checkup and visiting nurses, every human resources parties showed more than 80% approval rate, but for oriental medical care service, the private medical personels showed relatively low approval rate(52.9%). Therefore the planning for reinforcement of health center's function requires the reflection of human resources party's opinion and the implication of system which can control and combine the differences in party's opinions.

• Child Health Nursing Research
• /
• v.6 no.2
• /
• pp.119-131
• /
• 2000

The purpose of this study was to identify the trends and contents of intervention towards children using meta analysis, to support the basis for using in the field and research method about nursing intervention. We used 27 materials which was reported from 1970 to August, 1999 : dissertation study and Korean Nurses' Academic society Journals, the Journal of Korean Academic society of Adult Nursing, The Korea Journal of Maternal and Child Health Nursing. The types of intervention we used came from 3 different researchers. Snyder showed cognitive, movement, social sensory intervention. McCloskey & Bulechek categorized as the following : self-care assistance, acute care management, life-style alteration, health promotion, life support intervention, Craft & Denehy classified psychosocial intervention and biophysiological intervention. Some findings are summarized as follow : Out of the 27 researches sensory intervention had the most in there thesis, recently cognitive intervention research has a tendency to increase. 18 researches has acute care management in there theses, and health promotion was found the least. Out of the 27 thesis 15 thesis was classified as biophysiological intervention and 12 had psychosocial. 27 thesis had 11 types of interventions which originally was categorized by Snyder, therefore sensory intervention thesis had the most. 11 types of intervention which originally was classified by McClosky & Bulechek, teaching and information had the most out of acute care management. Out of 27 thesis, 14 had dealt with newborns, especially newborns with sensory intervention. Therefore school age and above had cognitive intervention which was used for teaching and information. Infants, preschool, schoolage children received acute care management the most, health promotion intervention was used towards adolescences. Depending on the characteristics of dependent variables, it was analysed using meta however 17 thesis are possible except primary experimental research. Mean effect size comparison by Snyder classification, cognitive intervention was the largest mean(1.51), sensory intervention was larger(0.71) also, movement intervention was in the middle(0.56) as shown. Comparison done by McClosky & Bulechek, the intervention leading to life style alteration was the largest mean(1.97), teaching was used the most. Comparison by Craft & Denehy classification, psychosocial intervention was larger(1.15) than biophysiological intervention (0.67). The result of nursing intervention through age classification, the largest weighted mean effect size in the research was towards infants and neonates. The research which was focused on nursing intervention, has important meaning in nursing practice and knowledge development. When we know that children's nursing intervention is necessary and overcome our biased view, efficiency of children's nursing intervention are increased and professionalized. Therefore results will be important basic data to guide a development of child nursing intervention & classification.

• Journal of Preventive Medicine and Public Health
• /
• v.33 no.4
• /
• pp.436-448
• /
• 2000

Objectives : To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. Methods : A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was peformed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience, OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. Results : There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. Conclusions : There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

• Journal of Society of Preventive Korean Medicine
• /
• v.10 no.1
• /
• pp.109-121
• /
• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• Journal of Korean Academy of Nursing
• /
• v.30 no.6
• /
• pp.1580-1591
• /
• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• Journal of Korean Academy of Nursing Administration
• /
• v.10 no.1
• /
• pp.63-81
• /
• 2004

Purpose: To identify job satisfaction of hospital employees and the relating factors Methods: The study sample was a total of 1,031 healthcare workers(doctors, nurses, pharmacists, medical engineers, office workers, etc) at a tertiary teaching hospital. The data were collected using a questionnaire developed by a expert group. The questionnaire consisted of 21 items including job characteristics, organizational culture, and personal characteristics on the five Likert scale. Results: The overall satisfaction on job characteristics was 3.24 on the five Likert scale. The satisfaction of each item was 4.14 in role clarity, 3.26 in communication participating rate, 3.10 in work variety, 3.06 in autonomy, and 2.64 in workload. The overall satisfaction on organizational culture was 3.00. Particularly, the satisfaction on collaboration was 3.83, co-worker's support. 3.73, identity, 3.62, education/training opportunity, 3.12, pay, 2.62, welfare, 2.35, promotion, 2.34, and organizational conflict, 2.00. The level of satisfaction on personal characteristics was 3.00. In the satisfaction of each item, the score of disposition was 3.83, contribution to the hospital, 3.75, pride as a member of hospital, 3.70, and attitude on job performance, 3.68. The correlation between satisfaction and other variables was statistically significant with the exception of work variety. The satisfaction related significantly to loyalty index(r=.486, p=.000), autonomy(r=.415, p=.000), pride as a member of hospital(r=.411, p=.000), supervisor support(r=.364, p=.000). Conclusions: The results showed developing organizational strategy to promote job satisfaction can decrease the turnover rate and increase loyalty to the organization. It will contribute to enhance productivity in hospital.

• Child Health Nursing Research
• /
• v.3 no.1
• /
• pp.30-41
• /
• 1997

This is descripitive study conducted to identify educational needs of mothers of nephrotic syndrome patients. The study subjects were composed of 74 mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from June to september in 1996. A questionaire for this study was item Kikert type 5 point scale, developed on the basis of previous literature and researcher's clinical experience and the reliability of the used instruments was α=.97. t-test, and ANOVA were used to determine the effect of general characteristics of subjects on their educational needs. Pearson correlation was done to measure relations between general characterictics of subjects and their educational needs and Stepwise Multiple Regression was done to test a variable affecting educational needs. The results were as follows. 1. Mean score of the educational needs of the subjects was 137.06(Maximum 176) . The educational needs of home care was the highest score, but the question numbers are smaller than other categories. So, the educational need of the diagnosis and treatment was regarded as the highest in contents. 2. The number of subject's children, except for patient revealed significant negative correlation to educational need. 3. The number of subject's children, except for patient(R²=.215289 P=.0006)and the age of patient (R²=.23770 P=.0001) were emerged as important variables affecting the degree of mothers' educational need. Suggestion are as follows on the basis of these results. 1. It is proposed that nurses use these results of the study activly for the educational program for Nephrotic Syndrome patients and their mothers. 2. It is identified that the educational needs of the mothers of nephrotic syndrom is high. So, it is suggested to identify and analysis the degree of the nurse's educational performance perceived by mother. 3. It is suggested to make a comparative study of the degree of nurse's understanding of the importance on educational items with the instruments of this study.

• Child Health Nursing Research
• /
• v.3 no.1
• /
• pp.5-18
• /
• 1997

This study was designed to compare the educational needs of the mothers of LBW infant and normal neonate for development of the educational program. The subjects for this study were 37 mothers of LBW and 60 mothers of normal neonate at 3 general hospitals in Seoul and Inchon. The data were collected during the period from July to November, 1996. The Educational Need for Infant Care was measuerd by questionnaire that has developed by researchers. The data were analized by descriptive statistics, non-paired t-test, ANOVA, ANCOVA using SPSS PC/sup +/. The results were as fellow : 1) The educational needs of the mothers of LBW infant were higher than the mothers of normal neonate(F=14.50, P=.000). 2) There were significant associations between the educational needs of the mothers of LBW infant and delivery history(nullipara. or multipara. ) and caregiver of postpartum(t:-2.08, P=.045 ; F=3.94, P=.0282). 3) There were significant associations between the educational needs of the mothers of normal neonate and numbers of children and caregiver of postpartum(F=5.53, P=.0064 ; F=3.22, P=.0480) .4) The educational need by content was signs, symptomes and management of disorders (i. g. cyanosis, seizure, fever, vomiting etc.) were higher than general care of baby(i. g. feeding, diaper change etc.) at two groups. In conclusion, when the nurses teaching the method of infant care to mother, there sholud be in consideration of delivery history and caregiver of postpartum. Also, its educational contents must be Included of signs, symptomes and management of disorders.

• Korean Parent-Child Health Journal
• /
• v.7 no.2
• /
• pp.168-181
• /
• 2004

Purpose: The purpose of this study was to identified patterns of studies and to analyze the nursing research related to the massage intervention in Korea and to improve direction of nursing research in massage intervention in Korea. Methods: The research studies related to the massage were selected from the Korean Nurses Academic Society Journal and dissertation which were conducted experimental research design the last 7 years in Korea. The total numbers of the studies were 58. Result: The study subjects were post operational state in 34.5%, healthy adult in 17.2% studies. The others dealt with infant, cancer, dementia, hypertension, preterm neonates, elderly. Types of massage were whole body in 31.1%, foot in 22.6%, hand in 17.2%, back in 13.8% studies. And Meridian massage in 17.2%. Length of massage was below 5 minutes in 17.2%, 6~10 minutes in 29.4% and 11~20 minutes in 32.8% studies. Frequency of massage was only 1 time in 25.9%, 2~5 times in 31.1% studies. Massage produced psychological and physiological effects. Positive psychologic effects were anxiety relief, pain relief, mood enhancement and fatigue relief. Positive physiologic effects on body systems were blood pressure, heart rate, edema, skin temperature, immune system, blood glucose, excretion, PMS syndrome and growth and development. Conclusion: As a result, effects of massage were almost positive. Therefore massage is useful alternative nursing intervention. But more attention research is needed to identify the objectivity instrument to measure and repeat research.

• Quality Improvement in Health Care
• /
• v.9 no.1
• /
• pp.74-89
• /
• 2002

Background : The purpose of this study was to investigate the incidence of unplanned endotracheal extubation and to identify the influencing factor of unplanned extubation in ICUs for providing baseline data in developing prevention strategies and administrative standards. the medical records and hospital information system. In order to analyze factors related to unplanned extubation, the subjects of this study were divided by unplanned extubation group and planned extubation group and were matched by its sex, age, and disease groups in a ratio of one to two. The data were analyzed by descriptive statistics, ${\chi}^2$- test, t-test, Fisher's exact test, and logistic regression analysis with SPSSWIN 10.0 program. Result : 1) Forty-seven(4.99%) of 942 intubated patients experienced unplanned extubation 65 times during the twelve-month period. Thirtyfour( 72.34%) of 47 unplanned extubated patients required reintubation, whereas thirteen patients(27.66%) did not. 2) About half of unplanned extubation(46.8%) occurred during the night shift. 3) As for the nursing activity, respiratory nursing activity score(P=.0.06) and total nursing activity score(P=.011) showed statistically significant differences between unplanned extubation group and planned extubation group. 4) As for the patient status, unplanned extubation group showed more lower consciousness level(P=.000), more irritable or agitated behavior(P=.000), and had more applied physical restraints(P=.000) than planned extubation group. 5) As for the intubation related variables, unplanned extubation group revealed more intubated with respiratory failure(P=.000), more dependent on mechanical ventilation(P=.015) than planned extubation group. 6) Factors affecting unplanned extubations in intensive care unit patients were irritable or agitated behavior(odds ratio=13.757), night shift(odds ratio=7.166), and mechanical ventilation(odds ratio=6.257) from conditional logistic regression analysis. Conclusion : The most affecting factor of unplanned extubation was agitated or irritable behavior. Therefore the results of this study could be helpful to ICU nurses for meticulous care, decision making, timely intervention, and development of intervention strategies for preventing unplanned extubation.