• Journal of Society of Preventive Korean Medicine
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• v.20 no.1
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• pp.19-28
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• 2016

Objectives : This study is to research on usage patterns, recognition of system to Korean medicine among high school students who are the potential future medical consumer. Methods : Based on the questionnaire used by KIHASA(Korea Institute for Health and Social Affairs) in 2011 and KHIDI(Korea Health Industry Development Institute) in 2014, modifications were made to make questionnaire more suitable for this research. This self-administered questionnaire was conducted among 1,025 highschool students of 3 high schools in Ulsan city on september, 2015. Except 19 cases which considered statistically insignificant or with unreliable responses, 1,007 cases were analyzed by p-paired test and ANOVA test through the SPSS 22.0 for Win program. Results : Most of the high school students(66.5%) do not have an experience on Korean medical care. The number of students' first experience on Korean medical care is the largest during their elementary school (34.9%), which means the treatment was mostly for restorative reasons like growth care. The later the time of their first experience on Korean medical care, the higher ratio was shown on their recent utilization of Korean medical care. Korean medicine was rarely covered in most cases of public health education at school, and this public health education and usage pattern on Korean medicine have positive correlation. Compared 'Group who have used Korean medical care in 1 years except recent 3 months' to the 'Group who have used Korean medical care in 3 recent months', the former showed higher recognition in Korean medical care and insurance system. Conclusions : The proportion of Korean medicine is as low as 4.5% to whole medical market, and most of the consumers are senior. In addition, the aging phenomenon of Korean medical consumer have been continued. This specialized study on usage patterns and recognition among youth can be the basic research data which can be used for promotion, education and establishment of health policy and health care system.

• Journal of the Korea society of information convergence
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• v.7 no.1
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• pp.25-46
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• 2014

After examining the current situations of financial frauds and the reasons for their occurrence in the financial institutions through examples of financial frauds in domestic and abroad, this study presents ways to prevent such financial scams. The preventive measures consist of activities before and after the occurrence of financial frauds and during normal financial operations. The activities are as follows: 1. Preventive activity should be strengthened before the occurrence of financial frauds. That is, first, the enforcement of consistent internal control is needed. Second, in order to block the probability of financial frauds involved with employees, ethics education and a reward program for inside tippers need to be run. Third, financial institutions need to apply for comprehensive insurance policy to minimize the lost in case. 2. Preventive activity should be strengthened during normal financial operations. First, self authentication system for customers needs to be introduced. Second, dealings of day, week, and month need to be thoroughly checked and the system of audit needs to be expanded. Third, message service for the information on financial frauds and their preventive measures needs to be expanded. Fourth, public notification system against examples of financial frauds needs to be expanded. 3. Preventive activity after the occurrence of financial frauds should be strengthened. First, awareness for preventive measures such as imposing penalty on the manager needs to be enhanced. Second, strict restrictions on financial frauders such as a criminal charge needs to be strengthened. Third, there should be legal devices and resolutions in order to retrieve all the money deceived by financial frauds.

• Perspectives in Nursing Science
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• v.7 no.1
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.32-45
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• 2004

Objective : The aim of this study were to measure quality of life(QOL) in liver transplant recipients, to compare QOL between living donor liver transplant recipients and cadaveric liver transplant recipients and to investigate whether SF-36 may be used as a disease-specific instrument in liver transplant recipients. Methods : We conducted a single-center cross-sectional study of 133 LT recipients ages 13 to 65 years, all of whom had had Liver Transplantation(LT) at least 1 months previously. QOL was assessed using a self-completion questionnaire consisting of the Bang Whal Ran(1991) instruments and the 36-Item Short-Form Health Survey(SF-36) health status profile measure. We investigated whether the SF-36 instrument may be used as a disease-specific instrument in LT recipients. Individual scale scores range from 0 to 100, with higher score reflecting better health. Data on demographics, clinical status at pre transplantation 1 day, post transplantation clinical status, and graft function were collected to identify predictors of post transplantation QOL. Results : Standard measures for test-retest reliability, internal consistency, and discriminant and concurrent validity were examined. The reliability of the SF-36, as measured by test-retest correlation(Pearson coefficients: 0.729, p=0.002) and by internal consistency(Cronbach's alpha: 0.9431) exceeded conventional acceptability criteria. The correlation between domain scores of SF-36 and the Bang Whal Ran(l991) was clear and logical in that the clinical characteristics of SF-36 strongly correlated with the clinical component summary score of the Bang Whal Ran(l991)(r = 0.8155, P<.01). SF-36 scale scores were compared between Cadaveric Liver Transplant recipients and Living Donor Liver Transplant recipients. Donor types of post LT did not influence HRQOL(p>0.05). 87% of the liver transplant recipients were satisfied to get LT. Satisfaction of post LT showed significantly greater HRQOL(p<0.001). Conclusion : SF-36 is found reliable and valid. This study indicates thet Donor Type did not influence HRQOL after LT. The information gained from this study will help us to better define expectations and the clinical course after liver transplantation to patients and their families.

• Journal of agricultural medicine and community health
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• v.32 no.1
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• pp.13-26
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• 2007

Objectives: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. Methods: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. Results: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. Conclusions: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.6
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• pp.449-458
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• 2016

The study verified the work capacity (job performance, perception, knowledge) and satisfaction on managing the inventory of operating room nurses working in a more than 700-bed hospital. The purpose of this study was to provide basic data of education for work capacity and satisfaction and quality insurance by analyzing the scores between the three different operating rooms and the correlation between the work capacity and satisfaction by investigating the related factors. This study presented a structured and self-administered questionnaire to 181 nurses who had been working in the operating room more than six months. The mean and standard deviation of the job performance, perception, knowledge, and satisfaction were 4.2(${\pm}0.56$), 3.4(${\pm}0.76$), 3.5(${\pm}0.40$), and 3.4(${\pm}0.55$), respectively. The work capacity and satisfaction of each group did not show a statistically significant difference. The correlations between the job performance and knowledge, knowledge and perception, perception and satisfaction were positive (r=.627, p<0.01), (r=.663, p<0.01) and (r=.485, p<0.01), respectively. Among the factors related to the general characteristics of operating room nurses, only age significantly affected their job performance. This study provides basic data on the maintenance and improvement of their competence and satisfaction by being served as a resource for sustainable human resources management and training, and efficient management of the communication channel between hospitals.

• Health Policy and Management
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• v.16 no.3
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• pp.86-106
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• 2006

The purpose of the study is 1) to explore clinic and hospital CEOs' satisfaction and expectation level on the affiliation with the larger size teaching hospitals, 2) to find the factors influencing the satisfaction and expectation level on the affiliation with the large hospitals. Data for analysis was collected to use self-administrative structured questionnaire on 335 CEOs of small or middle sized clinics and hospitals affiliated with large sized teaching hospitals located in Seoul and Kyung Ki Province. For the study, the researchers develop the constructs for questions on the satisfaction and the expectation of the affiliation, the attitude, knowledge on the affiliation, previous relationship of the affiliation, and selection guideline of the affiliation with exploratory factor analysis and reliability test. Through the confirmative factor analysis using AMOS 4, the researchers develop constructs based on exact relationship between constructs and questions. CEOs' expressive and unexpressive satisfaction level are 2.54 of 5 point(38.5 of 100) and 2.78 of 5 point(44.5 of 100), and the expressive and unexpressive expectation level are 2.77 of 5 point(44.3) and 3.16 of 5 point(54.0). These levels are relatively row for importance of affiliation. Expectation levels do not influence satisfaction levels. Attitude of affiliation influences expressive expectation and unexpressive satisfaction, reason for affiliation unexpressive satisfaction, and previous relationship to affiliated hospitals influence both of expressive and unexpressive satisfaction. The expressive expectation level and the expressive satisfaction level influence unexpressive expectation and unexpressive satisfaction, respectively. There is cognitive dissonance between expectation and satisfaction, therefore numbers of affiliation might be smaller or weaker in the future than present time. Many CEOs feel environmental press such as competition and the press of health insurance, but they might not think affiliation is best solution. Therefore, large hospitals try to give affiliated clinics and hospitals practical benefits to increase satisfaction and expectation levels, and they need to new affiliation form such as joint venture and joint ownership. The expectation and the satisfaction level was influenced by CEOs' gender, type of health service facilities, distances between the affiliated facility and the large mother hospital, and reason for affiliation.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.111-119
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• 2004

Purpose : To identify those factors influencing the post-operative satisfaction in myopia patients receiving laser in situ keratomileusis (LASIK) Methods : This study included 288 consecutive patients who received LASIK between July and December 2001 from two eye clinics located in Seoul and Pusan. Factors that were considered to influence post-operative satisfaction included pre-operative baseline characteristics, pre-operative expectation for treatment outcomes, and treatment outcomes. Before undergoing LASIK, study subjects were asked to rate the degree of their expectation for the improvement of visual functions and symptoms after LASIK on a 5-point Likert-type scale: where 1 referred to 'somewhat worse,' 2 to 'no change,' 3 to 'somewhat improved,' 4 to 'improved,' and 5 to 'very improved.' Self-administered questionnaire was used to evaluate baseline visual functions and symptoms on a 5-point scale before LASIK. At 6 months after LASIK, the evaluation was repeated to measure treatment outcomes in terms of the difference in the score before and after LASIK. Post-operative satisfaction was also measured at 6 months on a 5-point scale. Multiple regression analysis was performed to examine the independent relationship between influencing factors and postoperative satisfaction. Results : A total of 171 patients (59.4%) participated in the 6-month follow-up investigation. The average expectation scores for the improvement in visual functions and symptoms were 3.8 and 3.4, respectively. The average score for the 7 questions assessing satisfaction was 4.0. The results of the regression analysis showed that the post-operative satisfaction increased with improvement in the visual function ($\beta$=0.16, p<0.05) and symptoms ($\beta$=0.25, p<0.05), the degree of preoperative refractive error ($\beta$ =0.26-0.67, p<0.05) and in male patients ($\beta$=0.31, p<0.1). The pre-operative expectation was not a statistically significant factor in explaining postoperative satisfaction in the regression model. Conclusion : The finding from this study was that patients with very severe myopia tended to be more satisfied with the treatment than those with mild myopia, which implies that LASIK can be more beneficial to those suffering from a severe visual condition. Patient satisfaction was also significantly affected by the treatment outcomes experienced after LASIK. This suggests that improving the clinical outcome is the most fundamental requirement for the improvement of patient satisfaction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.504-508
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• 2004

Surgical process of oral and maxillofacial area as well as dental treatment are stressful situations to the patients. It is well known that serum level of stress hormones including adrenocorticotropic hormone(ACTH) and cortisol increase when the body is exposed to stress. However, there have been few studies on demographic and clinical factors related with stress. Therefore, the purpose of this study was to supply data to cope with stress more comprehensively and efficiently by analyzing the effect of factors related with stress in addition to surgical procedure. Prospective cohort study method was selected. Serum levels of ACTH and cortisol were measured by sampling bloods pre-operatively and post-operatively from 45 patients who had been operated at the Bundang Jesaeng Hospital department of oral and maxillofacial surgery. To evaluate factors associated with stress, patients were classified according to gender, age, method of payment(insurance or self), experiences of operation, kind of operations(expected operations or unexpected operations). Relative risk was calculated to assess relationships between changes of serum level of ACTH and cortisol and factors related with stress, whereas Chi-square analysis was executed to evaluate statistical significance. With regard to serum level of ACTH, relative risk was 1.3 in the group of the patients who were less than 40 years old. With regard to serum level of cortisol, relative risk was 1.8 for women compared with men, 1.4 in the group of the patients who were less than 40 years old and 1.6 in the group of the patients who had not experienced any other operations. In addition to surgical procedure, factors related with stress included gender, age, method of payments, experiences of operation and kind of operations. Therefore, we should provide comprehensive schemes to reduce stress of the patients going through oral and maxillofacial surgery.

• Journal of the Korean Society of Marine Environment & Safety
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• v.11 no.2 s.23
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• pp.41-49
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• 2005

In general, the criminal responsibility of seaman should always be directly assumed by the seamen, according to the principle of self-incrimination. Therefore, the only possible countermeasures for the criminal responsibility of seamen may be to reduce the responsibility by using criminal procedures (ex. the warrant substance examination system, the review system of legality for confinement as much as possible. Another possibility is to reduce the penalty through the revision of the law. In detail, concerning the problem of fine, the maximum fine for oil spill accidents by criminal negligence is KRW 30,000,000 under the current Ocean Pollution Prevention Act, and when an oil spill occurs, the maximum fine tends to be levied regardless of the amount of the spilled oil; thus, it is judged that grading the fine according to the amount of spilled oil may be worth considering. Regarding P & I's payment of fine, contrary to general belief, it is only possible to make up the loss when P & I takes up the legal responsibility or acknowledges its payment. In order to solve the problem, it is possible to consider the option of introducing new collective insurance program or mutual aid system. Also, as seamen are not specialists in legal issues, the ship owners' association or the marine afficers' association need to develop some program through which they can receive systematic assistance from legal specialists including lawyers when they encounter any legal problems (ex. free legal aid programs for farmers and fishermen). Finally, it may be possible to establish enact new laws or revise the existing Act on Special cases Concerning the Settlement of Traffic Accidents to insert a new section on marine accidents.