• 한국병원경영학회지
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• 제13권3호
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• pp.94-113
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• 2008

The purpose of this study to develop the Hospital Management Award(HMA) programme which would be a basic information for advancing hospital industry in Korea. HMA programme in the study are designed with general census building method of researchers and with the data of professions opinion which was survey with structured questionnaire Major results of this study are as follows. First, Hospital Management Award(HMA) programme is perceived very necessary and useful for advancing hospital industry of Korea (positive response rate: 93.0%). Second, Criteria, Classification of hospitals may be the function, size and ownership of hospital. Third Evaluating area of hospital management, examining method and evaluation marking points are designed on the basis of hospital management information system. Forth, this study suggests same strategies for execution of the programme. On the basis of the study results this study suggests that Hospital Management Award(HMA) programme would rather actualized in advance by formal institute and/or association. And some in depth studies are required mainly for development of the action plan of HMA programme.

• 한국의료질향상학회지
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• 제1권1호
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• pp.66-94
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• 1994

Hospital Accreditation Programme(HAP) has been introduced in many countries in the world for these recent years. This article reviews the HAP in the aspects of the organization, survey and evaluation process, evaluation criteria, and its impact to the hospital quality improvement. The nations included in this study are USA, UK, Canada, Australia, and Korea. To carry out this comparative study, the authors have reviewed articles and accreditation manuals having been issued in many countries. An expert panel of medical doctor, nurse, pharmacist, administrator, and specialist in health facilities formulated a study framework. The results of this study enhance understanding about hospital accreditation activities according to each nation's health care system. In recent years, the Korean government has launched the plan to improve the quality of health services by strengthening the hospital accreditation programme. This study results can provide useful information in development and implementation of the national hospital accreditation programme in Korea.

• 대한영양사협회학술지
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• 제19권4호
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• pp.317-342
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• 2013

The purpose of this study was to evaluate the current state of foodservice and clinical nutrition management in a hospital-based nutrition department. Nutritional guidelines and survey reports of hospital evaluation programs from 2004 to 2009 were analyzed. In total, 275 hospitals in the first period and 288 hospitals in the second period were evaluated. The division of knife and chopping board use decreased from 97.2% in 2005 to 89.7% in 2008, the maintenance of a proper freezer temperature (below $-18^{\circ}C$) increased from 82.1% in 2004 to 97.7% in 2007 (88.9% to 97.4% from large hospitals and 69.8% to 86.5% from small/medium hospitals in 2005 and 2008, respectively). In tube-feeding management, the performance rate of material cold storage and the offer rate of tube-feeding were 65.9% and 94.2% in 2007, respectively. The cold storage of material, proper use within 24 hours after opening or production, and the use of an appropriate label were 47.3%, 71.2% and 67.2% in 2009, respectively. The rate of a management system for undernourished patients was 86.0% in 2007 (56.4% for large hospitals, 18.9% for small/medium hospitals) and 14.3% in 2009. In standards of nutrition support management, the performance rates of constructing a nutrition support team, the nutrition support team activity, and organizing multidisciplinary team were 66.7%, 43.6%, and 64.1% respectively, in 2004. For large hospitals, those rates were 61.1%, 36.1%, and 58.3%, in 2005, 93.0%, 62.8%, and 91.9% in 2007, and 69.2%, 43.6%, and 69.2% in 2008, respectively. The results of this study suggest standards on sanitary foodservice preparation, production, and tube-feeding production need to correspond with HACCP regulations for small/meidium hospitals in standards of a healthcare accreditation system. It will be necessary to understand the operating conditions of nutrition departments in convalescent hospitals, psychiatric hospitals, and geriatrics hospitals. As the application of accreditation is required from 2013, standards will need to be improved and continuously updated for healthcare accreditation.

• 농촌의학ㆍ지역보건
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• 제18권2호
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• pp.105-119
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• 1993

The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

• 한국간호교육학회지
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• 제9권2호
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• pp.298-309
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• 2003

The educational preparation of nurses has been the focus of considerable debate globally. It is needed the change of the basic nursing education for professional nurse to prepare the trends of the health care needs of clients for coming new generation. And also it is believed that educational preparation for being nurses is to be responsible to clients' needs. The purpose of the study was to develop a baccalaureate program in nursing. This study were implemented through three stages from April 2001, to April 2002.: preparation stage which were consisted of reviewing of the literatures, interviewing the fellow nurses in a variety workplace, and consulting professors who were concerned with the nursing education to identify the present educational problems, and analyzing the contents of seven major courses in nursing education, evaluation stage about a new developed curriculum with the directors of the five nursing schools, and confirmation stage of new developed education programme. The developed education programme was designed as a four year program with 126 credit hours including 39 credit hours of liberal arts, 34 credit hours of supplementary courses, and 53 credit hours of nursing major based on the four basic nursing dimensions of human, health, environment and nursing. Nursing majors were consisted of Nursing Ⅰ(oxygenation), Nursing Ⅱ(nutrition elimination), Nursing Ⅲ(activity rest), Nursing Ⅳ(neurologic- endocrine protection), Nursing Ⅴ(fluids electrolytes/sex reproductive), Nursing Ⅵ(psycho-social), Community Health Nursing, Fundamental Nursing, School Health, and Emergency care. This new nursing programme was focused on the nursing education for prevention and rehabilitation nursing care as well as the acute and chronic nursing care at hospital, on the integrated nursing programme to become effective, and the nursing process to encourage the critical thinking. The new education programme focused on the professional nurses who are responsible the nursing ethics, communication skills, and professional beliefs to suit the future trends in health. And also it will be needed for faculties to manage the integrated curriculum, to analyze the contents of each subject, and to communicate with each other before a new education programme apply to their education programme in future. This research was supported by the Han Kok Medical Science Foundation

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2841-2846
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• 2016

Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3319-3322
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• 2014

Breast cancer is the most common cancer in Jamaican women. This study assessed the clinicopathologic features of cases in a hospital-based specialist clinic in Kingston, Jamaica. A retrospective chart review was performed for the 2-year study period and relevant clinical and surgico-pathologic data were recorded and analyzed. Median age of the 121 breast cancer patients was 52 years (range 22-84, IQR 20) and there was 1 case of male breast cancer. Most patients (65%) were referred from the surgical service after definitive breast cancer surgery, 20% were referred for pre-operative systemic therapy, and 15% had a diagnosis of metastatic disease. The surgico-pathologic group comprised 78 women who were referred for adjuvant therapy. The majority had presented with a palpable breast lump (91%), with median tumour size 3.5cm (range 0.4-13, IQR 4). Most tumours were node positive (56%). Approximately one-third of patients had stage III disease (33%). Most women presented with large palpable tumours and had lymph node involvement confirmed on surgicopathological evaluation, indicative of limited early breast cancer detection. A national screening mammography programme is recommended for detection of earlier lesions. Pre-operative systemic therapy should be considered as an option for eligible patients.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.173-184
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• 2018

이 연구의 목적은 39개 공공병원 간호직을 대상으로 하여 직무자체 만족, 의사소통 만족, 평가와 보상체계 만족, 근무환경 만족, 공공병원 역할수행 만족이 환자들의 만족도, 재이용 의향, 타인추천의향 간의 구조적 인과관계를 구조방정식 모형분석을 통해 확인하기 위함이다. 이 연구의 자료는 '2012년 지역거점공공병원 운영평가'를 통해 수집된 2차 자료를 활용하였다. 이 연구의 대상자는 39개 지역거점공공병원의 간호직 2,375명과 환자 3,433명이었다. 간호직의 직무만족도 조사도구는 5개 요인과 13개 항목으로 구성되었다. 환자의 만족도, 재이용의향, 타인추천의향 설문도구는 각 1개 항목, 11점 척도(0점 매우 부정적, 10점 매우 긍정적)로 구성되었다. 이 연구의 자료분석은 SPSS 20버전과 AMOS 20버전을 활용하였다. 모형의 적합도 지수는 입원환자의 경우 ${\chi}^2$ 904.598 (df=81, p<0.001), GFI 0.938, AGFI 0.900, RMSR 0.076의 값을 갖고, 외래환자의 경우 ${\chi}^2$ 869.021(df=81, p<0.001), GFI 0.940, AGFI 0.900, RMSR 0.074값을 가진 권장기준 내 적합한 최적 모형을 도출하였다. 간호직은 공공병원에서 가장 큰 의료인 집단이면서 환자에게 직접 간호를 제공한다. 따라서 간호직의 직무만족도는 환자만족도에 지대한 영향을 끼침으로 환자만족도를 향상시키기 위해 간호직의 직무만족도는 중요하게 고려되어야 할 것이다.

• Journal of Community Nutrition
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• 제2권1호
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• pp.62-70
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• 2000

Nutrition education should be an important component of ongoing health promotion for older adults and their caregivers. This is because prevention through sound nutrition and food hygiene practices and regular excercise is the most cost-effective way to reduce risks for and deal with their major health problems. nutritions education services should effectively promote optimum intake and successful self-care. Unfortunately, however relative to other vulnerable groups, nutrition education for older adults has not been systematically developed or evaluated. Usually oder adults care a lot about their health, so this should be a relatively easy group to teach - but their increasing numbers, longevity and great diversity with respect to health, physical, and economic status and educational level present challenges. Some older adults may not perceive they would benefit from nutrition education, so interesting and motivating them is a challenge. The food and nutrition knowledge of older people has been acquired through a lifetime of experience. For most older adults in the Asian region, their sources are restricted by their restricted education, so that their major sources of information have been informal sources, such as television, radio, friends, family, and perhaps newspapers and magazines if they are literature. Nonetheless, dietary advice for older people should build on their existing knowledge and ingrained values. It should provide information useful in daily food selection, and focus on food, not nutrients - the same foods and groups considered appropriate for younger people, with consistent messages as given throughout the population. Attention must also be paid to discovering learning styles in older people. When we teach in schools, the young students are a captive audience resigned to their learning role. Learning by an older adult, however, reflects an effort to meet his or her perceived needs. Therefore, nutrition education should be a positive experience in a non-threatening environment, relaxed and non-competitive, and perhaps even social environment. The messages also need to be practical and achievable. A needs assessment is essential, because our ability to provide the most effective nutrition education will depend on our success in matching the needs, both perceived and unperceived. of this vulnerable group. Therefore, go to the potential older learners to assess their interest and preferences. Nutrition education activities for older adults are widespread, but few have been evaluated. Evaluation is therefore also recommended, particularly when new methods are used. Tips from other countries for giving successful nutrition education will be given, including some examples of applications as attempted in Hong Kong. Research needs will also be described. In conclusion, successful nutrition education for older adults depends on positive needs-based messages. This is may be hard to do, as few good examples are available to illustrate these principles.

• 한국식품영양과학회지
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• 제33권2호
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• pp.373-380
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• 2004

식품영양학과 학생들의 현장실습에 대한 만족도와 평가도를 알아보고 이에 영향을 미치는 인자들을 찾아봄으로써 보다 효율적인 현장실습 프로그램 개발에 필요한 기초자료를 제시하고자 실시한 본 연구결과를 요약하면 다음과 같다. 전체 조사대상자 중 대학 2학년생이 155명(67.7%), 대학교 3학년생이 14명 (6.1%), 4학년생이 60명(26.2%)이었으며, 남학생은 14명 (6.1%), 여학생은 215명(93.9%)이었고, 실습기관은 학교급식소 89명 (38.9%), 사업체급식소 107명(46.7%), 병원급식소 33명(14.4%)이었다. 실습기간은 1주가 16명(7.0%), 2주가 192명(83.8%), 3∼4주가 21명(9.2%)으로 2주를 가장 많이 실시하고 있었다. 실습 만족도는 실습지원비(1.90$\pm$1.18)와 실습기관의 위치(2.93$\pm$1.29)항목에서 낮았으며, 실습기관의 종류(3.75$\pm$0.88)와 실습기관의 실습관리자(3.63$\pm$1.05)에 대한 만족도는 높았다. 실습 평가도는 실습에 대한사전 준비 및 계획(3.27$\pm$0.74)과 현장실습이 진로결정에 도움을 주었다(3.61$\pm$1.02)는 항목에서 낮았으며, 실습과제의 수행(4.05$\pm$0.82)과 근무의 성실성(4.02$\pm$0.75)에 대한 평가도는 높았다. 실습기관의 종류와 관리 유형에 따른 현장실습 만족도에서 병원급식소가 학교급식소나 사업체 급식소에 비해 실습기관의 분위기, 실습비, 실습생에 대한 대우 및 처우, 학과 교수의 지도 항목의 만족도가 유의하게 낮았으며(p<0.05, p<0.03, p<0.05, p<0.05), 직영업체가 위탁업 체보다 실습기 관의 종류 등 총 7개 항목에서 만족도가 높았다. 현장실습 평가도는 학교급식소가 병원급식소에 비해 '나는 실습생으로서 성실히 근무하였다'와 '실습에 필요한 내용을 사전에 준비하고 계획하였다'는 항목에서 유의하게 낮았으며(p<0.05, p<0.05), 직영과 위탁의 관리 유형에 따라서는 유의한 차이가 없었다. 현장실습 지역과 거주지가 일치한 실습생이 일치하지 않은 실습생보다 실습생에 대한 대우 및 처우 항목의 만족도(p<0.05)와 '실습장소의 정리정돈과 관리에 힘썼다' '조리원들과 친밀해지고 신뢰받게 되었다'는 항목의 평가도(p<0.05, p<0.01)가 유의하게 높았다. 현장실습 기관과 취업 희망기관이 일치한 실습생이 일치하지 않은 실습생보다 실습기관의 종류, 위치 등 총 8개 항목의 만족도가 유의하게 높았으나 실습 평가도는 두 군간에 유의한 차이가 없었다. 현장실습 기간, 실습비, 실습 만족도와 평가도간의 상관관계를 살펴보았을 때, 실습기간은 실습기관의 분위기, 실습생에 대한 대우 및 처우 항목의 만족도와 정의 상관관계(p<0.05, p<0.05)를 보인 반면, '부과된 과제를 수행하는데 최선을 다했다'는 평가도와는 부의 상관(p<0.05)을 보였다. 실습기관으로부터 받은 실습비는 실습지원비, 실습생에 대한 대우 및 처우, 학과 교수의 지도에 대한 만족도(p<0.001, p<0.05, p<0.05) 및 '나는 실습생으로서 성실히 근무했다' 등 총 5개 항목의 평 가도와 정의 상관관계를 보였다. 실습 만족도와 평가도는 대부분의 항목에서 정의 상관을 보여 실습 만족도가 높을수록 평가도도 높았다. 이상의 연구결과를 종합할 때 식품영양학과 현장실습생들은 실습지원비와 실습기관의 위치 면에서 만족도가 낮고 현장실습업무 수행상 실습에 대한 사전 준비 와 계획이 부족하다고 평가하고 있었다. 학교나 사업체 급식소, 직영업체, 실습기관이 거주지역에 있거나 취업 희망기관과 일치 할 경우 실습 만족도가 높았으며, 특히 실습기관이 거주지역에 있거나 취업 희망기관과 일치할 경우에는 현장실습업무에도 긍정적인 영향을 미치는 것으로 나타났다. 따라서 식품영양학과의 현장실습이 매우 중요한 시점에서 이와 같은 요인들을 고려하여 현장실습의 효율을 높이고 체계화시켜 나가기 위한 학교, 실습기관, 정부 차원의 노력과 정책적 지원이 요구된다.