• 한국유기농업학회지
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• 제29권1호
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• pp.111-123
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• 2021

시설재배지에서 토양 양분으로 유기농업자재인 가축분 종류별 퇴비를 밑거름으로 처리한 후 발생하는 N₂O와 딸기의 생육 특성을 조사하기 위해 본 연구를 수행하였다. 가축분퇴비는 돈분과 우분, 계분을 원료로 하여 각각 만들어진 제품을 사용하였고, 딸기 표준시비량의 질소를 기준으로 단독 그리고 혼합 처리하였다. N₂O의 총배출량은 무기질비료 처리구와 비교하여 계분퇴비 처리구에서 10.7% 많았으나 다른 가축분퇴비 처리구에서는 16.5~41.9% 적게 배출되었다. N₂O가 주로 배출되는 기간은 비료살포 후 17일차까지로 전체 배출량의 70~87%를 차지하였고, 이후 158일간 13~30%가 발생하였다. N₂O 배출량은 토양의 NH₄⁺-N 함량과 부의 상관성을 나타내었다. 딸기의 생육 중 엽수, 엽폭, 관부직경은 처리구간 유의한 차이를 보이지 않았고, 엽장은 무기질비료 처리구보다 가축분퇴비 처리구에서 컸으며, SPAD 값은 우분퇴비와 계분퇴비를 혼합하여 시용한 처리구에서 가장 높았다. 딸기 과실의 무게와 당도는 처리구간 유의한 차이를 보이지 않았다.

• 치위생과학회지
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• 제11권4호
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• pp.311-317
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• 2011

본 연구는 2005년도에 실시된 제 3기 국민건강영양조사 자료를 이용하여 어린이의 생활안전행동과 구강보건행동의 관련성을 알아보고 사회인구학적 연관 요인을 평가하여 어린이의 생활안전행동와 구강보건행동을 효과적으로 증진하기 위한 기본 방향을 세우고자 수행되었다. 본 연구를 통하여 우리나라 어린이들의 생활안전행동과 구강보건행태에 대하여 다음과 같은 결론을 얻었다. 1. 대체로 어린이의 생활안전행동과 구강보건행동의 연관성이 발견되지 않았고 따라서 어린이의 생활안전행동과 구강보건행동의 변화를 추구함에 있어서 공통위험요인접근법 적용의 근거를 발견하지 못하였다. 2. 우리나라 3-11세 어린이는 56.3%가 하루 2회 이상 칫솔질을 실천하였고 74.7%가 예방적 치과진료 경험이 있는 것으로 나타났다. 자동차 뒷좌석 이용을 제외한 생활안전행동의 실천은 현저하게 부족하여 자동차 보호장구 이용율 10.4%, 자전거 안전모 착용율 4.3%, 및 인라인스케이트 안전모 착용율 29.0%에 그쳐(Table 2), 특히 생활안전교육의 강화의 필요성이 절실함을 보여주었다. 3. 미취학 어린이에 비하여 7세 이후 취학어린이에게서 생활안전행동과 구강보건행동의 실천률이 낮은 것으로 조사되어, 초등학생의 생활안전교육과 구강보건교육이 강조되어야 할 것으로 사료된다. 4. 3-6세 아동에서 거주지역 또는 가정의 경제수준 등 사회경제적 요인과 생활안전행동 및 구강보건행동의 연관성이 관찰되었으나, 취학아동에서는 대체로 유의한 연관성이 없었다(Table 3).

• 한국직업건강간호학회지
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• 제11권1호
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• pp.13-30
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• 2002

Industrial shift workers feels suffer mental stresses which are caused by unfamiliar day sleep, noisy environment, sleeping disorder by bright light, unusual contacts with family, difficulty in meeting with friends or having formal social meetings and other social limitations such as the use of transportation. Such stresses influence health of the workers negatively. Thus the health promotion policy for shift workers should be made considering the workers' ways of living and shift work specially. This study attempted to provide basic information for development of the health promotion program for industrial shift workers by examining predictive factors influencing health promotion behaviors of those workers. In designing the study, three power generation plants located in Pusan and south Kyungsang province were randomly selected and therefrom 280 workers at central control, boiler and turbine rooms and environmental chemistry parts whose processes require shift works were sampled as subjects of the study. Data were collected two times from September 17 to October 8, 1999 using questionnaires with helps of safety and health managers of the plants. The questionnaires were distributed through mails or direct visits. Means for the study included the measurement tool of health promotion behavior provided by Park(1995), the tool of self-efficacy measurement by Suh(1995), the tool of internal locus of control measurement by Oh(1987), the measurement tool of perceived health state by Park(1995) and the tool of social support measurement by Paek(1995). The collected data were analyzed using SPSS program. Controlling factors of the subjects were evaluated in terms of frequency and percentage ratio Perceived factors and health promotion behaviors of the subjects were done so in terms of mean and standard deviation, and average mark and standard deviation, respectively. Relations between controlling and perceived factors were analyzed using t-test and ANOVA and those between perceived factors and the performance of health promotion behaviors, using Pearson's Correlation Coefficient. The performance of health promotion behaviors was tested using t-test, ANOVA and post multi-comparison (Scheffe test). Predictive factors of health promotion behavior were examined through the Stepwise Multiple Regression Analysis. Results of the study are summarized as follows. 1. The performance of health promotion behaviors by the subjects was evaluated as having the value of mean, $161.27{\pm}26.73$ points(min.:60, max.:240) and average mark, $2.68{\pm}0.44$ points(min.:1, max.:4). When the performance was analyzed according to related aspects, it showed the highest level in harmonious relation with average mark, $3.15{\pm}.56$ points, followed by hygienic life($3.03{\pm}.55$), self-realization ($2.84{\pm}.55$), emotional support($2.73{\pm}.61$), regular meals($2.71{\pm}.76$), self-control($2.62{\pm}.63$), health diet($2.62{\pm}.56$), rest and sleep($2.60{\pm}.59$), exercise and activity($2.53{\pm}.57$), diet control($2.52{\pm}.56$) and special health management($2.06{\pm}.65$). 2. In relations between perceived factors of the subjects(self-efficacy, internal locus of control, perceived health state) and the performance of health promotion behaviors, the performance was found having significantly pure relations with self-efficacy (r=.524, P=.000), internal locus of control (r=.225, P=.000) and perceived health state(r=.244, P=.000). The higher each evaluated point of the three factors was, the higher the performance was in level. 3. When relations between the controlling factors(demography-based social, health-related, job-related and human relations characteristics) and the performance of health promotion behaviors were analyzed, the performance showed significant differences according to marital status (t=2.09, P= .03), religion(F=3.93, P= .00) and participation in religious activities (F=8.10, P= .00) out of demography-based characteristics, medical examination results (F=7.20, P= .00) and methods of the collection of health knowledge and information(F=3.41, P= .01) and methods of desired health education(F=3.41, P= .01) out of health-related characteristics, detrimental factors perception(F=4.49, P= .01) and job satisfaction(F=8.41, P= .00) out of job-related characteristics and social support(F=14.69, P= .00) out of human relations characteristics. 4. The factor which is a variable predicting best the performance of health promotion behaviors by the subjects was the self-efficacy accounting for 27.4% of the prediction, followed by participation in religious activities, social support, job satisfaction, received health state and internal locus of control in order all of which totally account for 41.0%. In conclusion, the predictive factor which most influence the performance of health promotion behaviors by shift workers was self-efficacy. To promote the sense, therefore, it is necessary to develop the nursing intervention program considering predictive factors as variables identified in this study. Further industrial nurses should play their roles actively to help shift workers increase their capability of self-management of health.

• 근관절건강학회지
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• 제5권2호
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• pp.238-252
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• 1998

Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

• 한국조경학회지
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• 제51권2호
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• pp.12-27
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• 2023

본 연구는 강동구의 조성형공원 중 도시 녹지축에 입지한 환경생태적인 가치가 높은 공원을 대상으로 도시공원의 생태적 리뉴얼 조성방안을 마련하고 이를 적용한 설계를 제안하였다. 강동구의 개황과 도시공원 개황을 분석하고 강동구의 토지이용 및 녹지율, 공원녹지, 녹지축 현황을 분석하여 리뉴얼 대상지를 선정하였다. 강동구의 조성형 공원은 근린공원 2개소, 어린이공원 52개소로 총 54개소였으며 현황검토 1단계에서는 공원이 자연축, 녹지축상에 입지 및 인접 여부 등 입지적 가치 분석을 통해 17개소를 추출하였고, 2단계에서는 각 공원 서비스권역 내 녹지 및 오픈스페이스 비율을 바탕으로 1단계 추출 공원 중 8개소를 선정하였다. 3단계에서는 공원면적의 법적 기준 충족 여부를 통해 2단계 추출공원 중 2개소를 선정하였으며, 4단계에서는 공원의 노후화 조사를 통해 3단계 추출 공원 중 1개소를 선정하였다. 리뉴얼 대상지의 도시생태적 현황은 엔트로피 저감 측면의 토지이용현황, 물순환 측면의 토양피복현황, 생물다양성 측면의 식재구조현황을 조사하였다. 리뉴얼 대상지 3곳의 현황분석 결과는 녹지면적은 18.3-45.3%로 부족하였고 시설지 면적은 54.7%-81.7%로 높아 도시온도 저감효과가 낮은 것으로 판단되었으며, 불투수포장 면적이 공원 면적의 34.5%-48.9%로 시설면적의 대부분을 차지하여 물순환 기능이 부족한 것으로 판단되었다. 식재구조는 단층과 복층구조로 이루어져 있고 교목층은 양호하였으나 하부식생이 빈약하였고 식이식물이나 대경목 식재지는 없어 생물다양성이 낮은 상태였다. 본 연구에서 리뉴얼 대상지로 선정한 선린어린이공원, 당말어린이공원, 샘물어린이공원을 생태적으로 리뉴얼 설계한 후 공원별 생태면적률은 리뉴얼 전보다 1.4-3배 이상 증가하였다. 도시 녹지축에 입지한 도시공원을 도시생태계의 관점으로 바라보고 이를 생태적으로 리뉴얼하면 도시생태계 측면에서 엔트로피 저감, 물순환 건강성 향상, 생물다양성 기반조성에 기대효과가 높을 것으로 판단된다.

• 무역상무연구
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• 제31권
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• pp.27-56
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• 2006

Today's financial institutions usually take environmental issues seriously into consideration as they could not evade lender liability in an increasing number of cases. On the international scene, a brand-new concept of the "Equator Principles" in the New Millenium has driven more and more international banks to adopt these Principles in project financing. Sustainable development has been a key word in understanding new trends of the governments, financial institutions, corporations and civic groups in the 21st century. The Equator Principles are a set of voluntary environmental and social guidelines for sustainable finance. These Principles commit bank officers to avoid financial support to projects that fail to meet these guidelines. The Principles were conceived in 2002 on an initiative of the International Finance Corporation(IFC), and launched in June 2003. Since then, dozens of major banks, accounting for up to 80 percent of project loan market, have adopted the Principles. Accordingly, the Principles have become the de facto standard for all banks and investors on how to deal with potential social and environmental issues of projects to be financed. Compliance with the Equator Principles facilitates for endorsing banks to participate in the syndicated loan and help them to manage the risks associated with large-scale projects. The Equator Principles call for financial institutions to provide loans to projects under the following circumstances: - The risk of the project is categorized in accordance with internal guidelines based upon the environmental and social screening criteria of the IFC. - For Category A and B projects, borrowers or sponsors are required to conduct a Social and Environmental Assessment, the preparation of which must meet certain requirements and satisfactorily address key social and environmental issues. - The Social and Environmental Assessment report should address baseline social and environmental conditions, requirements under host country laws and regulations, sustainable development, and, as appropriate, IFC's Environmental, Health and Safety Guidelines, etc. - Based on the Social and Environmental Assessment, Equator banks then make agreements with borrowers on how they mitigate, monitor and manage the risks through a Social and Environmental Management System. Compliance with the plan is included in the covenant clause of loan agreements. If the borrower doesn't comply with the agreed terms, the bank will take corrective actions. The Equator Principles are not a mere declaration of cautious banks but a full commitment of lenders. A violation of the Principles in the process of project financing, which led to an unexpected damage to the affected community, would not give rise to any specific legal remedies other than ordinary lawsuits. So it is more effective for banks to ensure consistent implementation of the Principles and to have them take responsible measures to solve social and environmental issues. Public interests have recently mounted up with respect to environmental issues on the occasion of the Supreme Court's decision (2006Du330) on the fiercely debated reclamation project at Saemangeum. The majority Justices said that the expected environmental damages like probable pollution of water and soil were not believed so serious and that the Administration should continue to implement the project seeking ways to make it more environment friendly. In this case, though the Category A Saemangeum Project was carried out by a government agency, the Supreme Court behaved itself as a signal giver to approve or stop the environment-related project like an Equator bank in project financing. At present, there is no Equator bank in Korea in contrast to three big banks in Japan. Also Korean contractors, which are aggressively bidding for Category A-type projects in South East Asia and Mideast, might find themselves in a disadvantageous position because they are generally ignorant of the environmental assessment associated with project financing. In this regard, Korean banks and overseas project contractors should care for the revised Equator Principles and the latest developments in project financing more seriously. It's because its scope has expanded to the capital cost of US$10 million or more across all industry sectors regardless of developing countries or not. It should be noted that, for a Korean bank, being an Equator bank is more or less burdensome in a short-term period, but it must be conducive to minimizing risks and building up good reputation in the long run.

• 복식
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• 제32권
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• pp.313-336
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• 1997

Nineteen stimulus photograghs varied in hue and color scheme of one clothing style of Korean dress worn by a female were used to investigate the effect of color color scheme and structure on impression formation for Korean dress. Subjects were 77 male and 86 female undergraduate and graduate students. The stimuli c9onsisted of two sets(cool and warm) of four similar color schemes two sets (cool and warm in Chima color) of five contrasting color schemes and one extra stimulus triad 3 hue base. Structures were de-fined by color schemes of Kit.Korum toward the color schemes of Jokori and Chima. Stimu-lus photogragh selected from Korean dress fashion magazines was managed and varied in hues and color schemes to Kit Korum Jokori and Chima according to Korean Standard Color through scanning and Adobe photoshop 3.0 program and then pictured through slide printer(HR-6000). Each subject assessed 19 stimulus color photographs with incorporated 7 point semantic differential response scale. The data were analyzed by frequency mean factor analysis t-test ANOVA and Scheffe test. Results indicate impression ofrmations are af-fected by clothing cues. 1) Four factors emerged to account for dimensional structure of impressions of female features on Korean dress. These four factors were titled as(1) preference.evaluation (2) individuality.attention (3) youth and (4) friendshio. The preference.evaluation factor was the largest including eleven adjectives and accounting for 29.62% of the variances. 2) Almost every clothing cue(color, color scheme, structure) had some effects on im-pressions formed But the color of Chima did not form the effects on impression of prefer-ence.evaluation factor. The effect of related color scheme was the most influential clothing cue on impressions of preference.evalation factor and friendship factor whereas the ef-fect of contrasting color scheme was the most influential clothing cue on impressions of indi-viduality.attention factor and youth factor. The effect of cool color of Chima was the most influential clothing cue on impression of indi-viduality.attention factor whereas the effect of warm color of Chima was the most influen-tial clothing cue on impressions of youth factor and friendship factor. The effect of Jokori/Chima.Kit.Korum structure was the most influential clothing cue on impressions of pref-erence.evaluation factor and youth factor whereas the effect of Kit.Korum/Jokori.Chima structure was the most influential clothing cue on impressions of individuality.attention factor and friendship factor. 3) The interaction effects were appeared among clothing cues. Significant interaction effects between color schemes(similar and contrasting) and colors of Chima(cool and warm were appeared on impressions of prefer-ence.evaluation factor imdividuality.atten-tion factor and friendship factor, Significant interaction effects between color schemes (similar and contrasting) and structures (Jokori.Chima.Kit.Korum; Jokori.Kit.Koru-m/Chima;Jokori/Chima.Kit.Korum;Kit.Korum/Jokori.Chima) were appeared on impressions of preference.evaluation factor youth factor and friendship factor. Signifi-cant interaction effects between colors(cool and warm) and structures were appeared on impressions of individuality.attention factor youth factor and friendship factor. Sighifi-cant interaction effects between colors(cool and warm) and structures were appeared on impressions of individuality.attention factor youth factor and friendship factor. Significant interaction effects among clothing cues(color color schemes and structures) were appeared on all impression factors. The friendship factor was the most friquently affected impression factor by interaction effects among clothing cues. In summary the clothing was used as nonverbal cues in the effect on impression for-mation of female dressed in Korean dress. it concluded that color schemes worked as cen-tral traits and colors of Chima and structures worked as peripheral traits in the formation of impression of the female clothed in Korean dress. hence organizing our impressions with respect to the parts of the Korean dress in re-lation to the whole holistic perceptual pro-cess Gestalt approach was used and supported.

• 한국작물학회지
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• 제64권4호
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• pp.353-365
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• 2019

본 연구는 근적외선 분광분석기(NIRS) 예측모델을 설정하여 유전자원 대량분석 체계를 확립하고 그에 따른 국내 외 밀 자원의 단백질 함량에 관한 기초 정보를 제공하고자 하였다. 1. 농업유전자원센터에 보유하고 있는 20,000여 자원 중 1,798자원을 검량 자원으로 선발하였다. 검량자원의 NIR 스펙트럼을 측정하였고, 단백질 함량 습식분석 데이터 입력 등 일련의 통계적 처리 과정을 거쳐 NIRS 예측모델을 설정했다. 검량 자원의 다양성 지수는 0.80이었고, 습식 분석법에 의한 단백질 평균은 13.2%, 함량 구간은 7.0-20.8%였다. 최적화된 NIRS 모델의 R², SEC, Slope은 0.997, 0.132, 1.000이었다. 300자원을 사용하여 외부 검정 과정을 실시하였고 R², SEP, Slope은 0.994, 0.191, 1.013이었다. 최적화된 NIRS 모델과 외부검정 결과의 통계치가 상호 유사하였고, 1에 가까운 R²와 Slope 값, 낮은 SEC와 SEP 값을 볼 때 본 연구에서 설정한 NIRS 모델은 습식 분석법을 대체하여 밀 자원의 단백질 함량 분석에 적용 가능할 것으로 판단되었다. 2. 국내외 수집된 밀 6,794자원의 NIRS 단백질 함량 측정값을 정규분포로 작성하여 특성을 파악했다. 자원의 다양성 지수는 0.79, 단백질 평균은 12.1%, 전체 자원의 임의구간 42.1% 단백질 함량자원 범위는 10-13%이었으며, 68.0%를 차지하는 자원들의 단백질 함량 범위는 9.5-14.7%였다. 3. 전체 6,794자원의 품종 집단 구성은 육성계통 3,128자원, 재래종 2,705자원, 육성품종 961자원이었다. 육성계통 자원의 다양성 지수는 0.80, 단백질 평균은 11.8%, 전체 자원의 68%를 차지하는 자원들의 함량 범위는 9.2-14.5%였다. 재래종 자원의 다양성 지수는 0.76, 단백질 평균은 12.1%, 전체 자원의 68.0%를 차지하는 자원들의 함량 범위는 9.8-14.4%였다. 육성품종 자원의 다양성 지수는 0.80, 단백질 평균은 12.8%, 전체 자원의 68.0%를 차지하는 자원들의 함량 범위는 10.2-15.4%였다. 재래종 자원은 가장 낮은 다양성 지수를 나타냈고, 육성계통과 육성품종은 동일한 다양성 지수를 나타냈다. 육성계통은 가장 낮은 단백질 평균을 나타냈고, 육성품종은 가장 높은 단백질 평균을 나타냈다.

• 직업교육연구
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• 제35권4호
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• pp.19-46
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• 2016

이 연구의 목적은 사회적 수요가 증가하는 특성화고등학교 간호과 교육의 운영 현황과 교육과정 편성 운영, 교육환경 등에 대한 현황을 분석하고 간호과 교육의 개선 방향을 탐색하는데 목적이 있다. 이 연구의 방법은 관련 선행연구를 분석하고 학교알리미, 교육통계연보 등 간호관련 학과 개설 및 운영 현황 자료, 학교 교육과정, 각 기관 및 협회의 홈페이지에 소개된 공시 자료 등을 수집 분석하였다. 이 연구의 주요 결과는 다음과 같다. 첫째, 2016년 1학기 현재 특성화고등학교 중에 간호과를 개설 운영하는 학교는 총 38개교로 전체 특성화고 마이스터고의 약 6.4% 정도이다. 이들 학교는 주로 보건간호과, 치의보건간호과, 간호과, 의료간호관광과. 간호회계 및 간호경영과 등의 명칭으로 개설하였다. 간호과 졸업생은 2012년 이후 취업률과 진학률간의 격차가 좁혀지고 있으며 2015년에는 특성화고등학교 전체 평균 취업률인 46% 수준이었다. 둘째, 특성화고등학교 간호과는 인력양성 목표를 간호조무사 양성에 두고 관련 취득 자격으로 간호조무사, 요양보호사 등을 주로 제시하고 있었다. 간호과 교육과정은 자격 취득 요건, 현장 직무 수행에서 필요한 역량과 관련한 과목들을 편성하고 있었으나 간호과 교육과정의 충분성, 자격과 교육과정 편성과의 정합성 등을 검토해야 한다. 법적 요건인 780시간의 현장실습은 주로 1학년부터 2학년까지 3번의 방학을 통해 병의원 현장에서 별도의 교육과정으로 운영되고 있었다. 셋째, 간호과 교육의 물적 환경은 전공별로 2개 정도의 실습실과 학생 규모를 고려한 시도교육청의 시설설비 기준을 적용하여 비교적 기본 환경을 구축 활용하고 있었다. 인적 환경인 교사 확보는 간호 표시과목이 없음에 따라 표시과목의 개설, 지역별 배치 기준의 검토, 전문성 함양을 위한 연수 및 연구, 장학의 지원을 위한 개선이 시급한 것으로 나타났다.

• 간호행정학회지
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• 제2권1호
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.