• Research in Community and Public Health Nursing
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• v.6 no.1
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• pp.5-33
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• 1995

The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant($\beta=1.535$, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found in rural health centers(Rc=.578, P=.069), 10. Relationships between job satisfaction and health care productivity was not found significant. Through these results, the assumed relationship between environment and organizational structure was not supported in health centers. Therefore, the relationship between the organizational effectiveness and the congruence between environment and organizational structure that contingency theory proposes to exist was not able to be tested. However decision-making authority was found as an important variable of organizational structure affecting family planning services and job satisfaction in urban health centers. Thus it was suggested that decentralized decision making among health professionals would be a valuable strategy for improvement of organizational effectiveness in public health centers. It is also recommended that further studies to test contingency theory would use variability and uncertainty to define environment of public health centers instead of complexity.

• Research in Community and Public Health Nursing
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• v.4 no.2
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• pp.100-108
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• 1993

The purpose of this study was to identify the workers the Knowledge, Attitude, and Practice of industrial health care services. The study was conducted from Dec 10, 1992 to Jan 20, 1993. The data was collected from 849 workers in 56 companies in Busan City. The data was analyzed by using the mean, S.D>, T-test, ANOVA. The tool for measuring the degree of Knowledge, Attitude and Practice of industrial health care of workers was developed by community health nursing academy and the reliability an of the tool was 0.82810. The results were as follows : 1. The general characteristics of workers : Distribution of workers consisted of laborer(55.0%), office workers(45.0%), in an age range from 25-39(55.0%), male employees were(69.7%), married employees were(62.4%), the educational level with the highest percentage was high school graduates(54.2%). The present work force had a career for 7 years or more with an income of 300-700 thousand won monthly(43.2). 2. The degree of Knowledge Attitude and Practice about industrial health care services of workers : The total score of the Knowledge, Attitude, and Practice was 49.09 points out of a possible 80(mean Score=2.46) 1) The total score of the Knowledge was 15.73 points out of 24. (Mean score=2.62) The following are the Knowledge scores: The necessity examination of occupational disease was(3.34) The knowledge of occupational disease was (3.12) The knowledge of health education was(1.29) 2) b. The total score of the Attitude was 26.01 point out of 44(mean score=2.36) The following are the Attitude scores: The necessity of health education for health examination was (3.14). The importance of health examination was(3.08) The necessity of measurement for working environment was(2.99). The satisfaction of the content in the periodic health examination was low(1.81). 3) The total score of the Practice was 7.35 points out of 12(mean score=2.45) The following are the orders of Practice scores: The participation in health examination was higher than in health education(1.33). 3. The general characteristics and the degree of knowledge, Attitude, and Practice of workers of industrial health care. 1) The level of worker's knowledge was significantly related by working part(t=2.54 P=0.000), marital status(F=4.35 P=0.029), educational level(F=3.91 and P=0.020), monthly income(F=2.98 P=0.029) 2) There were no significant difference between the general characteristics and the attitude of workers. 3) The practice was significantly related with working part(T=2.52 P=0.012), sex(T=2.28 P=0.23), marital status(F=4.25 P=0.012), monthly income (F=2.76 P=0.034) 4) The total score had a significant difference with working part(T=2.39 P=0.017), sex (T=3.84 P=0.000), marital status (F=3.18 P=0.032). Educational level (F=3.20 P=0.033), and monthly income(F=3.05 P=0.022).

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.109-119
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• 2010

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

• Research in Community and Public Health Nursing
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• v.4 no.1
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• pp.67-76
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• 1993

The purpose of this study was to find the status of health examination and health management of industrial companies located in Taegu and Kyung book areas. It will provide basic information for the provision of effective health management of industrial workers. 49 companies were selected as a study sample group, and data was collected by using a structured Questionnaire which was developed by the members of the Community Health Nursing Academy of Korean Nursing. The health managers of the companies filled out the Questionnaire. The data was gathered from Dec 20, 1992 to Jan 20. The results of the study was as follows : 1. The Study sample showed 85.7% manufacturing companies having 300 or more workers. 2. All the companies had health managers, and companies which had 1,000 or more workers had industrial physicians and nurses. Only 12.2% of the industrial physicians were full time employees, and almost all industrial nurses were full time employees. Except for industrial physicians and nurses, the proportion of hygienists (6.1%), nurses aids (4.1%), and environmental engineers (22.4%) with full time employment statuss was very low. The mean age of industrial physicians was 49.2 while that of industrial nurses was 27.2. The length of work experiences currently ranges for 1 to 3 years for all health workers: physicians, nurses, hygienists, and environmental engineers. 3. Health examination and follow up care 94.31% took general health examinations. Of those, the proportion of the workers, who were determined as C grade(in need of close examination) was 43.86%. The proportion of the workers who were determined as D grade was 22.19%. 13.28% of the workers evaluated at the D grade were taken as a gauge for temporary leave from work. While 8.7% and .09% of them were taken as gauge for a change in job, and or shortening work hours respectively. The proportion of workers who must have taken special examination was 65.04% and of those the proportion of the workers who actually took, the examination was 98.55%. 75% of the workers who were recommended for follow up care were given follow up care. The special examinations were done the most frequently to detect the effects of physical agents (59.2%). Direct notice to individual workers was used the most frequently as a method of notification after a special examination (61.2%). The length of time taken to receive the result of a special examination was less than 1 month (38.9%) and 36.7% had taken up to two months (36.7%.). Most results of special examination were obtained within 2 months. The referral rate of consulting special examination by health managers was estimated at 95.9%. 4. 89.8% of the companies had. their own company dispensaries and 75.5% of those. had separate dispensaries. 32.7% of the companies designated local clinics for health management of workers. Industrial nurses performed health examination the most frequently(1.4 points). Health appraisal for work places were. done the least(0.83 points).

• The Journal of Korean Academic Society of Nursing Education
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• v.3
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• pp.78-98
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• 1997

Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

• Korean Journal of Occupational Health Nursing
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• v.4
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of Digital Convergence
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• v.19 no.5
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• pp.449-460
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• 2021

The purpose of this study explained the experience of volunteering activities and the relationship of subjective self-awareness in order to examine the social meaning of volunteer activities. For adults aged 20 or older, 312 volunteering experience and social support awareness were analyzed on the level of self-identity by allocation sampling method depending on gender and age. The analysis results of this study were as follows. First, it was found that those who have experienced volunteer activitiies have a relatively simple willingness to participate in professional volunteer activities and those who have experienced volunteer activities. Second, social support and self-identification were different depending on whether they have experienced volunteer activities. Third, age, volunteer participation, willingness to participated in volunteering, and social support were analyzed as explanatory factors predicting self-identification of research participants. Based on the research results, volunteer activities to positively promote self-awareness suggested the need to practice volunteer activities according to the life cycle so that social meaning can be given. As a policy suggestion, the need for volunteer activities was closely analyzed to enable healthy self-forming for well-aging from adulthood to old age to discussed the need for policies and systems to strengthen volunteer motivation as leisure activities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.257-269
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• 2021

This study aimed to secure basic data for the development and operation of well-aging education programs by analyzing the physical, mental, and socio-economic needs of well-aging education for successful aging. The research tool was developed as a questionnaire to investigate the perception of well aging and the needs of well-aging education in terms of physical, mental, and socio-economic aspects. In February 2021, 1949 adults over the age of 19 were surveyed through an online and mobile survey by Gallup Korea. Descriptive statistics analysis, variance analysis, Borich needs analysis, and IPA analysis were conducted to analyze the needs of well-aging education. The results revealed economic power, exercise, and chronic disease management to be high in terms of the overall priority of the education needs for well-aging, and infectious disease management, independence, and social responsibility were surveyed in the order of low education needs. In terms of economic power, education needs were highest among all age groups except for the middle-age group (35-49 years old), 82.4% of all respondents, and education needs for exercise and chronic disease management were highest in the middle-age group. Therefore, it is necessary to develop well-aging education programs for each life cycle. These results are expected to be used as empirical data in establishing a platform for developing and operating educational programs for well aging.

• Health Policy and Management
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• v.10 no.3
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• pp.19-49
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• 2000

This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

• Journal of agricultural medicine and community health
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• v.39 no.3
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• pp.176-186
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• 2014

Objectives: As a sequel to the former analysis of the quality of life (QoL) among young-old and old-old in Korea, this research was aimed to identify factors related to the quality of life and the gender difference after controlling for the related factors among Korean elderly. Methods: Selected elderly data of 1,339 subjects from the 5th Korea National Health and Nutrition Examination Survey conducted in 2010 was analyzed. In this survey, QoL was measured using Euro Quality of Life (EQ-5D) instrument. Data were analyzed using complex survey data analysis on IBM-SPSS 20.0. The related factors were identified using general linear models with backward elimination. The gender difference was tested also using general linear models. Results: The distributions of educational level, family income level, and presence of cohabitant were different between male and female elderly in both young-old and old-old age group. So were the health behaviors and perceived health, and experience of stress, depression, and suicidal thoughts. QoL and its subscales- mobility, self care, daily living, pain and discomfort, and anxiety and depression- were consistently better among male elderly regardless of age group. Among the variables considered, education, family income level, presence of cohabitant, perceived health, age group and BMI were found to be related to the QoL at p=.05, and presence of chronic diseases at p=.10. The difference in QoL between male and female elderly after controlling for the variables was statistically significant. Conclusion: Improving QoL is particularly important for the elderly. In order to improve QoL of the elderly, age- and gender- differences need to be considered when developing services and programs for the elderly.