• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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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.

• Journal of The Korean Association For Science Education
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• v.36 no.6
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• pp.959-968
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• 2016

In this study, the Delphi Method was conducted to extract variables as effects of integrated education. Forty-six experts engaged in both the integrated education and research fields participated in this study. The Delphi survey was conducted for three rounds. In the first round, an open questionnaire was given asking variables possibly considered as effects of integrated education. In the second round, variables induced from analysis of the first survey results were given and the degree of agreement for each variable was determined according to the Likert scale. In the third round of the survey, mean, standard deviation, and the first and third quartile calculated using the results of the second survey were given to experts to determine their degree of assent. In addition, categories for variables were suggested. The degree of agreement for appropriateness of categorization and relative importance were determined As a result, a total of 18 variables were chosen except for career awareness. They were categorized according to their definition and properties into five categories: 'creativity' (flexible thinking, associative thinking, intuitive thinking, creative thinking), 'problem solving' (meta-cognition, problem recognition and solving, critical thinking, decision making ability, ability of knowledge application, knowledge and information processing skills), 'integrative perception and sensitivity' (concern and interest in various disciplines, understanding and acceptance of difference, integrative thinking), 'interpersonal relations' (communication skills, cooperation), and 'disciplinary literacy' (humanistic imagination, basic knowledge and literacy of each discipline, academic motivation). The degree of agreement was high in variables included in 'creativity' and 'problem solving' categories and the frequency of choosing the importance was high in variables included in 'integrative perception and sensitivity'. The educational implication related to implementation and practice of integrated education were discussed on the basis of results.

• Korean Journal of Environment and Ecology
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• v.37 no.4
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• pp.273-288
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• 2023

Although many studies have been conducted on techniques and effects that can be applied to forest meditation in domestic forest healing meditation research, there has been little research on the space where forest meditation takes place. Nevertheless, a meditation space is not just a place concept but a forest environment element responsible for the healing function of a forest, i.e., a place containing healing factors, and can be an essential clue to the healing mechanism. Therefore, to determine whether a healing forest meditation space is suitable for meditation, this study selected the attribute items of the meditation space using the Delphi expert survey and then surveyed the user satisfaction of the healing forest meditation space using the IPA (Importance Performance Analysis) technique. The survey was conducted from August to November 2022, targeting 315 adults who used the forest meditation space at the National Center for Forest Therapy, the Saneum Healing Forest, and the Jathyanggi Pureunsup Arboretum in Gyeonggi Province. The result of the IPA analysis showed the average satisfaction with the forest meditation space was relatively high at 4.33 points on a 5-point Likert scale (4.33 points for the National Center for Forest Therapy, 4.34 points for the Saneum Healing Forest, and 4.37 points for the Jathyanggi Pureunsup Arboretum), indicating that the three healing forest meditation spaces were suitable for forest meditation. Satisfaction with the "Sounds of nature" was high in all three forests. On the other hand, all three forests showed a relatively low satisfaction with "Quietness," indicating it to be a priority problem to be addressed. Also, an open-ended questionnaire survey showed that the mediation space's natural elements, such as natural sounds, scenery, air, forest spaces, and scents, had a higher positive impact on meditation satisfaction than artificial elements, such as facilities. Therefore, it is essential to secure sound resources such as the sound of water and birds around the meditation space, and it is also necessary to consider ways to create a meditation forest in an independent area to avoid encounters with visitors and allow only participants in the forest healing meditation program to enter to increase satisfaction with forest meditation.

• Journal of Intelligence and Information Systems
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• v.28 no.1
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• pp.287-310
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• 2022

Companies' interest in developing AI-based intelligent new products is increasing. Recently, the main concern of companies is to innovate customer experience and create new values by developing new products through the effective use of Artificial intelligence technology. However, due to the nature of products based on radical technologies such as artificial intelligence, intelligent products differ from existing products and development methods, so it is clear that there is a limitation to applying the existing development methodology as it is. This study proposes a new research method based on KANO-TOPSIS for the successful development of AI-based intelligent new products by using car voice assistants as an example. Using the KANO model, select and evaluate functions that customers think are necessary for new products, and use the TOPSIS method to derives priorities by finding the importance of functions that customers need. For the analysis, major categories such as vehicle condition check and function control elements, driving-related elements, characteristics of voice assistant itself, infotainment elements, and daily life support elements were selected and customer demand attributes were subdivided. As a result of the analysis, high recognition accuracy should be considered as a top priority in the development of car voice assistants. Infotainment elements that provide customized content based on driver's biometric information and usage habits showed lower priorities than expected, while functions related to driver safety such as vehicle condition notification, driving assistance, and security, also showed as the functions that should be developed preferentially. This study is meaningful in that it presented a new product development methodology suitable for the characteristics of AI-based intelligent new products with innovative characteristics through an excellent model combining KANO and TOPSIS.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.359-365
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• 2006

Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.