• Journal of Home Health Care Nursing
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• v.1
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• pp.57-70
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• 1993

This study was carried out to investigate agreement, content and demand for home nursing care of hospital inpatients in brain, spain and musculoskeletal diseases .The data was collected by interviewing with 242 patients who were hospitalized in university hospital on Taegu, from September 6,60 October 9, 1993. Of 242 patients, 66.1% agreed to home nusing care system and rate of agreement was highest between 30 years to 49 years of age as 75.5%, in middle urban area residents as 75.9% and was lowest in medicaid as 40.0% in general chareacteristics. The rate of agreement according to type of diagnosis was highest inpatients with spinal diseases as 75.6% according to functional status was the highest in patients who had daily living activity freely as 69.4% according to prognosis in patients at terminal stage as 80.0% and the rate of agreement to home nursing care of patients who wanted early discharege was 73.9%. The first-ranking reasom of agreement to home nursing care was asking for continuous relationship with doctor as 37.3% and there was statistically significant difference in reasons of agreement to home nursing care according to functional status of patients. The first-ranking reason of eary discharge among patients who wanted early discharge(74.8%) was because of long time stay in hospital. Among 23 items of nursing activity that patient wanted, the first-ranking item was recovery promotion, prevention of complication, education and counseling for health as 76.4%, drug management was 2nd-ranking item as 62.1% and the third was regular checking of vital signs as 55.9%. The lowest item of demand for home unring care was hospice care(3.9%) and airway keep(9.1%).

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.56-64
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• 1998

Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

• The Korean Journal of Health Service Management
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• v.2 no.1
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• pp.37-55
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• 2008

This study aims to enhance work efficiency and satisfaction by offering data that make a physical therapist cope with stress coming from the job efficiently by identifying and analyzing the job satisfaction and work stress perceived by a physical therapist, and the level of reaction of a physical therapist. The study distributed survey questionnaires to 300 physical therapists working in medical institutions in Busan via mail and by visit from March 3, 2007 by selecting them simply and randomly from the physical therapist list, and collected the questionnaires by March 20, 2007, 103 respondents were working at 17 general hospitals including a university hospital, 65 respondents at 12 medical centers, and 79 respondents at 39 doctor's offices. The study collected 251 copies, which showed the collection rate of 83.7%, and analyzed 247 copies (82.3%) excluding 4 copies of insincere answers. As a research tool for measuring job satisfaction the study used a tool employed for research into the job satisfaction of physical therapists who work at medical institutions in Gwangju, Jeonnam, and Jeonbuk by Kim Hee-Gwon(1992) and research regarding job satisfaction by Jeong Jeong-Hee(2004) as well as research regarding the factors of job satisfaction by Flippo(1980) & Seberhagen(1970) after adjusting the research tools to the purpose of the study. Also for questions about work stress, the study employed nurses' job stress measurement tool developed by Kim Mae-Ja and em Mi-Ok(1984) by modifying the tool to the purpose of the study, and for a measurement tool for reaction to stress, the study used a tool employed for research into reaction to stress of nurses at general hospitals by Choi Eun-Deok(2005) without modification. For data analysis, the study used the SPSS12.0 as a statistical method, and then used t-test or ANOVA for verifying actual numbers, percentile, average :score, standard deviation, rank, and difference. Also, the study conducted which is a post-test method for variables that show a significant difference at the level of p<.05 level after the analysis. The findings include the following. 1) The respondents' job satisfaction score was 3.21 points on the average (out of 5 full points). The peer relationship ranked the highest, posting 4.02 points on the average, and the job satisfaction with rewards was proven the lowest, posting 2.51 points. For the job satisfaction level by characteristics, there were significant differences (p<.05) in gender, hospital type, weekly working hours, monthly working days, number of patients per day, department in charge of therapy, and number of peers, and there was no significant difference in characteristics other than that. 2) The respondents' work stress score was 2.72 points (out of 5 full points) on the average. The respondents were shown to be under the highest stress when they suffered from excessive workload, posting 3.49 points on the average, and they were shown to be under the least stress when they had a conflict with peers at another department, recording 1.90 points on the average. for the job stress level by the characteristics of job, there was a significant difference in the reflection of job assessment(p<.05). 3) 1n respondents' reaction to stress, most of them were shown to make efforts in coping with stress, posting 2.80 points (out of 5 full points). For their experience of being wider stress, they answered that 'they felt depressed (2.85 points)" for their experience of coping with stress, they answered that 'they were indifferent to it or thought about something else' (2.62 points). Also, for their efforts in coping with stress, they answered that 'they were motivated to remove their strain by taking leave, playing, or using their preferences' (3.52 points), which ranked higher. For the level of reaction to stress by characteristics, there were significant differences by age, gender, marital status, total service years as a physical therapist, monthly working days, and department in charge of therapy(p<.05). It is necessary to offer correct information by conducting an in-depth analysis of the stressful situations of physical therapists who exert efforts in rehabilitating patients at hospitals by factor, and seeking management plans based on the research results. Also, it is necessary to develop a program for coping with stress efficiently for removing stress and to conduct research into the understanding and cooperation of administrators and persons in charge of physical therapists for reducing physical therapists' stress at hospitals.

• Journal of Distribution Science
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• v.9 no.2
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• pp.73-81
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• 2011

This study is designed to examine the effects of information source effects of the word mouth have on the formed expectations for the private institution and to explore the formed expectations' effects on the actual sales of the educational service. Moreover, its purpose is in analyzing what medication effects the pre-conceived expectation has on selecting the educational service. After testing hypothesis, the results showed that the source effects of the information from word of mouth had a significant effect on the expectation factors, in terms of expertise, similarity, likability and familiarity expectation factors. However, it was found that effect was not significant for the truthfulness. The significant result was found on the expectation factors before visiting the private institution on selecting educational service, indicating a positive effect. As for the influence of source of the word of mouth information on selecting educational service, the results from the mediation effects of the expectation factors on selecting the educational service showed that for expectation factors, expertise had the partial mediation effect, truthfulness, perfect mediating effect, similarity, partial mediation effect, likability, perfect mediating effect, and familiarity, perfect mediating effect. A test of the mediating role of attribute expectations in the influence of WOM message source attributes on educational services choices showed the following: 1) It was proven that attribute expectations played a partial mediating role in the influence of expertise and similarity, respectively, on educational services choices. 2) On the influence of trustworthiness, likability, and familiarity on educational services choices, respectively, attribute expectations had a full mediation effect. This research differs from the previous ones, which focused only on consumer satisfaction with educational services offered by private educational institutions in that it covers not only the influences of both WOM source attributes and key component factors of educational services on both educational services choices and satisfaction with such services but also the influence of WOM source attributes on attribute expectations prior to the first visit to a particular private educational institutions, and in turn the influence of such attribute expectations on educational services choices. Most particularly, the significance of this study lies in the fact that in an effort to more clearly explain the causal relationship between WOM source effects and educational services choices a test of the mediating role of attribute expectations was conducted. Although the research seems simple, some theoretical implications can be drawn as follows: WOM message source effects on educational services choices were positive and moreover these positive impacts are likely to be reinforced by means of the mediating variable of attribute expectations.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Journal of the Korean Applied Science and Technology
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• v.37 no.5
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• pp.1390-1401
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• 2020

This study is a descriptive research to identify the relationship among violence experience, resilience and job stress of nurses working in emergency department. The subjects of this study were 143 nurses with over one year working in emergency departments of 6 hospitals located in D city and C city and collected data through structured questionnaire. It was from November 6th to November 15th. The degree of violent experience of the subjects was 1.26 ± 1.31 out of 4. The average score of resillience was 2.50 ± 0.55 out of 4. The average score of job stress was 3.62 ± 0.49 out of 5. The result of correlation between violence experience, resilience and job stress, among the sub factors, in the correlation among violence experience and job stress sub factors, verbal violence experience was significantly positively correlated with nursing work(r=.194, p=.010), role conflict stress(r=.158, p=.030), and physical threat experience was positively correlated with nursing work(r=.200, p=.008), role conflict(r=.162, p=.027), and conflict with doctor(r=.145, p=.042). In the correlation between resilience and job stress sub factors, nursing work stress is hardness(r=-.189, p=.012), persistence(r=-.165, p=.025), and optimism (r=-.186, p=.013) and there was a negative correlation with the region. Expertise stress is hardness(r=-.230, p=.003), persistence(r=-.195, p=.010), optimistic(r=-.194, p=.010) and there was a negative correlation. Nurse-treated stress was positively correlated with spirituality(r=.154, p=.033). In the subcategory correlations of resilience and violent experience, the hardness had a negative correlation with the physical threat(r=-.150, p=.037) experience. The persistence was negatively correlated with the experience of physical threats(r=-.138, p=.050). The optimism was negatively correlated with the experience of physical violence(r=-.151, p=.036). As a result, it is necessary to create a safe working environment free from violence and to reinforce training on how to deal with violence in order to reduce the job stress of emergency department nurses. In addition, measures to cope with stress according to age and work experience and programs to increase resilience should be developed and mediated to reduce the job stress of emergency department nurses.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.149-158
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• 2003

Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.103-111
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• 2008

Background : It was not uncommon authors as psychiatrists faced women patients with somatoform disorders who expresses their symptoms has been started after the poor adherence to 'Doing the month' practices (DMP). DMP is known as a traditional ritual for Korean postpartum women. Aims : This study is an cultural approach to explore the practices of Korean women during the postpartum period are related with the formation of somatoform disorders. Methods : 41 multipara women with somatoform disorders diagnosed by DSM-IV criteria and 91 healthy normal control were enrolled. Subjects were given scales of SOM scale of SCL-90R, Somatic Symptom Scale-Korean version, Korean 'Doing the month' practices Scale(40 items), Postpartum Sick Scale(14 items), Beck Depression Scale and State Anxiety Scale. Results : 1) The period of DMP less than one week were prevalent in the patients group(43.9%) compared to the control group(7.9%, p<0.01). 2) The period of DMP after the abortions showed no difference between two groups. 3) Subjective rate for their poor DMP was significantly high in the patients group(73.2%) compared to the control group(33.0%), and the patients group showed high score in Postpartum Sick Scale as well(4.1, 1.6 respectively). 4) Poor DM was negatively correlated with SOM scale of SCL-90R(correlation coefficient r=-0.47, p<0.01). Conclusion : Poor DMP may make a crucial role for their heath condition after the deliveries and which would be one of the major factors of the somatoform disorders in Korean women. And postpartum physical symptoms after the poor DMP could be last long enough to be diagnosed as somatoform disorders. By understanding the cultural nature of the somatization phenomena the doctor-patient relationship could be enhanced.

• The korean journal of orthodontics
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• v.39 no.3
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• pp.168-176
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• 2009

Objective: The purpose of this study was to evaluate how airway changes influence facial growth during puberty in Korean children. Methods: Thirty-six patients aged 9 to 11 (mean age: 10.7 years) were selected. Cephalograms and hand-wrist x-rays were taken at pre-treatment (T1) and post-treatment (T2). The sample was divided into narrow (5.2 - 8.6 mm, AW-Narrow), medium (8.9 - 11.5 mm, AW-Medium), and wide (11.7 - 16.0 mm, AW-Wide) groups according to the airway width at T1. Cephalometric measurements at T1, T2 and growth from T1 to T2 were compared between groups. Results: The degree of increase in airway size in each group was 4.55 mm, 3.84 mm and 1.94 mm in the AW-Narrow, AW-Medium, and AW-Wide groups, respectively. Moreover, the differences were statistically significant. The significant smallest posterior facial height was found in the AW-Narrow group at T1. For the growth values from T1 to T2, the AW-Narrow group showed significantly larger values of PFH/AFH, facial axis, ANS (T1 - T2), and Gn (T1 - T2) than the AW-Medium group. Conclusions: The compensational changes in the airway width and facial growth were found in the narrow group. Surgical approach of the airway to prevent unfavorable facial growth in these years of age should be carried out, but with careful deliberation because these problems may be improved naturally.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.