• 제목/요약/키워드: Health domain

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The Primary Care Performance of Three Types of Medical Institutions: A Public Survey using the Korean Primary Care Assessment Tool

  • Jung, Hye-Min;Jo, Min-Woo;Kim, Hyun-Joo;Jang, Won-Mo;Lee, Jin-Yong;Eun, Sang-Jun
    • 한국의료질향상학회지
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    • 제25권2호
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    • pp.16-25
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    • 2019
  • Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

심근 경색증 환자의 죽상경화증 위험요인별 질병관련 지식과 건강행위 이행 (Disease-related Knowledge Level and Compliance of Health Behavior in Patients with Myocardial Infarction According to the Atherosclerotic Risk Factors)

  • 정혜선
    • 성인간호학회지
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    • 제13권4호
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    • pp.529-538
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    • 2001
  • Purpose: This study purposed to examine the disease-related knowledge level and compliance with good health behavior in patients with myocardial infarction according to the atherosclerotic risk factors. Method: The subjects consisted of 72 patients with myocardial infarction and the data were collected by interviewing the subjects with questionnaires and reviewing their medical records from September, 15, 1999 to July 31, 2000. Data were analyzed using the SAS program. Results: 1) With regard to atherosclerotic risk factors: of the subjects, 91.7% lacked regular exercise, followed by smoking (61.1%). 2) The average knowledge score of the patients was 19.7 and the average compliance score was 53.9. 3) There were no significant differences in the total knowledge scores according to the patients' atherosclerotic risk factors. 4) Non-diabetics were significantly higher in knowledge scores on domain of risk factors than the diabetics. 5) The overweight patients were significantly higher in knowledge score on domain of nature of disease than the normalweight patients. 6) The total compliance scores of the non-smokers were significantly higher than those of the smokers. 7) The total compliance scores of the patients who do regular exercise were significantly higher than those of the patients who forgo regular exercise. 8) The non-smokers were significantly higher in compliance scores on domain of diet than the smokers. 9) The diabetic patients were significantly higher in compliance scores on domain of smoking cessation than the non-diabetics. 10) Patients who do regular exercise were significantly higher in compliance scores on other domains than the patients who forgo regular exercise. Conclusion: According to the above findings, it can be concluded that intensive nursing care and education should be provided to patients who have atherosclerotic risk factors such as smoking, hypertension, diabetes mellitus, lack of exercise, over weight, or hypercholesterolemia to increase disease related knowledge level and to improve compliance with good health behavior.

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환자만족도 평가에 대한 방법론적 접근: IPA기법을 중심으로 (A Methodological Approach on the Evaluation of Patient Satisfaction: Focused on the Importance Performance Analysis(IPA))

  • 박재산
    • 보건행정학회지
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    • 제18권3호
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    • pp.1-17
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    • 2008
  • The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

단전호흡 운동프로그램에 참여한 중년여성의 운동효과에 대한 경험 (Effects of Dan-jun Breathing Exercise Program Experienced by Women in Midlife)

  • 현경선;강현숙
    • 기본간호학회지
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    • 제9권2호
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    • pp.180-189
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    • 2002
  • Purpose : This study focused on affirming of the effects of Dan-jun breathing exercise experienced by women in midlife. Method: The data were collected via direct interview from 20 participants, who participated in a Dan-Jun exercise program during three months. Collected data were analyzed by content analysis. Result : 1. As for the health problems of women in midlife before the Dan-jun exercise program, 93 items were extracted in the content analysis These items were categorized into 59 attributes and 15 higher attributes. 1) Of the 59 attributes of health problems, shoulder pain (30%) was the most dominant. 2) The 15 higher attributes consisted for the physical domain of, weakness, pain, joint stiffness, sexual problem, sleep disorder, gastro-intestinal disorder. menstrual irregularity. circulatory disorder, respiratory disorder. constipation, urinary incontinence, and for the psychological domain, anger, emptiness, depression, and anxiety. 2. As for the effects experienced by women in midlife after the Dan-jun exercise program, 169 items were extracted in the content analysis. These items were categorized into 85 attributes and 14 higher attributes. 1) Of 85 attributes, lightening of physical condition (55%) was the most dominant. 2) The higher attributes consisted in physical domain of, recovery of vigor, pain relief, menstrual regularity and improvements in flexibility. sexual problem, sleep disorder, gastro-intestinal disorder, circulatory disorder constipation, respiratory disorder and urinary incontinence, and for the psychological domain, relaxation, cultured mind and self-confidence. Conclusions : Dan-jun breathing exercise program for three months showed positive effects on physical and psychological health in women in midlife. In this context, it can be also considered as a significant nursing intervention for maintenance and promotion of the health of these women.

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USN기반 u-Healthcare 시스템 트래픽도메인 환경에서의 보안위험도 평가체계 설계방안 (A Building Method of Security Vulnerability Measurement Framework under u-Healthcare System Traffic Domain Environment Based on USN)

  • 노시춘
    • 융합보안논문지
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    • 제11권3호
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    • pp.39-46
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    • 2011
  • 의료정보 기술의 Smart 환경, Ad-hoc networking, 무선통신 환경은 u-Healthcare 요소기술과 함께 정보보안 취약성을 증가시키는 주요 요인이다. 트래픽 도메인이란 u-Healthcare 의료정보시스템을 통과하는 트래픽 구간의 구분 영역으로서 보안기술의 적용이 가능하도록 네트워크 영역을 구분하는 개념이다. 그 구분의 기준은 보안기술의 적용이 필요한 영역, 트래픽 경로와 트래픽 성격이 타 도메인과 차별화 가능한 영역, 보안기술 적용시 타 영역의 보안기능으로 기능중복이 발생치 않는 영역이다. u-Healthcare 의료정보시스템 도메인은 사용자단말구간, 공중통신망 인프라구간, 네트워킹구간, 인트라넷구간으로 도출된다. 의료정보시스템을 도메인별로 구분하여 취약점을 평가하는 이유는 도메인별로 취약점에 대한 대처방법이 다르게 도출되기 때문이다. 본 연구는 의료정보시스템 도메인을 도출하고 도메인별 보안취약성 진단체계를 설계하여 USN 기반 u-Healthcare 시스템에서의 보안대책을 강구하기 위해서이다. 본 연구에서 제안하는 모델을 사용할 경우 현재까지 막연하게 진행 되어온 USN 기반 의료정보네트워크 보안취약성 진단대책 수립 방법을 좀 더 효과적으로 수행 할 수 있을 것으로 기대한다.

학령전기 아동 어머니의 모아상호작용에 대한 인식 (Recognition of Mother-Child Interaction by Preschoolers' Mothers)

  • 박성희
    • Child Health Nursing Research
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    • 제18권1호
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    • pp.36-42
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    • 2012
  • Purpose: The purpose of this study was to explore recognition of mother-child interaction by preschoolers' mothers. Methods: Data were collected through in-depth interviews with mothers of 12 preschoolers. The data were analyzed following Downe-Wamboldt's content analysis methodology. Results: From the data, 170 significant statements were selected and were classified into 7 categories and three domains (maternal, child, dyadic). First, the maternal domain consisted of maternal sensitivity, acceptable responsiveness, and child developmental encouragement. Second, the child domain consisted of child's sensitivity, responsiveness, and initiative. Third, the dyadic domain consisted of mutuality. Conclusion: These results suggest that preschoolers' mothers recognize the significant qualitative aspects of interaction with their children. Based on these results, instruments for preschooler-mother interaction need to be developed.

공기조화설비 겸용 제연설비 덕트의 성능개선을 위한 연구 (A Study on Performance Improvements about Duct of Smoke Control System Combined with Air-Conditioning Equipment)

  • 오택흠;박찬석
    • 대한안전경영과학회지
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    • 제23권4호
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    • pp.67-72
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    • 2021
  • To ensure the safety and functionality of a railroad bridge, maintaining the integrity of the bridge via continuous structural health monitoring is important. However, most structural integrity monitoring methods proposed to date are based on modal responses which require the extracting process and have limited availability. In this paper, the applicability of the existing damage identification method based on free-vibration reponses to time-domain deflection shapes due to moving train load is investigated. Since the proposed method directly utilizes the time-domain responses of the structure due to the moving vehicles, the extracting process for modal responses can be avoided, and the applicability of structural health evaluation can be enhanced. The feasibility of the presented method is verified via a numerical example of a simple plate girder bridge.

고혈압이 있는 근로자가 인식한 산업간호사 보건관리 활동 평가 - 보건관리 대행사업장을 대상으로 - (Evaluation of Occupational Health Services on Workers with Hypertension in Small and Medium Sized Enterprises -Subject to Enterprises taken the Occupational Health Management Agency-)

  • 조정민;전미영;김명희
    • 한국보건간호학회지
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    • 제16권2호
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    • pp.445-453
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    • 2002
  • Purpose: This study has been designed to evaluate occupational health services on workers with hypertension Method: Study participants were 108 workers having a diagnosed hypertension. The instrument used for this study was the questionnaire developed by Cho(1998). Analysis of the data was done with SPSS Win 10.0 for descriptive statistics, Correlation coefficient. Results: 1. The mean score of process domain was $3.77\pm.43$ The score of process domains were usefulness of health management$(3.98\pm.49)$, education or counselling$(3.87\pm.53)$, follow up in medical examination$(3.79\pm.58)$, usefulness of providing materials$(3.53\pm.62)$, perception of medical examination $(3.37\pm.80)$ 2. The mean score of outcome domain was $3.47 \pm.44$ The score of outcome domains were obstructiveness of social life$(3.90\pm.78)$, habits of living $(3.41\pm.76)$, blood pressure change $(3.25\pm.81)$, perception of seriousness$(3.02\pm.88)$. 3. Blood pressure change was significant correlated with education or counselling(r=.31) and usefulness of providing materials(r=.28).

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손자녀 양육 스트레스 측정도구 개발 - 주간양육 할머니를 중심으로 - (Development of a "Grandmothering Stress Index" for Korean Day-care Grandmothers)

  • 김문정;정재원
    • 여성건강간호학회지
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    • 제14권1호
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    • pp.56-65
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    • 2008
  • Purpose: The study was to develop an instrument to measure grandmothering stress for Korean day-care grandmothers and to test the validity and reliability of the instrument Method: The items of the instrument were based on a literature review and secondary data, After content validity tests and a pilot test, 20 items were developed. In order to test the reliability and validity of the scale, data were collected from 126 grandmothers. Result: After a factor analysis, five factors and 15 items were selected. These explained 67.2% of the total variance. The first domain was termed 'Health problems', and explained 18.1 % of the total variance, and the second domain of 'Possibility of role substitution' explained 13.8%. The third and the fourth domains were 'Relations with adult children' and 'Grandchildren's characteristics' explaining 12.5% and 12.1 %, respectively. The last domain explained 10.8% of the total variance with the theme 'Restriction of social life' After accomplishing the reliability analysis, Cronbach's alpha coefficient was determined to be .75. Conclusions : This initial step in the development of a Grandmothering Stress Index is valuable to reflect the subject of Grandmothering stress in senior citizens in Korea. Future study should to refine the constitution of the instrument.

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한국판 Western Ontario MacMaster(WOMAC)의 Rasch분석 (Rasch Analysis of the Korean Western Ontario McMaster (KWOMAC): In the Out-Patients Over 65 Years With Osteoarthritis of the Knee)

  • 고은경;이충휘
    • 한국전문물리치료학회지
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    • 제14권1호
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    • pp.82-89
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    • 2007
  • The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a valid and widely used instrument for the assessment of osteoarthritis patients. In this study, data was obtained from the out-patients with painful osteoarthritis of the knee. One hundred-three out-patients were interviewed by physical therapists. In an exploratory way, a Korean version of the KWOMAC was analyzed for unidimensionality, item separation, and item difficulty using the Winsteps programs. Ninety-five patients with osteoarthritis of the knee over 65 years were analyzed for Rash analysis. In the analysis several functional items poorly fit to the model. These items included "heavy domestic duties" and "standing". In the pain domain, one item ("at night while in bed") did not fit the model. In the stiffness domain one item ("after sitting, lying, or resting later in the day") did not fit the model. Although 4 items from the 3 domains (pain, stiffness, function domain) do not fit well, the KWOMAC domains were confirmed by Rasch analysis. Thus the KWOMAC needs to be further examined before it can be used to properly determine the health status of the elderly with OA.

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