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A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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Comparison of Subjective Symptoms of Fatigue and Salivary pH among Teachers between Special School and Elementary (피로자각증상(疲勞自覺症狀)과 타액(唾液) pH에 관(關)한 조사연구(調査硏究) - 특수학교(特殊學校) 및 국민학교(國民學校) 교사군간(敎師群間)의 비교(比較) -)

  • Lee, Soon-Ja;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.506-517
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    • 1989
  • Two hundred and fifty teachers of special school (for the disabled) and 414 elementary school teachers were selected for the targets in order to compare their degrees of fatigue symptoms and to find what kind of ralationship is between subjective symptoms of fatigue and pH is the saliva. It was 30 minutes before their closing hours on April 21th, 1989 that their physical, mental and neuro-sensory symptoms and salivary pH were examined. The test results are summarized as fallows : It is observed that an interrelation between subjective fatigue and pH in their saliva shows a significant relationship between physical and neuro-sensory symptoms in a sense of statistics. The rate of subjective fatigue complained by the special teachers is higher than that by the elementary teachers. In the case of salivary pH, the special teachers' is as a whole lower than the elementary teachers'. The complain rates in each item, checked, of special teachers are generally higher than those of the elementary teachers. It is in the mental symptom related item that there are many sub-items which show significant difference. According to the average of salivary pH based on the degrees of complained symptoms shown in the pH related items, the salivary pH of the group with complained symptoms is lower than that of the group without complained symptoms. In the rate of complaints, by sex, both sexes of the special teachers show high ones, but salivary pH is low. The complain rate of mental symptoms shown by female group from the special teacher Is significantly higher(p<0.05). By age, the group in their thirties from the special teachers show the higher complain rate of mental symptoms (29.3%) and the lower salivary pH (p<0.05) than that (15.1%) of the elementary teachers belonging to the same age catagory. However, the special teachers in their forties show the lower complain rate of physical symptoms that of the elementary teachers (p<0.05). From the viewpoint of their working years, the special teachers below 14 years and elementary teachers above 15 years in their career show high complain rates. Among those who belong to the catagory of 10-14 working years, the special teachers show the higher complain rate of mental symptoms than that of their counterparts. In the case of the salivary pH, the special teachers of all working-year catagories show the higher pH than that of the elementary teachers. But there is not significantly difference. From the viewpoint of sleeping hours in the previous night of the questionaire surveyed, among those who slept for over 7 hours, the special teachers show the higher complain rate of mental symptoms with a significant difference, but the lower salivary pH than that of their counterparts. From the viewpoint of their marital status, existence of disease history, the special teachers show the higher complain rate of subjective fatigue, but the lower salivary pH than that of the elementary teachers respectively. According to the above results, the special teachers generally show the higher complain rate of subjective fatigue, the lower salivary pH, and the higher complain rate of mental symptoms. To prevent the possible accumulation of mental fatigue of the special teachers, ways and means to make use of leisure time, recreational facilities are necessarily provided. Since the degree of fatigue and salivary pH have a correlation to some extent, it is necessary that further continuous studies on the correlation between the degrees of fatigue and salivary pH should be pursued.

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Job importance, job performance, and job satisfaction in dietitians at geriatric hospitals or elderly healthcare facilities in Jeju (제주지역 요양 (병)원 영양사의 직무중요도, 직무수행도 및 직무만족도 분석)

  • Kang, Hye-Sook;Lee, Yunkyoung;Chae, In-Sook
    • Journal of Nutrition and Health
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    • v.49 no.3
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    • pp.189-200
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    • 2016
  • Purpose: This study analyzed job importance, job performance, and job satisfaction in 38 dietitians working at geriatric hospitals and elderly healthcare facilities in Jeju surveyed from September 15-24, 2014 with the aim of providing basic data for improving the quality of meals and nutrition management for elderly patients. Methods: Data were analyzed using descriptive analysis, ${\chi}^2$-test, t-test, ANOVA, and Pearson's correlation coefficients using the SPSS Win program (version 12.0). Results: Regarding job importance, the average score was 4.29 (out of 5), indicating that hygiene and safety management scored the highest at 4.77 (out of 5), and nutrition management scored the lowest at3.86. In terms of job performance of subjects, the average score was 2.87 (out of 5), indicating that cooking operation management scored the highest at 4.42 (out of 5). Regarding the Importance-Performance Analysis (IPA) of job importance and job performance, hygiene and safety management and cooking operation management scored high for importance and performance (B quadrant) menu management, human resource management, and nutrition management scored low for importance and performance (C quadrant) and purchasing management and financial management were included inD quadrant and A quadrant, respectively. For the level of job satisfaction of subjects, the average score was 3.37 (out of 5), indicating that relationships with colleagues scored the highest at 3.72, and improving professionalism scored the lowest at 2.95. Additionally, job importance and performance of subjects were positively correlated withjob satisfaction (r = 0.395, r = 0.386, both p < 0.05). Conclusion: In conclusion, scores for job importance and job performance of nutrition management were low, and job satisfaction of improving professionalism scored low. Therefore, continuous training and education programs of nutrition management should be provided to improve professionalism of dietitians at geriatric hospitals and elderly healthcare facilities.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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A Grounded theory Approach on the Experience of Sexual Abuse Victims (성폭력 피해여성의 경험에 관한 연구)

  • Kim, Kyung-Hee;Nam, Sun-Young;Chee, Soon-Ju;Kwon, Hye-Jin;Chung, Yeon-Kang
    • Journal of the Korean Society of School Health
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    • v.9 no.1
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    • pp.77-98
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    • 1996
  • This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiosity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", "avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging, "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "information availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporating the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthiness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthiness. 6. The older the victims, The weaker the senses of being taken aback and filthiness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 13. The more closed the personality of tile subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more lilely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuses, the more likely response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping. 17. The less available information concerning sexual abuses, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 21. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping. 22. The more likely the response to 'being taken aback' and 'filthiness' is 'informing and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypotheses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined with weak sexual curiosity and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness', further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 3) In case the level of violence is strong and 'being taken abuse' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protective and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despite the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong and 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequency is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohesion is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

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A Study on the Radiation Dose in Computed Tomographic Examinations (전산화단층촬영 검사의 방사선 선량에 관한 연구)

  • Lim, Chung-Hwang;Cho, Jung-Keun;Lee, Man-Koo
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.381-389
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    • 2007
  • The purpose of this study is investigation of radiation dose in CT scan. Data were collected from various references and organizations. Doses measured by CT scanners of each medical organization were analyzed and they were calculated through the examination protocol. The results are as follows : 1. $CTDI_W$ value per 100mAs measured by Head Phantom was the highest in <4-slice MDCT scanner> of 24.20 mGy. $CTDI_W$ values were significantly different among scanner generations(p < 0.01). 2. $CTDI_W$ value per 100 mAs measured using body phantom was the highest in <4-slice MDCT scanner> of 13.58 mGy and the $CTDI_W$ values were significantly different among scanner generations(p < 0.01). 3. When contrast medium was not used, the highest scanner was <16 slice MDCT> of $818.83\;mGy{\codt}cm$ in exposure dose in brain scan(p < 0.05). When the contrast medium was used, the highest scanner was <4 slice MDCT> and its average was $1,460.77\;mGy{\cdot}cm$(p < 0.1). 4. When the contrast medium was not used, the highest scanner was <16-slice MDCT> of $521.63\;mGy{\cdot}cm$ on average in terms of the exposure dose in chest inspection(p<0.05). when the contrast medium was used, the highest scanner was found in 8 slice MDCT scanner and its average was $1,174.70\;mGy{\cdot}cm$. There was no statistically significant difference among scanners. 5. When the contrast medium was not used, the highest scanner was <16-slice MDCT> and its average was $856.27\;mGy{\cdot}cm$ in exposure dose on the abdomen-pelvis(p<0.05). when the contrast medium was used, the highest scanner was <16-slice MDCT> and its average was $1,720.64\;mGy{\cdot}cm$ on average (p < 0.05). 6. When the contrast medium was not used, the highest scanner was <8-slice MDCT> and its average was $612.07\;mGy{\cdot}cm$ in exposure dose in liver inspection(p < 0.05). when the contrast medium was used, the highest scanner was <8-slice MDCT scanner> and its average was $2,197.93\;mGy{\cdot}cm$ in exposure dose(p < 0.1). seventy six point two percent of medical facilities were in risk of radiation exposure while the number of phase was three to four times in their dose inspection of contrast medium.

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Perception on the Nursing Accident Experience of the Nurses and Its Cause (간호사(看護師)들의 간호사고(看護事故) 경험(經驗)과 사고원인(事故原因)에 관한 지각(知覺))

  • Lee, Soon-Bok;Moon, Heui-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.2
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    • pp.246-267
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    • 1995
  • Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

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The impact of cement industry on regional change (시멘트공업이 지역에 미친 영향)

  • ;Chin, Yong-Cheol
    • Journal of the Korean Geographical Society
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    • v.30 no.1
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    • pp.16-34
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    • 1995
  • This study aims to analyze the impact of cement industry on region change. For this study Maepo-Eub was selected as study area, where three cement factories are located. The data for analysis were obtained from interviews, questionaire surveys and the employee list of each cement factory. The analytic procedures for this study are as follows: 1) The change of regional employment was analyzed by development was industry in terms of the permanent address, education level, occupational status of the employee. 2) The degree of population growth are analyzed by developmental staae of the industry. Some conclusions from this study follows: 1) As these cement factories were built at Maepo in the 1960's, there were plenty of employment opportunities. Thus many technicians and workers flooded in Maepo-Eub. in the 1970's with the expansion of production facilities therewere much more immigrants to the industrial region, while there were outflow in the neighboring rural areas. In the 1980's the opportunity for the employment of cement factories have been decreased due to the introduction of the automation processes and larger, sized machines. Among the employee of three cement factories the native of Chungcheongbukdo (65%; in them Danyang 52%, Jecheon 32%) is dominant, the second is from Kangwon-do (13%), and the third is from Kyungsangbuk-do (11%) adjacent to Chungcheongbuk-do. It means that there are more employment opportunity in the near places of cement factories. 2) In the period of 1960's study area had experineed rapid social increase in population by the development of cement industry. That is, cement industries created new job opportunities and attracted large population concentration into this area. In the period of 1970's the population of the industrial region have increased continuously, while the population of neighboring rural areas have decreased. In the period of 1980's the population of Maepo decreased steadily because of decrease of labour forces through automation and commuting. Thus in the early stage of idustrial development large population concentrated in the neighboring villages of cement factories, and formed residential areas, commercial areas and service areas. As agricultural and was encroached, rural people left their regions to live in the more convenient suburbs. 3) People engaged in cement industry think that cement industry has a favorable influence on regional development, such as creating job opportunity, raising income level, developing business and service sector, and leading high economic growth. While farmers and some people think that cement industries as a pollution causing factories have a harmful influence on regional development, sucha as injuring the crops, causing environmental pollution, and being harmful to health. If pollution problems are solved, I think Maepo will play an important role as a regional center which can offer employment opportunity, business and service function to pheripheral rural areas, and raise a income level.

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CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT (소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성)

  • Pyo, Kyung-Sik;Kang, Yun-Hyong;Bahn, Geon-Ho;Cho, Soo-Churl;Lee, Eun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.227-236
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    • 1998
  • Objectives:Conduct disorder is one of the most frequent diagnosis in outpatient and inpatient mental health facilities for children and adolescents. This study investigated the clinical characteristics of children and adolescents with conduct disorder. Methods:The study employed a retrospective review of 45 inpatients diagnosed with conduct disorder by DSM-IV criteria at SNUH Child Psychiatric Unit from 1993, March to 1998, September. Results:The results were as follows:1) The sex ratio was 2:1, male dominant. Mean age on admission was $12.8{\pm}2.4$ years old(male:$12.2{\pm}2.3$, female:$14.1{\pm}2.1$). The mean age of male subjects was significantly lower than that of female subjects(p<.05). 2) We classified all subjects according to child- or adolescent-onset type by DSM-Ⅳ. Childhoodonset type was 42.2%, and adolescent-onset, 57.8%. The onset of male subjects were significantly earlier than that of female subjects(p<.05). 3) The most common complaint was 'serious violation of rules'(77.8%) by DSM-Ⅳ dimensions, while the most common single symtom was 'run away from home overnight at least twice while living in parental or parental surrogate home'(48.9%). 4) The comorbid psychopathology of the subjects were frequently described as follows, in order of frequency:substance use(42.2%), ADHD(35.6%), depression(20.0%), tic disorder(11.1%), bipolar disorder(4.4%). 5) On MMPI, both Pd and Ma subscales got the highest scores. The mean of total IQ by KEDIWISC was $100.0{\pm}15.1$. Female subjects' IQ was higher than that of male subjects. 6) Regarding the number of visits to the OPD after discharge, many subjects(33.3%) had visited OPD fewer than four times. Conclusions:In this study, the male to female ratio of adolescent type showed a decreasing trend. An interesting finding was the fact that socio-economic circumstances, as well as the level of education among patients, were higher than those of previous studies. The subjects' problem were also principally self contered and posed no threat to others.

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The Study of Structural Relationship among the Customers' Service Recovery of Complaint and After Behavioral Intention in the Service Industry (서비스 산업에서 고객 서비스 불평 회복과 사후행동의 구조적 관계 연구)

  • Heo, Seon Hee;Youn, Chun Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.1
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    • pp.165-176
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    • 2014
  • This study is directed to examine the most useful restoration strategies for turning the customers' dissatisfaction caused by unsuccessful spa service to the satisfaction through each fair factors and tries to suggest the practical schemes to cope with complaints and dissatisfaction of spa service customers by establishing the system dealing with customers' complaints. And this verifies the relationship between the alternative attraction and the intention of conversion as the action after the restoration from the unsuccessful services. Moreover, it analyzes the mediation effect that a formation of reliance through the restoration of unsuccessful services has. To achieve the purpose of this study, the subject got decided as women who are customers of private spa facilities situated in Seoul and Gyeonggi-do region for the purpose of skin care in 1 year recently. After understanding their experiences of complaining about the services, this study investigates the alternative attraction and the intention of conversion as the next action and the perception of fairness and trust in the efforts of Spa service business for recovery. As the result of verifying hypothesis, it is shown that the recovery satisfaction increases when the 3 points of the distributive justice, procedural justice, and interactional justice, which are the fairness factors of the effort to restore services according to the quality of service, are more positive. In the relation among recovery satisfaction, trust, the alternative attraction, and the intention of conversion, the result was that recovery satisfaction affects trust in positive way and alternative attraction in negative way. However, the positive and meaningful result came out in contrast with the hypothesis which predicted the negative effect of recovery satisfaction on the intention of conversion. Furthermore, it means that indirect effectiveness which carries trust and alternative attraction should be considered instead of the direct effectiveness that the recovery satisfaction affects on the intention of conversion. In this study, it can be interpreted that the combined increase of the trust and the alternative attraction makes the intention of conversion higher rather than the higher intention of conversion following the decrease of the recovery satisfaction in view of the result that the indirect effectiveness is high between the recovery effort and the intention of conversion. In the relation among the intention of conversion, trust, and alternative attraction, the intention of conversion got influenced in positive way and negative way by trust and alternative attraction respectively and trust influenced the alternative attraction negatively as well. It means the high quality of services or the recovery of services has a direct causation which carries conviction to the customers' intention of action.

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