• Title/Summary/Keyword: Health service quality

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Effective Customer Risk Management at the Nuclear Medicine Department: Risk Managemont MOT Development Application and Producing Public Relations Film (핵의학과 내에서의 효과적인 고객위험관리: 위험관리 응대 MOT 개발적용 및 홍보동영상 제작)

  • Ham, Jong-Hum;Hwang, Jae-Bong;Kim, Joon-Ho;Lee, Gui-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.110-122
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    • 2009
  • Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.

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Factors Affecting Use Satisfaction of Medical Institutions on Korean Society Adaptation of the Multicultural Families' Woman (다문화 가정 여성의 한국 사회 적응도가 의료기관 이용과정 만족도에 미치는 영향)

  • Choi, Sung-Suk;Yun, Hyun-Kyuong;Choi, Gyu-Yil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5875-5881
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    • 2012
  • Research objectives: This research is focused on the multicultural families based on the existing studies. The problems that the women of the multicultural families experience in this society were studied, in relation to the adaptability to Korea by identifying the elements related to the use of and satisfaction level towards medical institutions. As such, this research is expected to be used as a data that can help to provide quality medical service to the women of the multicultural families. Research method: 188 women of the multicultural families were targeted to carry out research by conducting interview and by leveraging translated survey questionnaire. Then, SPSS 18.0 program was used to conduct statistical analysis. As for the analysis methods, frequency analysis, technical statistics, ANOVA and multiple regression analysis method were used. The results of the research were as follows. First, for the satisfaction level towards medical institutions for each class following each nation, Vietnam manifested highest satisfaction level when it comes to the public sanitation clinic, followed by the Philippines and China in the order listed. Meanwhile, Japan manifested the lowest satisfaction level. In case of the Asian medicine hospital, Japan manifested the highest satisfaction level contrary to the public sanitation clinic, followed by Philippines and China in the order listed. Meanwhile, Vietnam manifested the lowest satisfaction level. Second, 'satisfaction level towards nationality, education level, income, degree of adaptation and access to the medical institutions via transportation,' degree of adaptation towards the Korean society was manifested as an influential variable. As the degree of adaptation towards the Korean society increased, satisfaction level towards the degree of access to the medical institutions via transportation was proven to be high. Third, 'Nationality, education, income, hospital administration to help adapt the level of satisfaction' income if the first 1,5 million to 2,0 million won that low satisfaction than from 1 million to 1,5 million won and Higher of Korean society to adapt was higher Hospital Administrationon the level of satisfaction Conclusion: Nationality, education level, income, degree of adaptation towards the Korean society affect satisfaction level towards medical institutions. To increase the elements that increase the satisfaction level towards the medical institutions, multi-dimensional approach by each nationality, education level and income is required. In particular, it would be considered necessary to increase the level of adaptability to Korea.

A Survey on the Satisfaction of Middle School Students with School Meals and Their Food Preferences (일부 중학생의 학교 급식 만족도 및 기호도 조사 연구)

  • Kim, Ju-Hee;Kim, Hyung-Sook
    • The Journal of the Korea Contents Association
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    • v.16 no.5
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    • pp.488-496
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    • 2016
  • A survey of the satisfaction of school meals and food preferences was conducted with an objective to enhance the quality of food service. The study conducted a survey for 292 middle school students (152 boys and 140 girls), who were either in $1^{st}$ or $2^{nd}$ year. According to the general information, the number of $1^{st}$ and $2^{nd}$ year students was 134 and 158, respectively. Usually, the mother (92.8%) prepared meal the most, followed in order by the grandmother (5.8%) and father (1.4%). The top priorities of choosing food were taste (82.9%), good for health (6.5%), nutritional value (4.5%), and flavor (3.1%). The satisfaction was investigated using a 5 point scale. The satisfaction of taste was rice ($3.99{\pm}0.74$), side dishes ($3.99{\pm}0.65$), soup ($3.61{\pm}0.86$), kimchi ($3.54{\pm}1.12$). The satisfaction of quantity was rice ($3.88{\pm}0.83$), soup ($3.87{\pm}0.79$), kimchi ($3.80{\pm}0.89$), and side dishes ($3.71{\pm}0.93$). The satisfaction of diversity was side dishes ($4.09{\pm}0.67$), rice ($4.01{\pm}0.77$), soup ($4.01{\pm}0.64$), kimchi ($3.84{\pm}0.86$). For food preferences, the noodle was ranked highest while vegetables showed the lowest. Overall, support will be needed to develop diverse menus for students. This study suggests the need for active nutrition education for establishing proper eating habits.

The Effect of the Use of Social Welfare Services on Psychosocial Adjustment Among Poor Children (사회복지서비스 이용이 빈곤아동의 심리사회적 적응에 미치는 영향)

  • Chung, Ick-Joong;Kim, Hye-Lan;Hong, Soon-Hae;Park, Eun-Mie;Huh, Nam-Soon;Oh, Jeong-Soo
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.105-131
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    • 2005
  • This study intended to understand how the use of social welfare services and the satisfaction from the use affect poor children's psychosocial adjustment. Especially, it focused to find out whether the use of satisfied services has an independent effect on poor children's psychosocial adjustment when other relevant variables are controlled. Participants are 904 poor children from 16 nationwide cities/provinces who receive financial sponsorship from Korea Welfare Foundation in cooperation with the Ministry of Health and Welfare. Among them, 8.2% is from youth-headed homes, 22.7% is from grandparent-care homes, 8.2% is from relative foster homes, 1.8% is from non-relative foster homes and 59.1% is from other poor families. The results of this study are as follows: 1) According to MANOVA, poor children who received 2 or more satisfied social welfare services are significantly different from those who received 1 or no service in their combined psychosocial adjustment subcategories. Delinquency among the subcategories is the most influencing variable in combined differences. 2) Controlling sex, age, family structure and other variables that are considered to be related to delinquency in previous research, the use of satisfied services is still the significant variable in decreasing delinquency among poor children. 3) Interaction effect between the use of satisfied services and parental supervision was statistically significant. Under the low level of parental supervision, the use of satisfied services has a significant effect on the decrease of delinquency. However, under the high level of parental supervision, the use of satisfied services has little effects. From these results, we found out that the use of satisfied social welfare services is a very significant factor influencing to prevent or decrease delinquency among poor children. Also we found out that it is critically important for poor children who receive the low level of parental supervision to have good-quality social welfare services in order to prevent delinquency.

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consumers' purchasing behavior of functional cosmetics and Inula based functional cosmetics merchandising research (국내 소비자의 기능성화장품 구매행태 및 선복화 활용 기능성화장품 상품화를 위한 연구)

  • Han, Do-Kyung;Lee, Hyun-Jun;Lee, Eun-Hee;Paik, Hyun-Dong;Shin, Dong-Kyoo;Park, Dae-Sub;Hwang, Hye-Seon;Hong, Wan-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.236-250
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    • 2016
  • This study was conducted to provide baseline data regarding functional cosmetics so that Inula. based cosmetics can increase its competitiveness in the market as well as to understand current trends to enable anticipation of demands for future product development. For this research, general consumers over the age of 20 residing in Seoul and the Gyeonggi district were surveyed. The results show consumers preferred serum-type products among various types of cosmetics, and that they purchased these once every 1-3 months. Consumers also preferred these products in less than 10-30ml capacity, and at costs of less than 30,000-50,000 KRW. For whitening, functional cosmetics consumers also preferred the serum type, in less than 30-50ml capacity and priced less than 30,000-50,000 KRW. Consumers preferred to purchase functional cosmetics in single units. The major purchasing location, with a high preference rate, was cosmetic stores, and the major sources of information, also with high preference rates, were 'experienced reviews from family, friends and acquaintances' and 'TV advertisements'. Respondents selected 'over 50,000 KRW' the most for all items when responding to 'Purchase Intent for Functional Cosmetics containing Inula', and responded that they were willing to pay 10%-30% more for functional cosmetics containing Inula compared to standard functional cosmetics. These results show that businesses in the cosmetics industry need to take consumer demand into account when developing new functional cosmetic products, as well as establish plans to create specialized spaces that provide better quality service and increase word of mouth effect through better utilization of various types of offline media, social media, and blogs. The study also shows a need for businesses to develop products fully utilizing the Inula flower, which has been shown to be effective as a natural skin whitener, wrinkle reducer and skin moisturizer, to appeal to the increasing number of customers interested in health and beauty.

Effect of Cattle Manure Application on Mineral Contents of Glazing Pasture (방목 초지에서 우분퇴비 시용이 목초의 무기성분 함량에 미치는 영향)

  • Hwang, Kyung-Jun;Park, Hyung-Soo;Park, Nam-Geon;Jeong, Ha-Yeon;Ko, Moon-Suck;Kim, Moon-Chul;Song, Sang-Teak;Kim, Dae-Woon
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.29 no.1
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    • pp.37-42
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    • 2009
  • This experiment was conducted to investigate the effect of cattle manure application on macro contents change in pasture. The treatment consisted of T1: 100% chemical fertilizer (CF 100%), T2: 50% CF+50% cattle manure (CM), T3: 25% CF+75% CM, T4: 100% CM 100%, T5: 100% CM(1st year (yr.) +100% CF (2nd yr.)+100% CM (3rd yr.), T6: 100% CM (1st yr.)+100% CF (2nd yr.)+100% CF (3rd yr.). The highest substitution effect of chemical fertilizer with cattle manure indicated by the highest yield of 11,169 kg/ha was obtained from the application of 100% CM (1 yr.) + 100% CF (2 yr.). The forage yield of plots applied with 100% CM (1 yr.) + 100% CF(2 yr.) was only 4% more than the yield of plots applied with 100% CM. It was only 3% less than the yield of plots applied with 100% CF. In this study, cattle manure application recorded slightly lower forage dry matter (DM) yield than 100% CF application but they were statistically comparable on the third year of production. The all treatments have narrow range of P, K, Ca, Mg and Na contents $0.25{\sim}0.32%,\;3.08{\sim}3.71%,\;0.42{\sim}0.55%,\;0.21{\sim}0.38%$ and $0.08{\sim}0.15%$.

Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field (치과임상영역에서 발생된 의료분쟁의 판례분석)

  • Kwon, Byung-Ki;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Kim, Chong-Youl;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.283-296
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    • 2006
  • Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours (병원 간호사의 선호근무시간대에 관한 연구)

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
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    • v.36 no.1
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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Problems in the Korean National Family Planning Program (한국가족계획사업(韓國家族計劃事業)의 문제점(問題點))

  • Hong, Jong-Kwan
    • Clinical and Experimental Reproductive Medicine
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    • v.2 no.2
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    • pp.27-36
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    • 1975
  • The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

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