• Title/Summary/Keyword: Hospital Nurse

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The Effects of Organizational Politics and Conflicts on Quality of Communication among Nurses (조직 내 정치와 구성원 간 갈등이 의사소통의 질에 미치는 영향에 관한 연구: 간호조직을 대상으로)

  • Cheong, Jong One
    • Journal of Digital Convergence
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    • v.19 no.1
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    • pp.285-293
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    • 2021
  • Politics and conflicts within organizations are natural phenomena found in any type of organization, affecting organizational outcomes and output variables. Nevertheless, there are not many previous studies on politics and conflict within nursing organizations. Therefore, in this study, we would like to analyze how the internal politics and conflicts, which have been excluded from the previous studies related to nursing organizations, affect the quality of communication between nurses. Data were collected from 310 nurses in an university hospital. Using SPSS21, the data were analyzed by descriptive statistics, Pearson's correlation analysis, and multiple regression analyses. As results of the analyses, the organizational politics and relationship conflict have negative effect on the quality of vertical and horizontal communication, and task conflict has a positive effect on them. Organizational politics and relationship conflict have negative effects on quality of formal communication. Organizational politics and conflicts did not significantly affect the quality of informal communication. These results suggest that active, managerial efforts should be executed to overcome the negative effects of organizational politics and emotional conflicts among nurses. Furthermore, empirical research on organizational politics and conflicts within nurses organizations should be expanded.

Nursing Students and Clinical Nurses' Awareness of Virtual Reality(VR) Simulation and Educational Needs of VR-based Team Communication and Teamwork Skills for Patient Safety: A Mixed Method Study (간호대학생과 병원간호사의 가상현실기반 환자안전을 위한 팀 의사소통과 팀워크 기술에 대한 교육요구의 차이: 혼합연구설계)

  • Hur, Hea Kung;Jung, Ji Soo
    • The Journal of the Korea Contents Association
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    • v.22 no.1
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    • pp.629-645
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    • 2022
  • The purpose of this study is to investigate the educational needs of virtual reality(VR)-based communication and teamwork skills for patient safety intended for nursing students and nurses. For this study, mixed method design was used with surveyed data collected 60 nursing students and 123 nurses. And fourteen nurses was conducted focus group interview. SPSS/WIN 25.0 and inductive content analysis for focus group interviews were utilized for data analysis. The results indicated that the awareness of VR and educational needs of team communication, and teamwork skills were above average, and nursing students required higher educational needs than nurses. Teamwork knowledge was moderate, and there was no significant difference between the two groups. Regarding nurse's communication in hospital, 4 themes of contributing factors and 2 themes of result factors that cause communication difficulties among nurses were derived from the qualitative data. Therefore, it is necessary to develop a virtual reality-based simulation program reflecting the educational needs of nursing students and nurses in order to improve team communication and teamwork skills for patient safety required for nursing students and nurses.

The Effect of Patient-Engaged Bedside Handoffs Protocol in Comprehensive Care Units (간호·간병통합서비스 병동에서의 환자참여 침상인계 프로토콜 적용 효과)

  • Lee, Bo Young;Park, Kyung Jin;Im, Jae Hyun;Song, A Reum;Yeon, Mi Hyang;Song, Hyun Ju;Jeon, Do Jin;Baek, Kyu Won;Jang, Joo Young;Choi, Su Jung
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.3
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    • pp.223-232
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    • 2022
  • Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.

A Study on the Development of Intravenous Injection Management Application for EMR System Interworking (EMR 시스템 연동 정맥주사 관리 애플리케이션 개발에 대한 연구)

  • Jin-Hyoung, Jeong;Jae-Hyun, Jo;Seung-Hun, Kim;Won-yeop, Park;Sang-Sik, Lee
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.15 no.6
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    • pp.506-514
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    • 2022
  • This paper is about developing an intravenous injection management system that can provide nurses with information related to intravenous injection in real-time to compensate for possible instability factors during intravenous injection. The intravenous injection management system consists of an app-based user S/W and a web-based administrator S/W. User S/W is implemented to provide users with the ability to identify patients who need intravenous injection through smartphones, tablet PCs, and nursing PDAs, recognize information codes given to patients, and enter and share treatment contents and treatment items after intravenous injection. As a result of intravenous injection treatment uploaded through the user app, the manager S/W can check the records of intravenous injection treatment items, perform user management functions, emergency notification registration and management functions, and data upload functions. The implemented system has not yet been tested on the EMR system used in the actual hospital. Therefore, through further research, S/W will be optimized and actual environmental application tests will be conducted through cooperation with hospitals.

The Influences of Leisure Satisfaction and Burnout on Job Satisfaction of Clinical Nurses (임상간호사의 여가만족도와 소진이 직무만족도에 미치는 영향)

  • Lee, Tae-Kyeong;Yun, Ji-Ah;Kang, In-Soom
    • Journal of Industrial Convergence
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    • v.20 no.5
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    • pp.111-123
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    • 2022
  • The purpose of this study is to investigate the influences of leisure satisfaction and burnout on job satisfaction of clinical nurses. The Data were collected the questionnaires consisted of general characteristics, leisure-related characteristics, leisure satisfaction, and burnout, and job satisfaction. For leisure satisfaction, the relaxation factor(16.57±2.68) was the highest among the sub-domains, and physical exhaustion(23.50±3.42) was the most severe for burnout. Leisure satisfaction and job satisfaction showed a positive correlation(r=.16, p=.013), and leisure satisfaction and burnout showed a negative correlation (r=-.19, p=.003). As factors related to job satisfaction, burnout(β=-0.68, p<.001) and ER(β=-0.12, p=.014) were found, and the total explanatory power was 47.0%, of which 44.0% was burnout. The model was found to be statistically significant(F=52.26, p<.001). The results of the study were as follows, a plan to improve leisure activities and leisure satisfaction is needed to reduce burnout. Through this, we aim to help improve the quality of life of clinical nurses.

Effect of Nurse's Perception of People with Disabilities, Experience of Contact with Persons with Disabilities, and Human Rights Sensitivity on Attitudes toward Persons with Disabilities (간호사의 장애인에 대한 인식, 장애인 접촉경험, 인권감수성이 장애인에 대한 태도에 미치는 영향)

  • Ahn, Eun-young;Lee, Hye-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.39 no.2
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    • pp.205-219
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    • 2022
  • This study is a descriptive research study to understand the effects of nurses' perception of the disabled, contact experience with the disabled, and human rights sensitivity on attitudes toward the disabled. The subjects of the study were 181 nurses working at two university hospitals in D City and one university hospital in C Special Self-Governing City. Data were collected from September 2, 2021 to October 6, 2021. The collected data wre analyzed using IBM SPSS 26.0 program, and analyzed with t-test, ANOVA, Pearson's Correlation Coefficients, and Multiple Regression Analysis. Factors affecting the subject's attitude toward people with disabilities were perception of people with disabilities(t=-3.96, p<.001), presence or absence of contact with patients with disabilities(t=3.23, p=.001), and the ability to perceive responsibility among human rights sensitivity(t=2.13, p=.035), whether or not they had completed education for improvement the awareness of the disabilities(t=2.90, p=.004), and whether they were recognized of the Act on the Right to Health and Medical Accessibility for the Disabled(t=2.44, p=.016), which showed 30% of explanatory power(F=9.36, p<.001). Accordingly, it is necessary to develop an educational program that can foster nurses' attitudes toward the disabled, including awareness of the disabled, human rights sensitivity, the Health Rights Act for the Disabled, and the experience of contact with the disabled.

Effect of Senior Simulation on Geriatric Unit Nurses' Attitude and Job Satisfaction toward the Elderly (노인유사체험이 노인병동 간호사의 노인에 대한 태도와 업무만족에 미치는 영향)

  • Choi, Soowon;Park, Myonghwa
    • 한국노년학
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    • v.29 no.2
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    • pp.513-527
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    • 2009
  • The purpose of this study was to verify the effect of senior simulation on geriatric unit nurses' attitude and job satisfaction toward the elderly with one group pretest-posttest design. The subjects of this study were the 30 nurses who are working in geriatric units in a general hospital in Daegu, Korea and who were well informed about the purpose of this study and allowed to join the study. The data were collected from August 23 to September 6, 2006. The experimental procedure was to do activities for daily living for 45 minutes wearing senior simulation suit. Self administered questionnaires were used to ask the nurses' attitude toward the elderly and job satisfaction in their work before, right after, and one week after senior simulation. According to the results of this study, there were significant changes in the geriatric nurses' attitude toward the elderly and job satisfaction after aging simulation implying that senior simulation is an effective intervention to facilitate nurses to do quality care for the elderly with sympathetic understanding and attitude. Senior simulation needs to be applied to geriatric education for the nursing students and health care providers who are involved in care for the elderly.

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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A Study of the Effect of Structured Rehabilitation Education on the Stress of the Family with Stroke Patients (구조화된 재활교육이 뇌졸중환자 가족의 스트레스에 미치는 영향)

  • Kim, Byung-Eun;Lee, Jung-Min;Lee, Hyang-Yeon
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.22-39
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    • 1997
  • Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

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A Study on Status of Utilization and The Related Factors of Primary Medical Care in a Rural Area (일부 농촌지역의 일차의료이용실태와 그 관련요인에 관한 연구)

  • Wie, Cha-Hyung
    • Journal of agricultural medicine and community health
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    • v.20 no.2
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    • pp.157-168
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    • 1995
  • This study was carried out, through analyzing the annual reports(year of 1973-1993) on health status of Su Dong-Myun, and specific survey data of 332 households(Su Dong-Myun 209, Byul Nae-Myun 123), located in Nam Yang Ju-Si, Kyung Gi-Do, from July 20 to July 31, 1995, to find out more effective means for primary medical care in a rural area. The results were as fellows : 1. Number of population in Su Dong-Myun was 5,419 in 1973, 4,591(the lowest) in 1987 and 5,707 in 1995. In the composition rate of population, "0-14" of age group showed markedly decreasing tendency from 43.1% in 1975, to 19.1% in 1995, however "65 and over" markedly in creasing tendency form 5.3% in 1975 to 9.8% in 1995. 2. Annual utilization rate per 1,000 inhabitants in Su Dong-Myun showed markedly increasing tendency from 1973 to 1977 such as 343 in 1973, 540 in 1975, 900 in 1977. However, since 1979, the rate showed rapidly decreasing tendency, such as 846 in 1979, 519 in 1985, 190 in 1991 and 1993. 3. The morbid household rate per year was 53.6% of respondents and the rate per 15 days was 48.2%. In disease classification rate of morbid household per year, Arthralgia & Neuralgia was the highest rate(33.9%) and gastro-intestinal disorder(19.3%), Cough(11,9%), Hypertension(7.8%), Accident(3.2%) in next order. 4. In the utilizing facilities for Primary Medical Care, Medical facilities was showed the highest rate(58.1% of respondents) and Pharmacy and Drug Shp(33.1%), Tradition Method(4.0%) in next order. In the Medical facilities, General private clinic was showed the highest rate(34.3%) and specific private Clinic(22.3%), Hospital(19.0%), Health (Sub)center(16.3%), Nurse practitioner (3.3%), Oriental hospital and clinic(2.7%) in next order. 5. Experience rate, utilizing health subcenter was 51.8% of the respondents, and it was 55.0% in Su Dong-Myun and 46.3% in Byul Nae-Myun. In utilization times of health subcenter, times-rate showed next orders such as 1-2 times/6months(31.6%), 1-2 times/year (22.1%), 1-2 times/months(19.2%), 1-2 times/3months(15.6%). 6. In objectives, visiting Health Subcenter, Medical Care was the highest rate(59.8% of the respondents) and health control(23.3%) was in next order. In Medical Care, Primary Care by general physician was higher rate(51.1%) almost all. In the Health control, Immunization too was high rate(18.0%) in health control activities. 7. The reasons rate, utilizing health subcenter showed next order, such as distance to Medical facilities(33.0% of the respondents), Medical Cost(28.1%), Simple process of consultation (10.8%), Effectiveness of cure(7.6%), Function of primary medical care(7.0%) and Attitude of physician(6.5%). 8. In the affecting factors to utilization of primary medical facilities, medical needs was showed the highest rate(29.5% of the respondents) and medical cost(15.4%), distance to medical facilities(14.2%), traffic vehicle(14.2%) and farm work(6.9%) in next order. 9. In the priority between 'daily farm work,' and 'primary medical care', only 46.4% of respondents answered that primary health care is more important than the daily farm work The 22.6% of respondents answered 'daily farm work', and the 12.3% answered 'the equal of the both'. 10. In the criterion of medical facilities choice, medical knowledge and technical quality was showed the highest rate(56.3%), distance or time to medical facilities(10.9%), sincerity and kindness of physician(9.4%), medical cost(8.7%) and traffic vehicle(6.5%) in next order 11. In the advise for improvement of health subcenter function, the 36.1% of respondents answered that 'enforcement of medical personnel and equipment' was required, and then 'improved medical technology'(25.5%), 'good attitude of physician'(14.9%), 'improved medical system'(13.3%), 'enforced drug'(6.7%) in next order. 12. The study on affecting factors to utilization of primary medical facilities was very difficult subject to systematize the analyzed results, due to a prejudice of protocol planner, surveyer and respondent, and variety and overlapping of subject matter.

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