• Title/Summary/Keyword: Information anxiety

검색결과 723건 처리시간 0.034초

정신건강의학과 자문 의뢰된 암 환자의 항우울제 내약성 비교 연구 (Comparison of Antidepressants Tolerability in Cancer Patients Referred for Psychiatric Consultation)

  • 고은미;박진성;하주원;임세원;김태석;하지현;백종우;이병철;최병무;이강준;김성완;양종철;고영훈;오강섭
    • 정신신체의학
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    • 제21권1호
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    • pp.3-10
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    • 2013
  • 연구목적 암환자들은 다양한 정신건강의학과적 증상을 겪으며 약물 부작용에 취약하다. 본 연구는 정신건강의학과 자문 의뢰된 암환자에서 항우울제의 내약성을 비교하고자 한다. 방 법 9개 대학병원 및 종합병원 정신건강의학과에 자문 의뢰된 암 환자들을 후향적으로 검토하여 자료를 분석하였다. 가장 빈번하게 처방된 세가지 항우울제(Escitalopram, Mirtazapine, Paroxetine)의 6개월 동안 치료 중단율을 비교하였다. 결 과 처방 빈도는 Escitalopram 150(47.2%), Mirtazapine 92(28.9%), Paroxetine 76(23.9%) 순서로 항우울제 투여 중단 비율은 세군 간 유의한 차이가 없었다. 입원 환자에 비해 외래 환자에서 유의하게 약물 중단 위험도가 높았다(p<0.0001). 결 론 임상 현장에서 암환자의 항우울제 치료 중단율은 약물 종류에 따라 차이가 없었다. 치료 순응도 향상을 위하여 암환자의 특성을 고려한 개별 접근이 필요할 것이다.

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사회적 기술 부족과 충동성으로 인해 또래갈등이 심한 분교아동의 상담사례 (Counseling Case Study of a Child with Peer Confliction due to Lack of Social Skills and Impulsiveness)

  • 이인선
    • 초등상담연구
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    • 제5권1호
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    • pp.227-253
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    • 2006
  • It seems common for students living at a small county and islands to experience psychological conflicts and be unaccustomed in the peer society because they are not familiar with peer interaction and social skills. This is a case study of L (hereinafter called L) who was grown up in the sheltered school at a small county. L was psychologically disturbed because he couldn't get along well in the transferred school. It is the reason why he had lived in the sheltered school at a small county, so he had not enough exposure to interact with peer and social skills. Sometimes he was obstinate irrationally and when he had trouble with friends, he threw something out or went out of school and tricked juniors dangerously. The fact of disperse with families, parent's indifference, and hate of older brother made L to have ill feeling against family. He had low motivation and low self confident in learning because of short attention time and accumulated poor learning progress. In this study, he was evaluated at various area, such as, intelligent, affective, personal and inter-personal, before counselling. To evaluated the effect of the counselling, K-WISC-III, KPRC, sentence filling test, social adaptation ability test, etc, were administered right after the counselling was over and 8 weeks later. For specific information gathering and analysing, observation diary and deepen counselling were accomplished by homeroom teacher, his mother, and his peers. To correct his problematic behaviors, 13 counseling sessions were accomplished for 6 months and those counselling sessions were recorded and analysed definitely. Followings are the result of this case study. First, he was recovered from the anxiety of inter-personal interaction and he started to interact with peers. The result of sac scale score of KPRC profile was lower than before as much as average student after counseling and 8 weeks later. This reveals that the distress against interpersonal relation have settled. Especially, through the result of sentence filing test, he seemed to feel attachment to peers and be positive, active in the relation of peer. For instance, he was active in the open class lesson and interacted well with peers. It could be said that he overcame the psychological distress comparing with previous time. Second, he could apologize to his peer and juniors for his fault. His attitude were well shown in the letter from an old friend at the sheltered school, average KPRC profiling score comparing with previous counseling time, and remarkable decrease of attack scale score of teacher and peer. Third, his view toward family turn out positive. He recognized his situation that he lived apart from family and even worried about his parent's financial difficulty. Through solving the confliction with his older brother, he could acquire the feeling of family reunion. Fourth, his learning motivation and self-confidence were increased. He confirmed his future positively and he might be judged more attentive because his intelligence index was higher than before as much as average student. With the main goal of this study, verification for effectiveness of counseling. understanding and helping problematic students such as L who lives at a small county and island through investigation of their real situation and problems with the method of counseling and socio-cultural analysis is worthwhile. Identification of ideal relationship with peer is related with positive self-conception, harmonic social adaptation and development of child. It is time to investigate easy adaptive in classroom and well-organised program to acquire general social skills for sheltered school students at a small county and islands.

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신생아 중환자실에 입원한 환아 어머니의 스트레스 (A Study on the Perceived Stress Level of Mothers in the Neonatal Intensive Care Unit Patients)

  • 김태임
    • Child Health Nursing Research
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    • 제6권2호
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    • pp.224-239
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    • 2000
  • This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's α coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

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암환자의 희망 예측요인 (Predictive Factors of Hope in Patients with Cancer)

  • 이화진;손수경
    • 성인간호학회지
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    • 제12권2호
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    • pp.184-195
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    • 2000
  • It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

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폐쇄성 수면무호흡증 환자에서 일주기 리듬 특성에 따른 주간 졸음과 우울감의 차이 (Morningness-Eveningness Affects the Depressive Mood and Day Time Sleepiness of Obstructive Sleep Apnea Syndrome Patient)

  • 김성호;주은정;이규영;구영진;김의중
    • 수면정신생리
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    • 제19권2호
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    • pp.77-83
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    • 2012
  • 목 적: 저녁형일수록 우울해지기 쉽다는 경향성이 일반 인구집단이 아닌 폐쇄성 수면무호흡증 환자들에서도 동일하게 나타나는지를 알아보고, 수면다원검사를 통해 획득한 데이터와 상황별 졸음 평가지 등을 통해 얻은 자료 중 저녁형일수록 증가되는 항목과 우울할수록 증가되는 항목을 알아보고자 하였다. 방 법: 2008년 1월 1일부터 2011년 2월 18일까지 을지병원 수면장애 클리닉에 내원한 환자들 중 수면다원검사를 통해 OSA로 진단받은 환자 211명을 대상으로 인구학적 자료와 신체 계측 자료를 얻었으며, 상황별 졸음 평가지(ESS). 아침형-저녁형 설문지(HOQ), 한국판 기분상태척도(K-POMS), 수면다원검사를 통해 얻은 자료를 분석하였다. 일원배치 분산분석을 통해 아침형군과 저녁형군, 중간형군 별로 인구학적 자료 및 신체계측자료, 수면다원검사 자료에 대한 평균값 비교를 시행하였다. 이후 연령과 체중을 보정하여 인구학적 자료 및 신체계측자료, 수면다원검사 자료들간의 편상관분석을 시행하였다. 또한 연령과 체중을 보정한 공분산분석을 통해 아침형군과 저녁형군, 중간형군 별로 각각의 인구학적 자료 및 신체계측자료, 수면다원검사 자료에 대한 평균값 비교를 시행하였다. 결 과: 나이와 체중을 보정한 편상관분석에서 HOQ점수에 따라 저녁형일수록 K-POMS, POMS-T, POMS-D, POMS-A, POMS-F, POMS-C 점수가 상승되는 경향이 나타났다. 반대로 아침형일수록 POMS-V, AHI, respiratory arousal index, snore time(%)이 증가되는 경향이 나타났다. 또한 우울할수록 POMS 총점과 POMS-T, POMS-A, POMS-F, POMS-C, sleep latency, stage 2 sleep(%)가 증가되는 경향성이 나타나고, 우울할수록 HOQ점수가 낮아지므로 저녁형이며, 우울할수록 stage 1 sleep(%), AHI, TAI, respiratory arousal index, 목 둘레가 감소된다고 생각할 수 있다. 공분산 분석을 통해 나이와 체중을 보정한 뒤 아침형, 중간형, 저녁형 사이에 유의한 차이가 있는 항목은 K-POMS, POMS-T, POMS-D, POMS-F, POMS-C, spontaneous arousal index이다. 결 론: 폐쇄성 수면무호흡증 환자에서도 일반인구집단에서처럼 저녁형일수록 우울한 경향성이 나타난다. 이러한 경향성은 주간 졸음 등과는 무관하며, 무호흡의 심각도와도 관련성이 적은 것으로 생각할 수 있다. 그러므로 폐쇄성 수면무호흡증 환자를 평가할 때 무호흡의 심각도를 평가하는 것과는 별도로 아침형-저녁형의 일주기리듬을 확인하고 저녁형인 경우 환자의 우울감에 대한 추가적인 접근을 하는 것이 의미가 있을 것으로 생각된다.

미세먼지로 인한 자전거 이용객의 야외활동 인식변화에 관한 연구: 사회네트워크분석을 중심으로 (A Study on Perception Change in Bicycle users' Outdoor Activity by Particulate Matter: Based on the Social Network Analysis)

  • 김보미;이동근
    • 환경영향평가
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    • 제28권5호
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    • pp.440-456
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    • 2019
  • 본 연구는 미세먼지에 대한 야외활동의 위험인식의 논란에 따른 미세먼지 우려의 본질을 파악해보고자 미세먼지의 노출로 건강에 영향을 많이 받는 자전거 커뮤니티를 대상으로 카페글과 댓글을 수집하여 분석하였다. 그 결과 첫째, 정부에서 주도한 미세먼지 정책은 매 시기별로 견고해지고, 세분화되고 있었지만 자전거 커뮤니티 내에서의 미세먼지 위험인식은 시간흐름에 따라 논의가 활성화되고, 심각해지고 있었다. 둘째, 미세먼지 우려로 인한 야외활동 인식변화를 분석한 결과 자전거 커뮤니티 회원들은 날씨 변수보다 미세먼지 등급에 따라 야외활동 여부가 달라지는 양상을 보였다. 또한 국내 미세먼지 수치나 마스크 성능에 대한 불신과 맞물리면서 일상생활과 건강에 심각한 위협을 주는 공포의 대상으로 변화되고 있었다. 궁극적으로 이러한 미세먼지 위험인식은 주로 야외에서 즐겼던 자전거활동 일부를 실내공간으로 이동하게 하였다. 하지만 경관, 사람, 날씨 등 야외에서 다양한 요소들을 누리며 즐겼던 자전거활동에 비해 단조로운 실내 자전거운동은 헬스, 요가 등의 다른 실내운동 유형으로 전환되고 있었다. 종합적으로 살펴보면 미세먼지에 대한 자전거 이용객의 위험인식이나 야외 자전거활동의 인식변화는 정부나 지자체 등에서 제공하는 미세먼지 농도수치의 정확성, 중국영향, 국내 어플리케이션 신뢰성, 마스크 성능, 미세먼지 농도 제시방법(숫자제시형, 점적 데이터 제공) 등 정책 불신과 검증되지 않는 과도한 정보 오류로 인한 논란이 가장 큰 역할을 하고 있는 것으로 도출되었다. 따라서 모든 계층을 아우르는 종합적 사회방안이나 정부주도형 미세먼지 정책을 제시하기보다 자전거 이용객들의 눈높이에서 미세먼지로 인한 건강상의 위험을 인지하는 것이 필요하다. 또한 총체적 유기적으로 미세먼지를 인식하도록 돕는 체감형 위험 커뮤니케이션이나 교육 및 홍보과정이 선행되어야 하고, 단계별 토의를 통한 사회적 합의와 함께 향후 야외활동 유형별로 세분화된 체계적 연구가 추진되어야할 것으로 판단된다. 이에 따라 본 연구는 정부와 지자체, 언론, 국민들의 효과적인 커뮤니케이션 방향 모색을 위한 학술적 근거로 제공될 수 있을 것으로 기대된다.

강직성 척추염 환자에 대한 12주간의 가정기반 운동 프로그램의 효과 (Effects of 12 weeks of home-based exercise program in patients with ankylosing spondylitis)

  • 조경환;전유나
    • 한국응용과학기술학회지
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    • 제38권3호
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    • pp.771-785
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    • 2021
  • 이 연구는 강직성 척추염 환자를 대상으로 12주간의 가정기반운동(home-based exercise) 프로그램을 수행하여 환자 특성별 염증관련 혈액지표, 관절가동범위, 통증척도 및 심리적인 지표 세부적이고 종합적으로 제공하고자 수행되었다. 연구의 목적을 위해 강직성 척추염을 진단받은 환자 10명을 선정하여 연령별(30대 vs. 40대 vs. 50대), 성별(남성 vs. 여성) 및 유병기간(5년 미만 vs. 5년 이상)으로 구분하였다. 가정기반 운동 프로그램은 유산소운동과 필라테스 기반 저항성 운동의 복합운동 형태로 최대심박수(maximal heart rate, MHR)의 50-70% 강도에서 주 4회, 12주 동안 수행되었다. 연구결과, 12주간의 가정기반운동 중재 후 강직성 척추염 환자의 혈중 CRP (C-reactive protein) 농도가 감소됨으로써 (-35.6%, p=.017) 혈중 염증 수치가 개선되었으며, 각 관절(고관절, 허리, 경추)의 가동성이 향상되었다(p<.05). 또한 질병활성도(Bath ankylosing spondylitis disease activity index, BASDAI)는 -67%(p=.005), 시각통증지표(Visual analogue scale, VAS)는 -64.8%(p=.005) 감소됨으로써 강직 및 통증이 전반적으로 완화되었다. 특히, 우울 정도가 -65.5%(p=.005), 불안 정도는 -55.2%(p=.008) 감소됨으로써 12주간의 가정기반운동은 신체적 변화 뿐 아니라 심리적인 요인도 개선 시켜주는 것으로 나타났다. 반면, 강직성 척추염 환자의 연령, 성별, 유병기간에 따른 운동 효과 차이는 나타나지 않았다(p>.05). 따라서 이 연구에서 적용된 12주간의 가정기반운동이 환자 특성과 상관없이 강직성 척추염 환자에게 보편적으로 사용될 수 있는 효과적인 운동프로그램이 될 수 있을 것으로 사료된다.

치위생(학)과 학생이 지각한 비대면 시험의 공정성, 시험 불안 및 학교 신뢰 간의 구조적 관계 (Structural relationship among justice of non-face-to-face exam, trust, and satisfaction with university)

  • 김형미;김창희;김정희
    • 대한치위생과학회지
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    • 제6권1호
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    • pp.37-50
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    • 2023
  • 연구배경: 본 연구는 치위생학과 학생들이 지각한 비대면 시험의 공정성과, 시험 불안 및 학교 신뢰간의 구조적 관계를 분석하고자 한다. 연구방법: 치위생학과 학생 267명을 대상으로 설문조사를 하였다. 조사항목은 일반적 특성과 평가에 대한 의견, 비대면시험의 공정성(분배 공정성, 절차 공정성, 상호작용 공정성), 학교 만족도, 학교 신뢰도 등으로 구성하였다. 통계분석은 독립표본 t검정과 일원배치분산분석, 구조모형분석을 하였다. 연구결과: 비대면 시험에서 학교만족도와 신뢰도에 직접적인 영향을 미치는 요인은 상호작용 공정성(β=.401, p<.001)과 분배공정성(β=.232, p=.002)이 높을수록 학교에 만족하였으며, 학교 만족도(β=.606, p<.001)와 절차공정성(β=.299, p<.001)이 높을수록 학교를 신뢰하였다. 학교신뢰도에 간접적인 영향을 미치는 요인은 상호작용공정성(β=.243, p=.010), 분배공정성(β=.141, p=.010)이었다. 학교만족에 영향을 미치는 요인은 상호작용 공정성(β=.592, p=.010), 분배 공정성(β=.208, p=.010)이며, 학교 신뢰도에 영향을 미치는 요인은 학교만족도(β=.56, p=.010), 상호작용 공정성(β=.332, p=.010), 절차 공정성(β=.229, p=.010), 분배 공정성(β=.116, p=.010)이었다. 결론: 비대면 시험에 대한 정보를 학교 또는 교수들이 충분히 제공하며, 시간을 들여 노력했을 때 정당한 성적을 받을 수 있도록 올바른 절차로 시행해야 학교를 신뢰하고 학교에 대해 만족할 수 있다. 학생들이 학교를 신뢰할 수 있는 공정한 비대면시험을 위한 다양한 콘텐츠 개발에 기초자료를 제공하고자 한다.

종합병원 입원환자의 공간사용 및 프라이버시 만족도 (Space Usage and Satisfaction with Privacy in General Hospital Inpatients)

  • 최인영;박혜경
    • 한국과학예술포럼
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    • 제36권
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    • pp.391-400
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    • 2018
  • 병원건축에서 사용자중심의 치료환경을 위해서는 효율성 및 경제성을 우선한 기능적 측면에서의 접근이 아닌 사용자의 심리·행태적 요구의 반영이 필요하다. 신체적 정신적으로 유약한 상태인 환자의 경우 익숙하지 않은 환경 속에서 심리적 압박감을 경험하게 된다. 그러나 선행연구 대부분이 물리적 환경에 대한 평가에만 주목하고 있어 병원이라는 특수한 환경에서의 환자들의 불안, 스트레스와 같은 심리·행태적 접근은 미흡한 실정이다. 이에 본 연구는 종합병원 입원환자를 대상으로 주요 공간의 공간사용 및 프라이버시 만족도를 살펴보았다. 이는 물리적, 행태·심리적 측면의 복합적 측면에서의 사용자중심 종합병원 디자인을 위한 기초자료를 제공하는데 의의가 있다. 연구를 위해 문헌연구와 현장조사, 설문조사를 진행하였다. 종합병원의 주요 기능공간과 병원프라이버시에 대해 고찰하고, 현장조사를 실시하여 조사대상의 계획현황을 파악하였다. 그리고 설문조사를 통해 기능 공간의 이용도 및 만족도, 프라이버시 만족도를 조사하였다. 연구결과는 다음과 같다. 첫째, 공간 이용도의 경우 전반적으로 보통 정도로 평가하였으며, 병실 및 로비를 일상적 공간으로 사용하는 것으로 나타났다. 연령별로 40대의 이용도가 가장 높으며 30대 이하의 경우 상대적으로 낮게 나타났다. 둘째, 공간 만족도는 보통 이상으로 만족하는 것으로 나타났으며, 특징적으로 디자인 된 로비공간에 대한 만족도가 가장 높게 나타났다. 사례별로는 수평적 전원형으로 계획하여 보다 넓은 면적을 확보한 B사례의 만족도가 높게 나타나 차이를 보였다. 셋째, 병원프라이버시의 경우, 보통수준으로 만족하는 것으로 나타났으며, 상대적으로 프라이버시 요구가 높은 반면 획득 수준이 낮음을 알 수 있었다. 그리고 프라이버시 만족도가 병원 전체 만족도에 영향을 미치는 중요한 요소임을 알 수 있었다.

Exploring the Role of Preference Heterogeneity and Causal Attribution in Online Ratings Dynamics

  • Chu, Wujin;Roh, Minjung
    • Asia Marketing Journal
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    • 제15권4호
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    • pp.61-101
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    • 2014
  • This study investigates when and how disagreements in online customer ratings prompt more favorable product evaluations. Among the three metrics of volume, valence, and variance that feature in the research on online customer ratings, volume and valence have exhibited consistently positive patterns in their effects on product sales or evaluations (e.g., Dellarocas, Zhang, and Awad 2007; Liu 2006). Ratings variance, or the degree of disagreement among reviewers, however, has shown rather mixed results, with some studies reporting positive effects on product sales (e.g., Clement, Proppe, and Rott 2007) while others finding negative effects on product evaluations (e.g., Zhu and Zhang 2010). This study aims to resolve these contradictory findings by introducing preference heterogeneity as a possible moderator and causal attribution as a mediator to account for the moderating effect. The main proposition of this study is that when preference heterogeneity is perceived as high, a disagreement in ratings is attributed more to reviewers' different preferences than to unreliable product quality, which in turn prompts better quality evaluations of a product. Because disagreements mostly result from differences in reviewers' tastes or the low reliability of a product's quality (Mizerski 1982; Sen and Lerman 2007), a greater level of attribution to reviewer tastes can mitigate the negative effect of disagreement on product evaluations. Specifically, if consumers infer that reviewers' heterogeneous preferences result in subjectively different experiences and thereby highly diverse ratings, they would not disregard the overall quality of a product. However, if consumers infer that reviewers' preferences are quite homogeneous and thus the low reliability of the product quality contributes to such disagreements, they would discount the overall product quality. Therefore, consumers would respond more favorably to disagreements in ratings when preference heterogeneity is perceived as high rather than low. This study furthermore extends this prediction to the various levels of average ratings. The heuristicsystematic processing model so far indicates that the engagement in effortful systematic processing occurs only when sufficient motivation is present (Hann et al. 2007; Maheswaran and Chaiken 1991; Martin and Davies 1998). One of the key factors affecting this motivation is the aspiration level of the decision maker. Only under conditions that meet or exceed his aspiration level does he tend to engage in systematic processing (Patzelt and Shepherd 2008; Stephanous and Sage 1987). Therefore, systematic causal attribution processing regarding ratings variance is likely more activated when the average rating is high enough to meet the aspiration level than when it is too low to meet it. Considering that the interaction between ratings variance and preference heterogeneity occurs through the mediation of causal attribution, this greater activation of causal attribution in high versus low average ratings would lead to more pronounced interaction between ratings variance and preference heterogeneity in high versus low average ratings. Overall, this study proposes that the interaction between ratings variance and preference heterogeneity is more pronounced when the average rating is high as compared to when it is low. Two laboratory studies lend support to these predictions. Study 1 reveals that participants exposed to a high-preference heterogeneity book title (i.e., a novel) attributed disagreement in ratings more to reviewers' tastes, and thereby more favorably evaluated books with such ratings, compared to those exposed to a low-preference heterogeneity title (i.e., an English listening practice book). Study 2 then extended these findings to the various levels of average ratings and found that this greater preference for disagreement options under high preference heterogeneity is more pronounced when the average rating is high compared to when it is low. This study makes an important theoretical contribution to the online customer ratings literature by showing that preference heterogeneity serves as a key moderator of the effect of ratings variance on product evaluations and that causal attribution acts as a mediator of this moderation effect. A more comprehensive picture of the interplay among ratings variance, preference heterogeneity, and average ratings is also provided by revealing that the interaction between ratings variance and preference heterogeneity varies as a function of the average rating. In addition, this work provides some significant managerial implications for marketers in terms of how they manage word of mouth. Because a lack of consensus creates some uncertainty and anxiety over the given information, consumers experience a psychological burden regarding their choice of a product when ratings show disagreement. The results of this study offer a way to address this problem. By explicitly clarifying that there are many more differences in tastes among reviewers than expected, marketers can allow consumers to speculate that differing tastes of reviewers rather than an uncertain or poor product quality contribute to such conflicts in ratings. Thus, when fierce disagreements are observed in the WOM arena, marketers are advised to communicate to consumers that diverse, rather than uniform, tastes govern reviews and evaluations of products.

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