• 간호행정학회지
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• 제5권2호
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• pp.237-251
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• 1999

The purpose of this study is to suggest successful strategies through which the effect of the information system of a hospital can be forecasted at the nursing department. In order to set up successful strategies, in the first place, both the methods of CSF(Critical Success Factor: Rockart, 1979) and ULD(User-Led Development) method and the method suggested by the Korea Productivity Center were applied. In order to measure the improvement of nursing productivity, the Dissonance theory was used. The data were collected from 100 employees serving at the clinic department of Kwangju Patriots' and Veterans' Hospital from July 4 to July 25, 1998 with reference to all 222 cases, for sampling work; then the part of the efficiency of the treatment or management of hospital business - simplification of the process of the treatment of hospital business and reduction of the time of the treatment of hospital business were measured; and in order to forecast organizational behavior, 100 cases of organization behavior were analysed, based on the well structured, questionnaires. In order to forecast the user's organizational behavior, a tool(Ronald. 1988; Stephen, 1982: Senn, 1992: Olsen, 1980: Anderson, 1988: Kim. 1992: Cho. 1994) to measure the extent or degree of the user's recognition or understanding whose reliability coefficient is 0.63 was used: and regarding the items expected by the users concerning the convenience of the system, a tool created by Bernadett, Szajna and Richard W. Scamell(1993) whose reliability coefficient is 0.88 was used. And finally, those data were analysed, utilizing the statistical package of SPSS/PC 6.0. successful strategies are suggested as follows: 1. In order that the Kwangju Patriots' and Veterans' Hospital's purpose can be successful through its strategic, information system, the quality of its services should be elevated. and for elevating the quality of medical services, elevation of the quality of medical expertism or specialty is an important factor in determining such quality. 2. In order to make the hospital information system to be successful, the hospital's top manager should participate in the effort making it successful with helping hands of the members or personnel of the hospital. 3. In order to make users participate in the hospital information system, it is prerequisite that all nurses in a hospital should voluntarily participate in the system 4. In order to reduce the expense, the time in coping with business per duty should be reduced by 10${\sim}$33.23%. The time of the direct nursing care which added value is relatively high should be elongated in order to elevate the quality of hospital services. 5. Since the introduction and spread of the hospital information system are influenced by the duration in the experience of computer use, the user of the hospital information system should have a plan to receive well-planned computer education. Finally it is suggested that the forecast of long-term productivity through a review of the user's expectation of the system should be inspected and tested through continuous studies of its effectiveness.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권1호
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• pp.5-25
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• 2020

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners' Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion: The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

• 한국보건간호학회지
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• 제15권1호
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• pp.182-201
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• 2001

This Study has attemped to compare the health care systems of South and North Korea. There has been a wide difference in the health care System between the South and North of Korea. In this paper, I have also shown that each health care system has its own unique response to the social, political, and economic conditions of the country. Therefore the author analyzed and summarized the important difference of health care system between the South and the North of Korea as follows. 1. Compared with the Laissez-faire health care system of South Korea, North Korea has the state socialistic health care system which provide health care services to the people free of charge. And the North Korea is marking positive efforts toward the scientification and systemization of Oriental Medicine which is called Dongui-Hak in the North-on the basis of Ju-Che idea. 2. North Korea's health care system appears to be strongly geared toward extensive and preventive treatment and launched the massive sanitary propagation campaign. which have resulted in a great success. North Korea has a system of universal comprehensive care for its population. The government has a central role in planning and regulating health care. 3. The government also employs physicians, nurses, and other professionals to provide health care to patients at public expense. In North Korea, health professionals are government employees. They work for a salary and the system is funded through general taxation. 4. In the North Korea, health services area system of the cities and countre's unit is strictly conducted along with the doctor's area responsibility system. And so without referal card, patients can not use the upper-grade medical facilities. The health care delivery system of North Korea is made up of the fourth level procedue unlike South Korea. 5. General office of Oriental Medicine, Academy of Oriental Medical Science and Guidance Bureau of Oriental Medicine are established in the organization of the Department of Health in the North Korea. And nowadays much emphasis are equally placed on the Oriental Medicine as well as Western Medicine. Both South and North Korea have faced with a critical moment of developing a mutually agreeable and acceptable system of health care for the unified nation.

• Genomics & Informatics
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• 제8권4호
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• pp.206-211
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• 2010

The Fas (TNF receptor superfamily, member 6) (FAS)/FAS ligand (FASLG) interaction plays a central role in the regulation of programmed cell death. FAS and FASLG polymorphisms in promoter regions affect transcriptional activities. To investigate whether FAS and FASLG polymorphisms are associated with the development and clinical phenotypes of stroke, 2 promoter single nucleotide polymorphisms (SNPs) in FAS (rs1800682, -670C/T) and FASLG (rs763110, -844C/T) were selected and genotyped by direct sequencing in 220 stroke patients [107 ischemic stroke (IS), 77 intracerebral hemorrhage (ICH), and 36 subarachnoid hemorrhage (SAH)] and 369 control subjects. For the analysis of clinical symptoms, all stroke patients were divided into 3 clinical phenotypes according to the respective results of the National Institutes of Health Stroke Survey (NIHSS) and the Modified Barthel Index (MBI) and the presence or absence of complex regional pain syndrome (CRPS). The SNPStats, SNPAnalyzer, and Helixtree programs were used to analyze the genetic data. Multiple logistic regression models (codominant, dominant, and recessive) were used to estimate odds ratios (ORs), 95% confidence intervals (CIs), and p-values. The promoter SNP rs1800682 was associated with stroke in the codominant (OR=0.48, 95% CI=0.25-0.94, p=0.04) and dominant models (OR=0.51, 95% CI=0.30-0.87, p=0.011). However, a FASLG SNP (rs763110) was not in Hardy-Weinberg equilibrium (p<0.05). In the analysis of stroke types, rs1800682 was associated with IS in the codominant (OR=0.30, 95% CI=0.12-0.74, p=0.025), dominant (OR=0.44, 95% CI=0.23-0.88, p=0.018), and recessive models (OR=0.45, 95% CI=0.21-0.99, p=0.042). The genotype frequencies of rs1800682 were different between ICH and controls in the dominant model (OR=0.49, 95% CI=0.26-0.94, p=0.031) but not between SAH and controls. In the analysis of clinical symptoms, however, rs1800682 was not related to the 3 clinical phenotypes (NIHSS, MBI, and CRPS). These results suggest that a promoter SNP (rs1800682, -670C/T) in FAS may be associated with the development of stroke in the Korean population.

• Journal of Radiation Protection and Research
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• 제37권4호
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• pp.219-225
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• 2012

방사선안전을 수행하는 방사선안전관리자를 대상으로 실제적인 방사선안전규제 수준을 파악하여 합리적인 안전규제 제도를 마련하는데 필요한 근거자료를 도출함으로써 방사선안전규제의 효율성과 편의성을 극대화할 수 있는 차별화된 규제에 도움이 되고자 하였다. IAEA의 RS-G-1.9 (2005), NRC의 NUREG Vol. 1~21 등과 국내 원자력안전법의 내용을 근거로 전체 약 10%에 해당되는 방사선이용기관의 방사선안전관리자를 대상으로 설문조사하였다. 피폭관리에 대한 요건($3.32{\pm}0.910$)이 가장 높은 인식수준을 나타냈고, 관련 서류의 기록, 비치, 보관에 대한 요건($2.84{\pm}0.826$)은 가장 낮은 인식수준을 나타냈다. 방사선원 현황 및 관리 요건, 시설 요건, 측정 및 오염관리 요건, 측정 장비 및 감시기 작동 요건, 교육 및 훈련 요건, 피폭관리 요건에서 산업기관이 의료기관보다 규제가 더 엄격해야 한다는 인식수준을 나타냈다. 방사선안전규제 수준이 산업기관과 의료기관에 통계적으로 유의한 차이가 있다는 것은 규제관련 그 원인이 존재하는 것이므로 실제적인 규제내용을 재평가해 볼 필요가 있음을 시사한다. 향후 연구에서는 국내 기관특성별로 규제요건을 개발하는 과정이 이루어질 필요가 있고, 기관특성을 고려하여 방사선안전규제를 수행한다면 편의성을 극대화한 안전규제를 달성할 수 있을 것이라고 사료된다.

• 한국직업건강간호학회지
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• 제11권2호
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• pp.108-120
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• 2002

This study analyzed the managerial efficiency of 11 organizations, the branch centers of a occupational health service organization in Korea, using the Data Envelopment Analysis (DEA) method. The DEA is a good method for evaluating health services since it can handle multiple inputs and outputs simultaneously, and also identify the sources and amount of inefficiency. The author approached this study using two efficient models: the monetary value model and the real value model. The DEA method based on the monetary value model included cost factors, while the real value model excluded cost factors. The input variables used were manpower of physicians, medical technicians, nurses, industrial hygienists and administrators; labor, maintenance, and material expenses. The output variables used were the number of medical examinations, workplace evaluations, group health management services and income from each service. The major results were as follows: First, in the monetary value model, 6 out of 11 organizations (54.6%) showed an efficiency score of 1.0, which means that they have been operating in very efficient ways. However, 5 organizations (46.4%) showed themselves to be relatively inefficient. Second, in the real value model, 7 out of 11 organizations (63.4%) showed an efficiency score of 1.0, which means they have been operating efficiently, while 4 organizations (46.4%) showed themselves to be relatively inefficient. Third, the reliability of DEA method were analyzed by comparing the results of the monetary value model and real value model. The results of 8 out of 11 organizations were same in terms of being efficient or not. Thus, the DEA could be a valid application method for occupational health service organizations. Fourth, the organizations that displayed common inefficiency in both the monetary value model and in the real value model 3, 9, and 10, were also considered to be managed inefficiency from expertise opinion. In summary, this study evaluated the efficiency of occupational health service organizations applying the DEA method with different variables, and found that the results of analysis could be valid in terms of both modeling and expert sense. In the future, the DEA method will be used as a useful tool to identify and evaluate the efficiency of occupational health service organizations through more applications and refinements.

• 지역사회간호학회지
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• 제11권1호
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• pp.231-244
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• 2000

Parish nursing is a community health nursing role developed in 1983 by Lutheran Chaplain Granger Westberg. An increasing emphasis on holistic care, personal responsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The purpose of this study is to investigate what the korean parishioners want in parish nursing and what type of role expectation from parish nurse. The subjects were 1138 parishioners of 23 churches of various denominations in nationwide Korea. Data were collected by self-reported question naires from Feb 4 to June 25. 1999. The data were analyzed by using percentage. frequency. $x^2-test$. multiple Response set with SPSS program. The results are as follows: 1. Desired parish nursing contents by parish nurses are: psychological counselling(23.4%) out of private counselling. stress management(21.1 %) out of private health education. Emergency care(14.1%) out of group health education. Blood Pressure check-ups (19.0%) out of Health check ups. home visiting(44.9%) out of patient visiting method. B T. pulse, respiration and blood pressure check(15.0%) in Care to serve in home visiting. spiritual preparation to accept the death(41.7%) in hospice care, advices to choice of medical treatment using guide(50.1%) in introducing and guiding of health care facilities, pray(21.7%) in spiritual care' faith support. 2. Desired Health Teaching Content According to Period of Clients by Parish Nurse are: Vaccination(22.5%) in infant and toddler health management. sexual education(25.3%) in adolescent health management. prenatal care (29.5%) in pregnant health management. osteoporosis prevention and management (22.4%) in Middle aged health management. dementia prevention and management(25.5%) in elderly health management. 3. The expectant role from parish nurse is spiritual care faith support(14.1%). patient visiting care(13.2%), hospice care(12.9%), private counseling(12.8%), health check ups (11.1 %), volunteer organization and training out of believer(11.0%), private health education (9.3%), group health education (8.3%). 4. In Necessity of Performing Parish Nursing according to Region, Most(over 95%) responded that nursing program is needed. so there is no significance between regions. In Performing Parish Nursing in their church, Most(92.2%) responded they want to perform program. 5. In case of performing parish nursing, 52% out of the subjects responded they want to participated in parish nursing volunteer's activity, for example. to be in active to be a companion to chat(42.1%), necessity support (25.3%), donation support(25.0%), exercise support(18.2%), vehicles support (9.9%). As a result. in holistic care and spiritual care, the need of parish nursing and the role expectation from parish nurse are very high among korean believers. Therefore, I suggest parish nursing centering around Taegu and Kyungbuk province should be extended to nationwide. For extending parish nursing program. more active advertisement and research is needed. After performing parish nursing program through out the country, further comparative research between regions should be practiced and Korean parish nursing program will be developed and activated.

• 지역사회간호학회지
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• 제16권3호
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• pp.341-350
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• 2005

Purpose: The purpose of this research was to find out factors affecting job stress and job satisfaction of nurses working at the welfare centers. Methods: This study was performed with 140 nurses who were working at or had retired within 1 year from general welfare centers in Seoul during the period from March 29 to February 29 2004. We used a questionnaire asking about general characteristics. work characteristics. stress factors and job satisfaction. We analysed 103 subjects who replied to the questionnaires. Results: The mean job stress level was 2.84 out of 5 and. as for the sub-factors of job stress. income was 4.19, career development 3.69, service environment 3.26 and support system 1.90. The mean job satisfaction level was 3.32 out of 5 and. as for the sub-factors of job satisfaction, job control was 3.58, efficiency of organization 3.27, job burden and responsibility 2.92 and role ambiguity 2.25. When the nurses' job stress was compared according to their general and work characteristics. stress level was significantly high in nurses who had a short experience. were working at the department of senior welfare center. or were the only staff at their workplace (p <0.05). In addition. satisfaction level was significantly high in nurses who were working at the department of senior welfare center and medical welfare team. were the only staff at their workplace or had a heavy work load (p<0.05). According to the results of multiple regression analysis. job stress level was influenced by age ($R^2$=0.212. p<0.01). and job satisfaction level by the number of staffs and work' load ($R^2$=0.272. p<0.1). Conclusions: The results of the study suggest that good atmosphere should be made up to communicate between the departments at the workplace in order to lessen job stress and enhance job satisfaction of nurses working at welfare centers. In addition. role division and job duties among special staffs should be reviewed in order to achieve high efficiency in performing job duties.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.405-412
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• 2018

예산은 조직성과의 체계적 관리와 조직상황을 진단하는데 중요한 관리도구이다. 병원은 비영리 조직으로서, 효율적인 예산집행이 중요하지만 현재 국내에는 병원의 예산슬랙에 관한 연구가 부족한 실정이다. 이에 본 연구가 수행되었다. 본 연구의 목적은 병원 예산시스템의 특성이 예산슬랙에 미치는 영향을 규명하는 것이다. 본 연구의 자료는 서울 소재 일개 대학병원의 예산 담당자 118명을 대상으로 자기기입식 설문조사를 시행하였다. 본 자료수집 기간은 2015년 7월 14일부터 7월 22일까지이다. 설문에 응답한 데이터는 STATA 14.0을 이용하여 빈도분석, 상관분석 및 회귀분석을 시행하였다. 연구결과 예산시스템의 특성 중 정보비대칭은 예산슬랙을 유의하게 증가시켰다. 반면에 예산 피드백과 예산 동기부여는 예산슬랙을 유의하게 감소시키는 것으로 나타났다. 본 연구결과 병원 직원 간 예산관련 정보의 원활한 공유가 효율적인 병원경영을 위해 중요하며, 예산슬랙을 체계적으로 관리하기 위해 예산행위에 있어서 예산피드백과 동기부여를 강화하는 것이 필요한 것으로 나타났다. 본 연구는 병원 예산슬랙 영향요인에 관한 연구가 부족한 상황에서, 예산슬랙 연구에 대한 관심을 환기시키고 국내 의료기관들의 경영 효율성을 향상시키는데 실증적인 기초자료를 제공해 줄 수 있을 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.783-786
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• 2015

Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.