• 가정∙방문간호학회지
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• 제12권1권
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• pp.41-69
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• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• 한국직업건강간호학회지
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• 제29권2호
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• pp.123-132
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• 2020

Purpose: This study examined the influence of nurses' communication competency, critical thinking disposition, and perception of patient safety culture on patient safety competency in armed forces hospitals. Methods: A crosssectional design was employed with a convenience sample of 204 nurse officers from four armed forces hospitals in South Korea. Data were collected through a self-administered questionnaire from August 10~23, 2019, and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression. All analyses were conducted using SPSS for Windows 21.0. Results: Patient safety competency scores were 4.35±0.40 for patient safety attitudes, 3.63±0.64 for patient safety knowledge, and 3.94±0.51 for patient safety skill. Communication competency, critical thinking disposition, and perception of patient safety culture were positively correlated with patient safety competency. Communication competency (β=.30, p=.002) and perception of patient safety culture (β=.24, p=.001) were identified as particularly important factors influencing patient safety competency. Conclusion: This study's results suggest that education programs to enhance communication competency and patient safety culture could increase patient safety competency among nurses in armed forces hospitals.

• 간호행정학회지
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• 제2권1호
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• 지역사회간호학회지
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• 제15권2호
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• pp.209-217
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• 2004

Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

• 한국직업건강간호학회지
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• 제13권1호
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• pp.30-39
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• 2004

Purpose: This study was performed to identify the factors of the job stress and to analysis affecting job satisfaction in clinical nurses, using the Job Stress Model by the National Institute for Occupational Safety and Health (NIOSH). Method: Data collection was done from July 21 to July 30, 2003. The study was involved in 203 nurses who work at the hospital. It was examined the self-recording questionnaire about general characteristics, work-related factors, non-work factors, instrument revised by NIOSH Job Stress questionnaire translated by the Korea Occupational Safety & Health Research Institute(1999). Instrument about shift work was the tool developed by Kim and Gu(1984). Result: Job satisfaction of subjects at an average level with $1.96{\pm}0.37$ score on the basis of 3 points. According to general characteristics, job satisfaction was high in those with older age and married group. According to work related general factors, job satisfaction was high with working career, an officer to higher grade. According to work characteristics factors, job satisfaction was low with much role conflict at work and much workload and much interpersonal conflict. As for the relationship between job satisfaction and non-work factor, job satisfaction was did not show statistically significant differences. As a result of Stepwise multiple regression analysis, job satisfaction was influenced by shift work, conflicts of between group and grade of office. Conclusion: Therefore, it suggests that the nurses need stress management related shift work for improvement of job satisfaction.

• 농촌의학ㆍ지역보건
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• 제15권2호
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• 지역사회간호학회지
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• 제10권1호
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• pp.5-18
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• 1999

The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

• 한국간호교육학회지
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• 제3권
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• pp.99-116
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• 1997

In response of the increasing demand for professional degree in nursing, some university in Korea offers RN-BSN program for R. N. from diploma in nursing. However, RN-BSN program in Korea is in formative period. Therefore, the purpose of this survey study is for the comparative analysis of RN-BSN curriculum in Korea and U.S.A. In this study, subjects consisted of 18 department of nursing in university and 5 RN-BSN programs in Korea and 18 department of nursing in university and 12 RN-BSN programs in U.S.A. For earn the degree of Bachelor of Science in Nursing, the student earns 134 of mean credits in U.S.A., whereas 150.3 of mean credits in Korea. The mean credit for clinical pratice is 30.1 in U.S.A., whereas 23.9 in Korea. Students are assigned to individually planned clinical experiences under the direction of a preceptor in U.S.A. In RN-BSN program, total mean credits through lecture and clinical practice for earn the degree of BSN is 35.5(lecture : 27.7, practice ; 7.8)in U.S.A., whereas,48.1 (lecture;42.1, practice;6.0) in Korea. RN-BSN program can be taken on a full-or-part time basis in U.S.A., whereas didn't in Korea. Especially, emphasis is place on the advanced nursing practicum that focus on the role of the professional nurse in providing health care to individuals, families, and groups in community setting in U.S.A. 27.7 of mean credits was earned through lecture in U.S.A., whereas 42.1 of mean credits in Korea. It means that RN-BSN program in Korea is the lesser development in teaching method and appraisal method than in U.S.A. Students of RN-BSN program in U.S.A. can earns credit through CLEP, NLN achievement test, portfolio review session etc as well as lecture. Therefore, the authors suggests some recommendations for the development of curriculum of RN-BSN program in Korea based on comparative analysis of RN-BSN curricula in U.S.A. and Korea. 1. The curriculum of RN-BSN Program in nursing was required to do some alterations. Nursing care, today, is complex and ever changing. According to change of public need, RN-BSN curriculum intensified primary care program in community setting, geriatric nursing, marketing skill, computer language. 2. The various and new methods of earning credit should be developed. That is, the students will earn credits through the transfer of previous nursing college credits, accredited examination of university, advanced placement examination, portfolio review session, case study, report, self-directed learning and so on. Flexible teaching place should ile offered. 3. Flexible teaching place should be offered. The RN-BSN curriculum should accommodate each RN student's geographical needs and school/work schedule. Therefore, the university should search a variety of teaching places and the RN students can obtain their degrees comfortably throughout the teaching place such as lecture room inside the health care agency and establishment of the branch school in each student's residence area. 4. The RN-BSN program should offer a long distance education to place-bound RN student in many parts of Korea. That is, from the main office of university, the RN-BSN courses are delivered to many areas by Internet, EdNet (satellite telecommunication) and other non-traditional methods. 5. For allowing RN student to take nursing courses, program length should be various, depending upon the student's study/work schedule. That is, the various term systems such as semester, three terms, quarter systems and the student's status like full time or part time should be considered. Therefore, the student can take advantage of the many other educational and professional opportunities, making them available during the school year.

• 한국학교ㆍ지역보건교육학회지
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• 제13권2호
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• pp.93-105
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• 2012

This study aimed to provide the fundamental resources for developing an effective safety education program. We analyzed the condition of school accidents and safety awareness, and the condition of school safety education and the factors related to safety education. Ultimately, this study can lead the following studies to develop the safety education program realistically, which can effectively change the safety behaviors of Korean students. Methods: We carried out a questionnaire survey that was targeted at the schools - three elementary, three middle, and three high schools - located in Chung-nam, from April 1, 2012 to May 2, 2012. Totally, the questionnaires of 578 students were fully filled out. The design of this study is a descriptive research. Results: 1. 64.5% of elementary school students, 33% of middle school students and 32% of high school students had experienced more than one safety accident. The frequency of occurrence was the highest in playgrounds for elementary and middle school students, and in stairs for high school students. The most safety accidents occurred during lunch time and at recess in elementary and middle school, and at recess in high school. Further, most of the students who had experienced the safety accidents had been treated in infirmary (school nurse's office) for elementary school students, and in a hospital for middle and high school students. 2. There was statistical significance in the safety consciousness for students in elementary school (18.09 points), middle school (17.68 points), and high school (17.26 points), on a twenty-point scale. (F=3.754, p=0.024). 3. Comparing the factors related to school safety education with safety consciousness, students in elementary school that gave an answer of the usefulness of safety education showed a high standard in the safety consciousness level. (F=12.347, p=0.002) For the need of safety education, the students in the elementary school and high school that expressed the necessity of safety education showed a high standard in the safety consciousness level. Conclusions: Accordingly, it is true that there are the differences at safety awareness among elementary middle high school students. This study is meaningful enough in that it provides the fundamental resources for developing the effective safety education methods for the subjects.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1097-1102
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• 2016

Background: Liver fluke infection with Opisthorchis viverrini and its associated cholangiocarcinoma constitute a serious problem in Thailand. Healthy behavior can decrease infection, therefore, the investigation of knowledge, attitude, and practice is need required in high risk areas. Objective: This study aimed to investigate the behavior and perceptions regarding liver fluke. Materials and Methods: A cross-sectional descriptive study was conducted in Chum Phuang district of Nakhon Ratchasima province, Thailand during July to November 2015. A total 80 participants who had screened with verbal screening test, stool examination, and ultrasonography, were purposive selected and completed a pre-designed questionnaire (Kruder-Richardon-20=0.80, Cronbach's alpha coefficient=0.82 and 0.79). T-test, ANOVA, and Pearson correlation test were used for analyzed data. Results: The results reveal that O. viverrini infection was 1.25%, and 3 patients had a dilated bile ducts. The participants had a high knowledge, attitude, and practice regarding liver fluke. The education, occupation, and income, were statistical significant to attitude regarding liver fluke. Nurses and television were the main sources of information regarding liver fluke, with statistical significance(p-value <0.05). Knowledge was significantly associated with attitude and practice (p-value<0.05). Conclusions: Participants had good behavior regarding liver fluke. Improvement of knowledge and attitude is influenced to practical change regarding this carcinogenic fluke. In addition, nurse and television are the main information resources for key success in increasing people perception for disease prevention and control in this area.