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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

Knowledge, Attitude & Practice for Sexuality of Teachers -Based on over 50 year old teachers- (교사의 성 지식.태도.실태 연구 -50세 이상 교사를 중심으로-)

  • Lee, Eun-Jung;Park, Young-Soo;Choi, In-Sook
    • The Journal of Korean Society for School & Community Health Education
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    • v.5
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    • pp.107-122
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    • 2004
  • To correctly plant the value of sex to the juvenile, we cannot overemphasize the importance of the sexual education in schools. Therefore, the study for teachers' consciousness and view of sex is also necessary, because they are subjects of education and role-models of sex of their students. Especially, if teachers are over fifty in age, it is more important, because it is obvious, as they are in positions of managers and directors of education, that their view of sexual value and consciousness are influencing the aim of education and the course of education. Hereby this study was conducted to check their sexual consciousness, attitude, and condition and to prepare for the basic data needed for the development of a sexual education program suitable to them. The methods of the survey of this study are applied by modifying or supplementing those of precedented studies. They are used after analyzing reliance of items according to Cronbach's $\alpha$ figure calculating law, and modifying or supplementing items lower in reliance. The questionnaire survey was conducted among 1,000 randomly selected from teachers working in middle and high schools in Korea from June 14th in 2004 to June 30th. The survey analyzed 632 questionnaires suitable to it. The outcomes of the survey of this study are like the following: First, the objects of the survey consist of 64.6% men and 35.4% women. Among them, 41.1% are under fifty and the rest are over fifty. As for the periods of marriage, 15.5% are unmarried, 16.3% are under ten years, 18.0% are between ten and twenty, and 50.2% are over twenty. Second, with reagard to sex, 25.6% admit the necessity of a heterosexual friend. 32.0% say that they are conservative to sex. 54.1% are taught sexual education. 67.1% attribute sexual education to nursing teachers. Third, among those who answer that they enoughly know the concept of sex, seenig by age, 25.0% are under fifty and 58.1% are over fifty. Seening by the periods of marriage, 9.2% are unmarried, 28.2% are under ten, 49.1% are between ten and twenty, and 59.0% are over twenty. Among those who answer that they enoughly know the concepts of sexual harassment and sexual violence, seenig by age, in the turns by above-mentioned order, each 47.7% and 76.3%. Seening by the periods of marriage, each 9.2%, 28.2%, 49.1%, and 59.0%. Fourth, among those who answer that "teachers also need sexual education and sexual counsel," by age, each92.7% and 91.4%. By the periods of marriage, each 89.8%, 95.2%, 89.4%, and 92.4%. As a matter of course, we can infer the necessity of the sexual education and sexual counsel for teachers. Fifth, among those who answer that they are satisfied with their sexuality, by age, each 41.1% and 61.3%. By the period of marriage, each 4.1%, 63.1%, 64.1%, and 61.5%. As for the sexual desire like spiritual intercourse, physical intercourse containing sexuality, by age, each 71.9% and 93.5%. By the periods of marriage, each 54.0%, 81.5%, 90.3%, and 93.0%. The survey shows that those over fifty and having long marriage are feeling the stronger desire towards sexuality. Through the outcomes of this survey, a few suggestions are possible: First, it is necessary to check of the teachers' view of sexual value and to study deep about the sexual tendency of them in twenties, thirties, and forties. It is to make them teach their students on the firm basis, and also to develop suitable sexual education and counsel program.

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A STUDY OF PARENTAL KNOWLEDGE AND ATTITUDE ABOUT INFANT ORAL HEALTH CARE (유아의 구강관리에 관한 보호자의 인지도 조사)

  • Kim, Myoung-Jin;Shun, Ye-Kyung;Shim, Youn-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.292-299
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    • 2000
  • The purpose of this study was to investigate parental knowledge and attitude and practices relating to infant oral health care and to promote their motivations to their children's oral health care. Authors interviewed 350 persons in Ilwon-Dong and whose children were between 0 to 36 months old and acquired questionnaire from them. The questionnaire constituted of questions about general knowledge of tooth eruption, methods of oral hygiene care, and opinions about preventive dental visit. The collected data were analysed and compared with other researches. The important results obtained from this study were : 1. Females and highly educated persons had more dental knowledge than males and poorly educated persons. But age and economic status did not affect their level of dental knowledge. 2. Fifty nine percents of respondents thought that tooth began to be formed before birth. 3. Seventy six percents of respondents thought that infant oral health care should begin before tooth eruption, but actually only 63% started oral hygiene care before age one. 4. Seventy percents of respondents used gauze for infant oral care. 5. Fifty seven percents of respondents still gave bottles to their children after they reached age one or more and 55% of respondents never heard of nursing caries. 6. Ninety percents of respondents agreed that carious deciduous teeth need restorations, and 31% of respondents thought that age two is the appropriate time for the first dental visit. 7. Forty seven percents of parents did not think that dental caries is an infectious disease. 8. Only Thirty three percents of parents visited dental clinics for examination and prevention during pregnancy and only 11% of expecting parents were offered dental health care education in pediatric or obstetrician clincs. 9. Information about oral health care was mostly given from baby megazines. 10. Overall parental knowledge about infant oral health care was not sufficient to maintain appropriate dental care for infants.

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Factors Related to Psychosocial Stress and Fatigue Symptom Among Nurses Working at Ward and Operating Room in University Hospitals (대학병원 병동 및 수술실 근무 간호사의 사회심리적 스트레스와 피로수준에 관련된 요인)

  • Park, An-Sook;Son, Mi-Kyung;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1781-1791
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    • 2013
  • The present study was intended to measure the level of psychosocial stress and fatigue symptom according to the various characteristics such as sociodemographic, health-related, job-related, job stress factors, and psychosocial factors among nurses working at ward and operating room in university hospitals, and to reveal the relation between these factors and psychosocial stress and fatigue symptom. The self-administered questionnaires were given to 220 nurses working at ward, and 147 nurses working at operating room in 4 participating hospitals located in Daejeon City during the period from July 1st to Aug 31st, 2012. As a results, the factors related to the psychosocial stress of nurses working at ward were age, subjective health status, job career, satisfaction of work, fit to the job, job demand, job control, coworker support, self-esteem, locus of control, type A behavior pattern. In operating room, there were age, sleep hours, subjective health status, job career, physical burden of work, satisfaction of work, fit to the job, consider quitting the job, job demand, job control, type A behavior pattern. The factors related to the fatigue symptoms of nurses working at ward were age, leisure time, subjective health status, satisfaction of work, consider quitting the job, job demand, locus of control, type A behavior pattern. In operating room, there were age, subjective health status, physical burden of work, supervisor support, coworker support, locus of control. Based on the study results, we suggest that the factors related to psychosocial stress and fatigue symptom of nurses were different from working station. We need development and application of programs to keep under management psychosocial stress and fatigue symptom.

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

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

A Case Study of Possession Display Pattern as a Mean of Self-identity Expression in Older People's Households (아이덴티티를 표현하는 노인가정의 소유물 배치패턴 사례연구)

  • Choi, Jung-Shin
    • Journal of the Korean housing association
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    • v.18 no.5
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    • pp.65-72
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    • 2007
  • What is the meaning of home to older people? How much is home significant for older people? How do they express self-identity through decorating their own homes? These are the new subjects that scholars in the West are involved in lately in terms of micro-perspective (George, 1998; Kellett, Gilroy & Jason, 2005; Gilroy & Kellett, 2006). It is evident that home has more significant meaning to older people than other age groups, since the older are more likely to spend greater time within the home through lower income, lessening mobility or loss of companions (Gilroy, 2005). Also the older tend to cling to their homes and attach to possessions than the younger. Older people's possessions are the things that memories of their lives were absorbed. Therefore, possession display can role as a mean of showing their past lives and memories. Gilroy and her colleagues (2005, 2006) found that there was a certain pattern of possession display in English older people's households, and that older people would like to express self-identity through decorating their own homes with their precious possessions. Then, isn't it interesting to find out if there is any pattern of possession display or decoration items in Korean older people's households as well? Thus, the aim of this study is to describe pattern of possession display as a mean of expressing self-identity in Korean older people's households. Interview with older people was used to find out the way and reason of display possessions. Observation method including taking photos and hand-drawings was also added in order to demonstrate detail condition of display items in the house. Possessions display and furniture arrangement in the living room and bedroom were investigated to find out a certain pattern of display and meaning. Research objects were healthy older people aged over 60, who are living independently from their adult children, and who can manage housekeeping by themselves. 32 households were investigated in the area of Seoul, Kyunggi, Chungchungnam, and Kangwon provinces. The findings demonstrate that most precious possession for Korean older people is photo of themselves; especially one taken in their younger age. The reason of it is because the photo reminds them of their heydays when they were vital. Photo of the most beloved one is displayed more frequently in the bedroom than in the living room indicating consistence with English case. As symmetrical display pattern was dominant in case of English older people's households, no dominant display pattern is found in Korean case. Korean older people also cling to their homes and possessions and want to keep their dwelling space as large as what they use now. It is notable that even after they become older and frail, they want sufficient space to display possessions as a mean of self-identity expression. Attachment to possessions and decoration can give older people significant meaning of identity, and it is the reason why architects or interior designers have to meet older people's needs. It needs consideration that residents are allowed to bring their old furniture and precious possessions when they move in elderly housing unit in order to minimize environmental shock, as well as feeling at home. This subject could suggest a clue to designers or architects who have to meet residents' needs in space design of elderly housing or facilities in the future. Psychological well-being of older people can be met by making them feel at home wherever they live. They need space where they can express their own identity and personality even in case when they have to live in a limited small space like elderly housing unit or nursing home.

Changes in prevalence of obesity according to gender in Korea adults: Using a population-based Korea National Health Check-up Database, 2011-2013 (우리나라 성인의 성별에 따른 비만유병률의 변화 : 국민건강보험 건강검진(2011-2013) 자료 이용)

  • Choi, Oh-Jong;Cho, Sung-Il
    • Korean Public Health Research
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    • v.44 no.4
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    • pp.87-97
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    • 2018
  • Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

The Demands and Awareness of Pediatric Dentists on the Korean National Health Insurance System (국민건강보험에 대한 소아치과 의사들의 요구와 인식 조사 )

  • Yunhyeong, Kim;Yongkwon, Chae;Koeun, Lee;Misun, Kim;Ok Hyung, Nam;Sungchul, Choi;Hyoseol, Lee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.3
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    • pp.285-299
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    • 2022
  • The aim of this study is to investigate the awareness and perception of pediatric dentists regarding dental health insurance (DHI) system in Korea. Online surveys were sent to the members of the Korean Academy of Pediatric Dentistry (KAPD), and the responses were collected. The survey, consisting of 41 questions, was subdivided into 'general background of the respondents', 'the awareness on national health insurance (NHI) and DHI', 'the awareness on DHI pertaining to pediatric dentistry', 'issues that need improvement on DHI pertaining to pediatric dentistry', 'DHI claims', and 'the roles of KAPD in DHI'. In total, 302 responded, with a response rate of 28.9%. Excluding 2 questionnaires with insufficient answers, a total of 300 survey results were analyzed. According to the analysis, pediatric dentists thought that the coverage of DHI was not as sufficient compared to that of NHI, but were expecting its scope to broaden in the future. The satisfaction rate was higher in pit and fissure sealant and composite resin filling than in caries-detecting quantitative light-induced fluorescence. Pediatric dentists considered permanent tooth composite resin filling (65.7%) needed an increase in insurance copayment, while topical fluoride application (74.7%) to require insurance coverage. DHI claims were generally handled by dental hygienists and/or nursing assistants. Approximately half of the respondents answered that they have had experiences on appealing for insurance denials. Lastly, pediatric dentists generally had a positive attitude towards providing information for the DHI. This study is expected to be used as a sound dataset for the DHI policy development concerning pediatric dentistry.

A Study on Perception and Attitudes of Health Workers Towards the Organization and Activities of Urban Health Centers (도시보건소 직원의 보건소 업무에 대한 인식 및 견해)

  • Lee, Jae-Mu;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Cheon-Tae
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.347-365
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    • 1995
  • A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.

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