• Korea Journal of Hospital Management
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• v.19 no.2
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• pp.73-88
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• 2014

Objective: This research investigates how to increase the quality of medical service and supply high quality of medical service to patients. By using Kano Model theory we examines what medical service attributes the hospital would be conducted preferentially for patient's satisfaction and provides informations of management strategies for hospitals. Method: To study patients' perception of medical service quality, first we performed pilot test to derive 30 medical service attributes. With 30 medical service attributes, we conducted survey of 300 subjects who have experienced medical services in 6 months. To examine patients' conception of medical services, a modified Kano's questionnaire using 5 scale is applied. Finally we calculated SI(Satisfaction index) and DI(Dissatisfaction index) and PCSI(Potential Customer Satisfaction Improvement) index with Kano's Model analysis results. Key Findings: We found that the quality of medical service categorized in 15 one-dimensional elements, 9 must-be elements and 6 indifferent elements. Moreover the attribute of gives prompt services and have patient's best interest at heart scored the highest SI, whereas the attributes of accurate and precise medical service, exact records, enough explanation and polite attitudes are the highest score of DI. And also good explanation of the bill scored the highest PCSI. In this study findings indicate that while medical service providers try to increase patients' satisfaction by improving hospital's environments, patients' perception of trust and good interpersonal relationships with medical service providers have strong and positive impact on patients' satisfaction.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.1
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• pp.130-140
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• 1999

This study was designated to investigate communication barriers of nurses in clinical settings. This study was done in 2 phases, first content analysis on descriptions of 50 nurses in three general hospitals and 40 nursing students on communication barriers for nurses in clinical settings, and second a survey to investigate the factors related to communication barriers and the relation between the nurse's characteristics and the extent of communication barriers in clinical settings from two nurses educators, 13 nursing students who experienced clinical practice and 71 nurses in 11 general hospitals. The results are as follows : 1. Through content analysis, 11 properties of communication barriers for nurses in clinical settings were identified. These were inappropriate communication style as a nurse, lack of professionalism, in appropriate control of emotions, lack of knowledge about the clincal setting, the lack of preparation about content of communication, the problem in trust relation, differences in priorities in needs, uncontroleable situation for nurses, inappropriate nurses' perception about patients, conflict with medical team and inadequate systematic support were identified and grouped in to four categories, communicator, message, feed-back and communication context. 2. The four factors in communication barriers for nurses in the clinical setting were identified and named as ambiguity in the nurses' position, lack of confidence, difference in perspectives with patients and in-adequate nurse-patient relationship. 3. There was a significant difference(F=5.31, P=0.0022, F=3.62, P=0.0316, F=2.80, P=0.067, F=9.01, P=0.0003) among the groups according to work place in rating the extent of the communication barrier in the clinical setting and in the four factors, the nurses working in the psychiatric patient unit rated the communication barrier in the clinical setting lowest among the groups. There was a significant negative correlation between the length of the nurses's carrier and the extent of communication barrier in three factors, ambiguity in the nurses' position, lack of confidence and inadequate nurse-patient relationship.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.423-436
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• 2019

Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.212-227
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• 2020

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

• The Journal of the Korea Contents Association
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• v.11 no.10
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• pp.301-311
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• 2011

This paper is aimed at providing fundamental data for marketing strategies needed to determine the direction of policy to operate hospitals in an effective way. From the analysis, it was found that: first, expectation toward hospitality of the staff, facilities, environment and administrative service of hospitals for the elderly exercises significantly positive(+) effects on satisfaction of patients; second, trust in and satisfaction with administrative service of hospitals for the elderly exerts significantly positive(+) effects on the intent of patients for revisit and information by word of mouth; and third, the intent for revisit influences positively the intent for information by word of mouth significantly. It is therefore needed to try to understand the motives and tendencies of the elderly in selecting hospitals, to promote their satisfaction and to cultivate the spirit for patient-oriented service. Furthermore, efforts should be made to gain trust of medical staff, effects of medical treatment as well as medical equipment in addition to laborious endeavors to work out marketing strategies backed up by price competitiveness of paradigm.

• Korea Journal of Hospital Management
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• v.28 no.2
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• pp.32-43
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• 2023

Purposes: This research is conducted to identify main features and trends of mission, vision and core values in Korean tertiary general hospitals by using text-mining. Methodology: For the study, 45 mission, 112 vision and 190 core values are collected from 45 tertiary general hospitals' homepages in 2022 and use word frequency analysis and Leyword co-occurrence analysis. Findings: In the tertiary general hospitals' mission, there are high frequency words such as 'health', 'humanity', 'medical treatment', 'education', 'research', 'happiness', 'love', 'best', 'spirit', and mission mainly includes the content of contributing humanity's health and happiness with these words. In case of vision, high frequency words are 'hospital', 'medical treatment', 'research', 'lead', 'trust', 'centered', 'patient', 'best', 'future'. By using these words in vision, it represents the definition and characteristics of vision such as ideal organizations in the future, goals and targets. As a result of the Leyword co-occurrence analysis, vision includes the content of 'high-tech medical treatment', 'special care for patients', 'leading education and research', 'the highest trust with customer', 'creative talents training'. -astly, the high frequency word-pairs in core values are 'social distribution', 'innovation pursuit', 'cooperation and harmony', and it defines standards of behavior for organizations. Practical Implication: To correct the problems of vision, mission and core values from findings, firstly, it needs for Korean tertiary general hospitals to use the words that can explain organization's identity and differentiate others in their mission. Secondly, considering strengthening the role of hospitals in their community and the importance of members in organizations, it is necessary to establish vision with considering community and members to activate vision effectively. Thirdly, because there are no specific guidelines of establishing mission, vision and core values for healthcare organizations, this research concepts and results could be utilized when other organizations establish mission, vision and core values.

• Clinics in Shoulder and Elbow
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• v.27 no.3
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• pp.309-315
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• 2024

Background: Radiocapitellar arthritis can cause pain, loss of motion, and impaired elbow function. Current surgical treatment options are limited. We have developed an original and simple surgical technique to address this, called arthroscopic matched osteoplasty of the radial head (AMOR). In AMOR, the radial head is partially resected and recontoured to match the capitellum and decompress the degenerate radiocapitellar articulation while preserving the ulnohumeral articulation where the cartilage is usually well preserved. Methods: Indications and the surgical technique of the AMOR procedure are described. A retrospective observational service evaluation study was conducted from electronic patient records. Collected clinical outcomes included range of motion, pain level, subjective functional score, and general satisfaction with the results of the procedure. The radiographic outcome was radiocapitellar joint space. Results: Between 2017 and 2021, eight consecutive patients underwent AMOR as part of an arthroscopic osteocapsular arthroplasty procedure. Radiographically, the mean radiocapitellar joint space improved from an average of 1.7 mm to 4.6 mm. Clinically, the mean pain score decreased from 8/10 to 3/10. Six of the eight patients (75%) were satisfied with their results. In two cases, initial improvement following surgery lasted less than 1 year, and one of these patients underwent total elbow arthroplasty for painful ulnohumeral osteoarthritis. There were no complications of surgery recorded. Conclusions: AMOR is a safe treatment option for painful radiocapitellar osteoarthritis and can be incorporated as an "add-on" procedure by surgeons performing elbow osteocapsular arthroplasty in cases with a positive grip and grind test and radiographic evidence of radiocapitellar OA. Level of evidence: IV.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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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.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.39-44
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• 2005

Velopharyngeal incompetence(VPI) is that soft palate and muscle of posterolateral pharyngeal wall can not close velopharyngeal port properly. Thing that prior to treatment for patient with VPI is to evaluation about nasopharyngeal closing function. This data is important for making a treatment plan and assesment of treatment effect to improve nasopharyngeal closing function. There are two ways of VPI assessment. The one is subjective method by auditory finding, the other is objective method by using equipment for language test. Using only subjective way is not adequate for evaluation of VPI because of low trust, so doing both two methods simultaneously help to make a diagnosis and assessment exactly. CPAP is effective method to treat hypernasality. This new treatment technique intensify oropharyngeal muscle for nasopharyngeal closing by direct resistance training. Becase conventional treatments have limitation, so many research about treatment effectiveness of CPAP are being studied. This study aims that we compare our result from Korean VPI patients with result about treatment effect in other advanced country, to make CPAP Treatment Questionares and to find ways that improve oropharyngeal closing function an[1 maximally increase language treatment effect.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.6
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• pp.548-557
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• 2020

Purpose: To better understand the benefits and harms of engagement with online pediatric liver disease communities within social media. Methods: We conducted a survey of caregivers of children with liver disease participating in online pediatric liver disease communities within social media, as well as a survey of healthcare providers (e.g., physicians, surgeons, nurse coordinators) from this field to better understand the perceived benefits and harms of participation. Results: Among 138 caregivers of children with liver disease that completed the survey, 97.8% agreed social media was a good place to learn about patient experiences and 88% agreed it was a good source of general information. Among caregivers, 84.8% agreed social media helps them to better advocate for their child. While 18% agreed that the information over social media was equal to the information from their healthcare team and 19% neither agreed/disagreed, only 3% indicated they would use this information to change care without telling their provider; in contrast, among 217 healthcare providers, 55% believed social media may lead caregivers to change management without telling their team. Conclusion: Engagement with online disease-specific communities in social media yields several benefits for caregivers and, in contrast to healthcare providers' concerns, participation is unlikely to lead to problems including caregivers changing the treatment plan without first discussing these plans with their team. Openness between caregivers and medical teams about the role for social media can help to improve trust and maximize the potential benefits of engagement with these groups.