• 간호행정학회지
• /
• 제13권3호
• /
• pp.352-361
• /
• 2007

Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.

• 디지털융복합연구
• /
• 제18권8호
• /
• pp.353-360
• /
• 2020

이 연구는 조선족 대학생들의 영어 실력 향상을 위한 기초자료로 활용하고자 시행하였다. 중국 소재 한 대학 203명을 대상으로 조선족과 한족 학부생들의 차이를 분석하고자 위해 기술 통계량 및 t-검정 분석이 사용되었다. 연구 결과는 한족 학생들에 비해 조선족 학생들의 준비성이 현저히 떨어지고 학습 성과도 약하다는 것을 보여주었다. 학습 성과에 미치는 요인들에 대한 분석은 영어 구술능력, 교과과정에 대한 태도, 자신의 영어실력에 대한 신념, 학습 전력에 있어서 그룹간의 유의미한 차이를 보였다. 반면, 학습에 대한 관심에 있어서는 그룹 간의 차이를 보이지 않았다. 본 연구는 EFL 수업에서 조선족 대학생들의 수업 준비성 및 학습 성과를 향상시키기 위한 시사점을 제공하는데 그 의의를 갖는다.

• 디지털융복합연구
• /
• 제19권4호
• /
• pp.393-401
• /
• 2021

본 연구는 대학생의 학습몰입, 자기주도학습, 학습성과가 온라인 수업만족도에 미치는 영향요인을 파악하여 비대면 온라인 수업의 효과를 극대화하고, 활성화할 방안의 기초자료를 제공하고자 시도된 서술적 조사연구이다. 대학생의 학습몰입, 자기주도학습, 학습성과, 온라인 수업만족도는 유의한 정적인 상관관계를 보였고, 온라인 수업만족도에 학습몰입, 학습성과는 정적인 영향이 있었으나 자기주도학습은 직접적인 영향은 없었다. 온라인 수업만족도에 대한 설명력은 49%였다. 본 연구결과에 따라 온라인 수업만족도를 높이기 위해서 온라인 수업에 대한 대학생의 학습몰입, 학습성과를 향상시킬 방안이 필요하다. 또한 교수자와 대학은 온라인 수업의 질적인 향상을 위한 적극적인 노력과 지원이 요구된다.

• 디지털융복합연구
• /
• 제19권5호
• /
• pp.163-174
• /
• 2021

본 연구는 직장인 성인 학습자의 학습 가치 지각 수준과 학습성과 간의 영향 관계를 확인하고, 이들 두 변수간의 관계에서 관리자 지원과 일-가정 향상의 조절 효과를 검증하는 것이다. 본 연구 목적을 달성하기 위해 3개의 가설을 도출하고 도출된 가설은 실증분석을 통해 검증하였다. 가설검증을 위해 기혼 직장인 중 평생학습 프로그램을 수강하고 있거나 재직자 특별전형학과 재학생을 대상으로 337부의 설문지를 배포하여 불성실한 설문지를 제외하고 총309부가 최종분석에 사용되었다. 가설 검증 결과 학습 가치는 학습성과에 정(+)의 영향을 미치는 것으로 나타났다. 또한 학습가치와 학습성과 간의 긍정의 영향 관계에서 관리자 지원, 일-가정 향상, 가정-일 향상이 조절역할을 하는 것으로 나타났다. 즉, 지각된 관리자 지원수준이 높을수록, 일-가정 향상과 가정-일 향상 수준이 높을수록, 학습 가치가 학습성과에 미치는 영향이 커진다는 것이다. 이러한 연구 결과를 바탕으로 실무적 시사점 및 미래연구를 방향을 제시하였다.

• 보건행정학회지
• /
• 제30권3호
• /
• pp.277-285
• /
• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• 한국의료질향상학회지
• /
• 제17권1호
• /
• pp.69-78
• /
• 2011

Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

• 보건행정학회지
• /
• 제18권4호
• /
• pp.1-22
• /
• 2008

Burden of disease analysis provides a unique perspective on health by integrating fatal and non-fatal outcomes, yet allows the outcome of two classes to be examined separately. Although many studies have shown the inequality in health outcomes across socioeconomic status (SES), an analysis and comparison of Disability Adjusted Life Year (DALY) between different socioeconomic groups has been rare. This paper calculates the DALY and analyzes the distribution of DALYs for different SES. This study draws from 3,278 cases from the survey on "The Livelihood and Welfare Needs of the Elderly (2004)". It first provides a comprehensive assessment of the burden of 10 chronic diseases of the elderly based on DALY. Then this paper analyzes inequalities in the burden of disease by the levels of SES such as education, income, family size, occupation, and subjective economic conditions. For the elderly, the burden of disease is the highest for hypertension, arthritis and cancer. DALY rate per 1,000 people for the most socio-economically disadvantaged group is expressed as a multiple of the standardized rate for the least disadvantaged group (Rate Ratios). Family size is strongly related to. the difference in the burden of disease between SES groups, and the elderly Who live alone have higher DALY rate than those who live with their family. Other significant variables related to SES groups include subjective economic conditions, occupation, elderly income, and household income.

• 보건행정학회지
• /
• 제23권3호
• /
• pp.244-259
• /
• 2013

This study investigates the moderation effect that organizational trust had on the relationship between perceptions of organizational politics and organizational commitment, intention to turnover, organizational citizenship behavior by analyzing the empirical data of 716 personnels collected from university hospital in Korea. We hypothesized that perceptions of organizational politics would tended to negatively related to a high level of organizational commitment and intention to turnover, organizational citizenship behaviors, and that organizational trust would moderate the relationship between perceptions of organizational politics and outcomes. These results suggest that organizational politics of perceptions had negative impacts on organizational commitment and organizational citizenship behaviors, while perceptions of organizational politics had positive impact on intention to turnover. Furthermore, the level of organizational trust moderated the relationship between perceptions of organizational politics and outcomes. Based on these findings, implications of the research findings are discussed, and recommendation for future research and practice are provided.

• 보건행정학회지
• /
• 제11권2호
• /
• pp.16-28
• /
• 2001

This study was to compare multidimensional outcomes of patient's satisfaction after cataract surgery and to identify factors influencing satisfaction after operation. Patient's satisfaction was measured with three dimensions : interpersonal care, physician explanation and hospital care. Overall satisfaction was measured as means of three dimensional scores. For the study, a prospective study was performed with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was performed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data (the visual acuity of operated eye, visual function, symptom score and satisfaction with vision) were obtained. The doctors were questioned with self-reported questionnaire forms. Medical records were also examined to understand surgery Process. The survey was conducted before(389) and after operation(327). Alter excluding cases with incomplete data, 3n cases were enrolled In this study. Both the overall satisfaction and the satisfaction with physician explanation increased after the operation whereas the satisfaction with interpersonal care and hospital care did not change significantly. Multiple regression analysis showed that the level of education, baseline satisfaction scores and the degree of vision improvement were statistically significant variables. The preoperative lower level of education, higher level of overall satisfaction (interpersonal care, physician explanation, hospital care scores) and the more the satisfaction with vision improvement were associated with the improvement of postoperative satisfaction scores.

• 보건행정학회지
• /
• 제32권3호
• /
• pp.272-281
• /
• 2022

With the outbreak of coronavirus disease 2019 (COVID-19) pandemic, health policymakers are adopting new policies regarding the issue of immunization disparities, especially for children in low-income communities of color who lack awareness and thereby access to vaccines. The purpose of this paper is to propose an evaluation framework using program theory-based evaluation approach and logic model to analyze and evaluate the immunization disparities in children aged 19-35 months. Data is collected from New York City department of Health and the U.S. Census Bureau for Northern Manhattan Start Right Coalition program which consists of 19,800 children, and the community-provider partnership includes 26 practices and 20 groups. Program theory is used to evaluate this community-based initiative with the logic model which is a visual depiction that illustrations the program theory to all stakeholders. The logic model highlights the resources, activities, outputs, outcomes, and impacts of the program to guide to planners and evaluators and to call attention to the inadequacies or flaws in the operational, implementation and service delivery process of the program in offering a new perspective on the program. This framework adds to the literature on evaluations of immunization disparities in determining whether evaluators can definitively attribute positive immunization outcomes in the community to the program and conclude whether it has potential in expanding or duplicating it to other similar settings, especially in other rural areas of the United States, and abroad, where routine immunization equity gaps are wide due to income, racial and ethnic diversity, and language barrier.