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A Study on the Goal-Orientation of QI Performers in the Medical Centers (의료기관 QI 담당자의 목표추구몰입에 관한 연구)

  • Kim, Mi-Sook;Park, Jae-Sung
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.105-124
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    • 2008
  • The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

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Expectations of the First Visit to Orofacial Pain Clinic for the Patients with Temporomandibular Disorders (구강안면통증클리닉에 처음 내원한 턱관절장애 환자들의 내원 목표)

  • Won, Sang-Yeon;Kim, Hye-Kyung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.265-273
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    • 2010
  • Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.

SUITABILITY OF SHELLFISHES FOR PROCESSING 3. Suitability of Pacific oyster for processing (패류의 가공적성 3. 굴의 가공적성)

  • LEE Eung-Ho;CHUNG Seung-Yong;KIM Soo-Hyeun;RYU Byeong-Ho;HA Jin-Hwan;OH Hoo-Gyu;SUNG Nak-Ju;YANG Syng-Tack
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.8 no.2
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    • pp.90-100
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    • 1975
  • The estimation of the pre-processing condition of oyster is of great importance for distributors and processors. This study was attempted to establish the basic data for evaluating the processing suitability of oyster, which is the most important shellfish for domestic use and export. The data were analysed by measuring the condition index, chemical composition and heavy metal content of oysters. In order to eliminate the manual work that has to be done on a tightly closed oyster shell and avoid shrinkage in the oyster meat which is attendant on the steaming process, chemical means to open oyster were examined. finding the method of pretreatment of polyphosphate for frozen oysters were attempted to improve the product quality. The prevention of undesirable color change of the canned oyster meat is another problem to solve. The important results are as follows : 1. The ratio of meat volume and meat weight to the holding capacity by shells may be useful as an index to measure the condition index of oysters. 2. As a whole, monthly changes of moisture and fat content in oysters were reversely correlated. Protein content slightly decreased from April and rapidly decreased in July, and again rapidly increased in August but from September to November decreased slightly. In April, the content of glycogen was 4 percent. From this period to September, glycogen was rapidly decreased. From July to September, it was only 0. 7 to 1 percent but increased from October. There were little seasonal changes in pH value. The pH value of oyster meat was 6.0 to 6.2. The crude ash content was slightly decreased from June to August. 3. The range of monthly change of heavy metal content are as follows: Total mercury was 0 to 0.019 ppm, cadmium was 0.026 to 0.053 ppm, copper was 0.111 to 0.594 ppm, and lead_was 0.061 to 0.581 ppm. 4. By the results of condition index, chemical composition and heavy metal content of oysters, the suitable harvest season as raw materials for processing was the end of December to the end of May of next year. 5. The pretreatment of 10 percent polyphosphate in 5 percent salt solution of oyster meat appeared effective to reduce thawing drip during cold storage. 6. The pretreatment of $Na_2EDTA$ and BHA did not show the color prevention effect to the canned oyster meat during storage. 7. Magnesium chloride affected to open the valves of oysters.

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The Related Factors of Atopic Dermatitis Severity in Elementary School Students (일부 초등학생에서 아토피 피부염 증상 관련요인)

  • Choi, Kyung-Mi;Kim, Keon-Yeop;Lee, Moo-Sik;Hong, Jee-Young;Bae, Seok-Hwan;Hwang, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.2
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    • pp.759-764
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    • 2011
  • This study was conducted to provide the basic data for the health management of the primary school, by finding and analyzing the factors affecting the degrees of atopic dermatitis symptom's severeness. The subjects of our study were collected 273 pupils mothers, whose children are undergoing through the atopic symptoms. The investigation process took the entire month of the November in 2006. The result of the older the pupils, the severer their symptoms(p<0.05). The longer the period(p<0.01), the more widely spread over the body, and the severer the symptoms(p<0.01). In the dietary habit, the more meat they eat, the severer the symptom(p<0.05). and in relation to the eating the food outside home, the more frequently they eat the fast-food, the severer the symptom. In the multiple logistic regression analysis, using the degrees of atopic dermatitis symptom's severeness as the dependent variables. it is discovered that the longer infection period they have and the more frequently they have the fast-food, the severer the symptom of the atopic dermatitis. The parent's love for the child, the monthly cost for the management of the infection, and the parent's feeling toward the child, can have a greate influence on the physical health, the feelings and the relation with the friends of the infected child, when the child shows the symptoms of scratching his skin. The conclusions of When all the results above are put together, the dietary habit of eating the meals mostly prepared with the meat should be corrected, and the education to form the pupil's right dietary habit, such as, putting the limit on the fast-food, must be made, in order to prevent the symptom of the atopic dermatitis from getting worse. And by the recognizing the atopic dermatitis as the family health problem, the comprehensive family health management, including the mother should be made.

The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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A Collaborative Video Annotation and Browsing System using Linked Data (링크드 데이터를 이용한 협업적 비디오 어노테이션 및 브라우징 시스템)

  • Lee, Yeon-Ho;Oh, Kyeong-Jin;Sean, Vi-Sal;Jo, Geun-Sik
    • Journal of Intelligence and Information Systems
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    • v.17 no.3
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    • pp.203-219
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    • 2011
  • Previously common users just want to watch the video contents without any specific requirements or purposes. However, in today's life while watching video user attempts to know and discover more about things that appear on the video. Therefore, the requirements for finding multimedia or browsing information of objects that users want, are spreading with the increasing use of multimedia such as videos which are not only available on the internet-capable devices such as computers but also on smart TV and smart phone. In order to meet the users. requirements, labor-intensive annotation of objects in video contents is inevitable. For this reason, many researchers have actively studied about methods of annotating the object that appear on the video. In keyword-based annotation related information of the object that appeared on the video content is immediately added and annotation data including all related information about the object must be individually managed. Users will have to directly input all related information to the object. Consequently, when a user browses for information that related to the object, user can only find and get limited resources that solely exists in annotated data. Also, in order to place annotation for objects user's huge workload is required. To cope with reducing user's workload and to minimize the work involved in annotation, in existing object-based annotation automatic annotation is being attempted using computer vision techniques like object detection, recognition and tracking. By using such computer vision techniques a wide variety of objects that appears on the video content must be all detected and recognized. But until now it is still a problem facing some difficulties which have to deal with automated annotation. To overcome these difficulties, we propose a system which consists of two modules. The first module is the annotation module that enables many annotators to collaboratively annotate the objects in the video content in order to access the semantic data using Linked Data. Annotation data managed by annotation server is represented using ontology so that the information can easily be shared and extended. Since annotation data does not include all the relevant information of the object, existing objects in Linked Data and objects that appear in the video content simply connect with each other to get all the related information of the object. In other words, annotation data which contains only URI and metadata like position, time and size are stored on the annotation sever. So when user needs other related information about the object, all of that information is retrieved from Linked Data through its relevant URI. The second module enables viewers to browse interesting information about the object using annotation data which is collaboratively generated by many users while watching video. With this system, through simple user interaction the query is automatically generated and all the related information is retrieved from Linked Data and finally all the additional information of the object is offered to the user. With this study, in the future of Semantic Web environment our proposed system is expected to establish a better video content service environment by offering users relevant information about the objects that appear on the screen of any internet-capable devices such as PC, smart TV or smart phone.

A Study of Health Condion and Shift Service of the Nurse in (종합병원 간호사의 교대근무와 건강상태에 관한 연구)

  • Kim, Soon-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.119-133
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    • 1997
  • Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

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Stressful Life Events, Health Symptoms, Social Support and Coping/in Early Adolescents (스트레스생활사건, 건강문제, 대응, 사회적 지지의 관계 -청소년을 대상으로-)

  • 오가실;한정석
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.414-429
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    • 1990
  • Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social, support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean=16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76, respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using an SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie were selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events(Gamma=.35, p=.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma=.13, p=.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptability to biological social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize the diverse sources of social support that are readily available to adolescents.

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A Study on Food Service Franchise Location Factors and Quality of Service Factors, The Impact on Customer Satisfaction (외식 프랜차이즈 입지요건과 서비스 품질 요인이 고객만족에 미치는 영향)

  • Kim, Jo In Seog;Cho, Kyu Youn;An, Sang
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.5
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    • pp.77-90
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    • 2016
  • This study is to examine the importance of site selection and service quality in franchise business as food service franchise became one of the fastest-growing service industries today. The chief finding of this study is as follows: First, a survey in locational and service quality factors affecting food service franchise shows that responders are more concerned with hygiene and visibility of the store than proximity and transportation advantages which reflects low statistical significance, thus the distance did not seem to be a big problem for the responders in the context that they mostly visit nearby food franchise. Second, the examination of the influence by the service quality factors and customer satisfaction shows significant positive relation with customer response, speed and accuracy, and accuracy factors which reveals that the responders prefer prompt response and swift judgment toward the customer's needs and expectations, professional knowledge services to the credibility factors in which little correlation with the customer satisfaction were found. Third, the examination of the influence by the service quality factors, locational factors, and re-visit reveals that customer response and specialty showed statistically significant correlation with intention of WOM (Word of Mouth) and revisit, which suggests that swift judgment and response toward the customer's needs and expectations, professional knowledge services is of great importance to both customer satisfaction and revisit. The study on the aspects of locational and service quality factors affecting franchise industry's customer satisfaction was conducted as above, an investigation in both factors' influence on the customer satisfaction was made, and based on the results of the analysis, this research seeks an optimal operation strategy of a franchise business. Food service franchise are relatively very competent to business adminstration and reaction capability to consumption changes due to the already established market, and there are stores springing up everywhere inspired by the founders who are too confident of their success in the franchise business. However, it is necessary for the franchise beginners to figure out a zone oriented, regular customer oriented business strategy than just complying with the head office manual. Owing to an increasing trend of opening medium to large sized stores and investments in the wake of converting to multiple business type Korean food franchise, there is growing need to set up new concept of store development and operational management strategy in order to overcome the excessive competition and limited sales volume of the old-fashioned small sized, small capital franchise stores. Furthermore, as most business category of food service franchise serve very similar menus, from a product differentiation point of view, it is required to map out flexible sales concept including the adoption of competitive and low-price strategy. In conclusion, as is shown in the analytical research, the customers' optimal choice fluctuate over their preferences like customer convenience and circumstances rather than insisting on specific brand, thus it will be necessary for the franchise stores to draw up aggressive strategy and planning in running food service franchise to maximize their profits.

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A STUDY ON THE PARENTAL MARITAL RELATIONSHIP OF CHILD PSYCHIATRIC PATIENTS (소아정신과 환아 부모의 부부관계에 대한 연구)

  • Lim, Ke-Won;Hong, Kang-E;Rhee, Kun-Hoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.160-175
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    • 1991
  • The purpose of this study is to investigate the parental marital relationships and the parent-child relationships of child psychiatric parents and its control group. This study was carried out two questionnaire instruments ; The marital satisfaction inventory(MSI) and the dyadic adjustment scale(DAS). The subjects are parents of the child psychiatric patients. A matched control group and parents of child psychiatric parents in Seoul area which were collected from July 1987 to September 1987, and classified into five subgroups : 1 Psychiatric disorder 2) Neurotic disorder 3) Tic disorder 4) Autistic disorder 5) Mental retardation. The results are as following ; 1) M.S.I scale scores of parents of patients group are lower than that of control group. 2) D.A.S scale score of parents of patients group is significantly lower than that of the control group(P<0.01). 3) The global distress scale(GDS) of the M.S.I. was most positively correlated with affective communication(AFC) and problem-sloving communication(PSC). 4) Female shoed more modern concept of role identification than male but tend to have heavier role assignment especially in child rearing practices which could be characterized by maternal domination. 5) Affective communication and sexual relationship between married couple and child rearing practices are influenced by their own family history of distress. 6) The marital global distress scale(GDS) score was highest in the parents of psychosis, the next in the parents of neurosis, autism, mental retardation, and tic disorder in descending order of severity. 7) The dyadic maladjustment score was highest in the parents of psychosis, the next in the parents of neurosis, tic, autism and mental retardation in descending order of severity. 8) Conflict in child rearing and parenting problems were particularly prominent in parents of the tic patients, and their marital relationship was not significantly disturbed. The above finding suggested that couple adjustment and marital dissatisfaction were closely related with child rearing problems and the children's disorder. So marital dissatisfaction and marital maladjustment seem to play a significant role in the genesis of psychosis and neurosis not much in autism and mental retardation.

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