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Association of Sleep Perception With Objective and Subjective Sleep Variables in Insomnia Patients (불면증 환자의 수면인식과 객관적, 주관적 수면변수의 연관성에 대한 연구)

  • Yoon, Gahui;Oh, Seong Min;Seo, Min Cheol;Lee, Mi Hyun;Yoon, So Young;Lee, Yu Jin
    • Sleep Medicine and Psychophysiology
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    • v.28 no.2
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    • pp.70-77
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    • 2021
  • Objectives: Our study aims to investigate the clinical and polysomnographic variables associated with subjective sleep perception. Methods: Among the patients who underwent nocturnal polysomnography (PSG) at the Center for Sleep and Chronobiology of Seoul National University Hospital from May 2018 to July 2019, 109 diagnosed with insomnia disorder based on DSM-5 were recruited for the study, and their medical records were retrospectively analyzed. Self-report questionnaires about clinical characteristics including Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) were completed. Subjective sleep quality was measured using variables of subjective total sleep time (subjective TST), subjective sleep onset latency (subjective SOL), subjective number of awakenings, morning feeling after awakening, and sleep discrepancy (subjective TST-objective TST) the morning after PSG. Pearson and Spearman correlation analyses were used to determine the factors associated with subjective sleep perception. Results: In patients with insomnia, subjective TST was negatively correlated with Wake After Sleep Onset (WASO) (p = 0.001) and N1 sleep (p = 0.039) parameters on polysomnography. Also, it was negatively correlated with PSQI (p < 0.001) and BDI (p = 0.014) scores. Sleep discrepancy was negatively correlated with PSQI score (p = 0.018). Morning feeling was negatively correlated with PSQI (p = 0.019) and BDI (p < 0.001) scores. Conclusion: Our results demonstrated that subjective sleep perception is associated with PSG variables (WASO and N1 sleep) and with PSQI and BDI scores. In clinical practice, it is helpful to assess and manage insomnia patients in consideration of objective sleep variables, subjective sleep quality, and depressed mood, which can influence subjective sleep perception.

Report on the Eradication of Nutria (Myocastor coypus Molina, 1782), an Invasive Alien Species, from Jeju-do, South Korea - Case of Songdang-ri, Jeju-si - (제주도 침입외래생물 Nutria (Mycastor coypus Molina, 1782)의 퇴치 사례 보고 - 제주시 송당지역의 사례 -)

  • Ga-Ram Kim;Jun-Won Lee;Seon-Mi Park;Sung-Hwan Choi;Young-Hun Jung;Hong-Shik Oh
    • Korean Journal of Environment and Ecology
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    • v.36 no.6
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    • pp.582-591
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    • 2022
  • This study was conducted to eliminate Myocastor coypusMolina, 1782 (Nutria) from Jeju Special Self-Governing Province, South Korea. Habitat identification and eradication were carried out from September to November 2013, and a survey was carried out until June 2022 to check whether the eradication was successful. The habitat was identified with unmanned cameras, interviews, and literature surveys, and the capture was performed using the trapping method with food to attract nutria to the habitat area. The study area for the follow-up survey, which was set relatively wide considering nutria's home range, included wetlands and rivers within 4.0 km2 of the habitat area (eradication area). As a result, nutria's habitat was confirmed only at Songdang Ranch, Songdang-ri, of Jeju Island, with traces of habitat (footprints, excrement, and burrows) confirmed in waterways and ponds within the pasture. Eight individuals were captured, including four females, three males, and one individual in too advanced a state of decay to identify the sex. The follow-up survey thoroughly investigated the habitat and its surroundings, focusing on three areas with permanent water, Seongeup Reservoir, Cheonmi Creek, and Molsuni Pond, but no signs of habitat were identified. Therefore, it is determined that nutria inhabiting Jeju Island has been completely eradicated. It is believed that the successful eradication of nutria in the Jeju Special Autonomous Region was possible due to a synergy between 1) the eradication of nutria at the beginning of the settlement phase through rapid capture after confirming the nutria habitat and 2) the delayed expansion period because of rare presence of wetlands, where water is constantly stagnant, on Jeju Island. These results imply that quickly identifying the ecological characteristics of the species and preventing disturbances before they or at the beginning of the ecological disturbance through control and eradication at the initial stage of settlement before the expansion stage is an effective measure to cope with the influx of alien species.

The Effect of Consumers' Value Motives on the Perception of Blog Reviews Credibility: the Moderation Effect of Tie Strength (소비자의 가치 추구 동인이 블로그 리뷰의 신뢰성 지각에 미치는 영향: 유대강도에 따른 조절효과를 중심으로)

  • Chu, Wujin;Roh, Min Jung
    • Asia Marketing Journal
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    • v.13 no.4
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    • pp.159-189
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    • 2012
  • What attracts consumers to bloggers' reviews? Consumers would be attracted both by the Bloggers' expertise (i.e., knowledge and experience) and by his/her unbiased manner of delivering information. Expertise and trustworthiness are both virtues of information sources, particularly when there is uncertainty in decision-making. Noting this point, we postulate that consumers' motives determine the relative weights they place on expertise and trustworthiness. In addition, our hypotheses assume that tie strength moderates consumers' expectation on bloggers' expertise and trustworthiness: with expectation on expertise enhanced for power-blog user-group (weak-ties), and an expectation on trustworthiness elevated for personal-blog user-group (strong-ties). Finally, we theorize that the effect of credibility on willingness to accept a review is moderated by tie strength; the predictive power of credibility is more prominent for the personal-blog user-groups than for the power-blog user groups. To support these assumptions, we conducted a field survey with blog users, collecting retrospective self-report data. The "gourmet shop" was chosen as a target product category, and obtained data analyzed by structural equations modeling. Findings from these data provide empirical support for our theoretical predictions. First, we found that the purposive motive aimed at satisfying instrumental information needs increases reliance on bloggers' expertise, but interpersonal connectivity value for alleviating loneliness elevates reliance on bloggers' trustworthiness. Second, expertise-based credibility is more prominent for power-blog user-groups than for personal-blog user-groups. While strong ties attract consumers with trustworthiness based on close emotional bonds, weak ties gain consumers' attention with new, non-redundant information (Levin & Cross, 2004). Thus, when the existing knowledge system, used in strong ties, does not work as smoothly for addressing an impending problem, the weak-tie source can be utilized as a handy reference. Thus, we can anticipate that power bloggers secure credibility by virtue of their expertise while personal bloggers trade off on their trustworthiness. Our analysis demonstrates that power bloggers appeal more strongly to consumers than do personal bloggers in the area of expertise-based credibility. Finally, the effect of review credibility on willingness to accept a review is higher for the personal-blog user-group than for the power-blog user-group. Actually, the inference that review credibility is a potent predictor of assessing willingness to accept a review is grounded on the analogy that attitude is an effective indicator of purchase intention. However, if memory about established attitudes is blocked, the predictive power of attitude on purchase intention is considerably diminished. Likewise, the effect of credibility on willingness to accept a review can be affected by certain moderators. Inspired by this analogy, we introduced tie strength as a possible moderator and demonstrated that tie strength moderated the effect of credibility on willingness to accept a review. Previously, Levin and Cross (2004) showed that credibility mediates strong-ties through receipt of knowledge, but this credibility mediation is not observed for weak-ties, where a direct path to it is activated. Thus, the predictive power of credibility on behavioral intention - that is, willingness to accept a review - is expected to be higher for strong-ties.

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A Comparative Study on the Mental Health of Adolescents Residing in Child Care Institutions (Orphanages) and Youth Shelters (아동양육시설과 청소년 쉼터에 거주중인 청소년들의 정신건강 수준 비교)

  • Yeonwoo Joun;Cheolgyu Shin;Hyunjeong Kim;Keun Oh;Heeyoung Seo;Jonggook Lee;Je Jung Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.125-133
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    • 2023
  • Objectives : This study aims to compare the mental health of adolescents living in child care institutions (orphanages) and youth shelters, to provide basic data for appropriate psychiatric interventions for each facilities. Methods : The sample consisted of 157 adolescents in child care institutions and 31 adolescents in Youth Shelters who completed the Korean version of the Youth Self Report (K-YSR). We compared the K-YSR scores between the two groups and also examined factors related to suicidality. Results : Adolescents in youth shelters were older and had higher rates of drinking (p<0.001), smoking (p<0.001), and "abnormal sleep" (p=0.007) than adolescents in child care institutions. They also showed higher 'suicidality' (p=0.004) and K-YSR scores. On the other hand, adolescents in child care institutions have lower 'suicidality', but they have higher 'suicidality' when they have 'abnormal sleep' (OR 4.194; p=0.006), 'abnormal diet' (OR 2.503; p=0.010), and 'concerns about weight gain' (OR 2.503; p=0.010). Additionally, 17.6% of participants in the study showed 'suicidality'. The 'suicidality' group had a higher overall K-YSR score than the non-suicidal group, and had higher 'abnormal sleep' (OR 3.766; p=0.014) and 'concern about weight gain' (OR 2.864; p=0.032). Conclusions : Adolescents in youth shelters appear to have more serious clinical difficulties than adolescents in child care institutions, so prompt psychiatric intervention is needed. Additionally, it is necessary to consider mental health assessments including suicidality when adolescents in child care institutions complain of sleep, eating, or weight gain problems.

Association between seafood intake and depression in Korean adults: analysis of data from the 2014-2020 Korea National Health and Nutrition Examination Survey (한국 성인의 수산물 섭취와 우울증과의 상관성 연구: 2014-2020년도 국민건강영양조사 자료를 이용하여)

  • Hyemin Shin;Won Jang;Yangha Kim
    • Journal of Nutrition and Health
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    • v.56 no.6
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    • pp.702-713
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    • 2023
  • Purpose: Depression is a prevalent mental health concern globally including South Korea. Given the growing interest in the relationship between diet and mental health, this study aimed to investigate the association between seafood consumption and depression among Korean adults. Methods: A cross-sectional analysis was conducted using data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014-2020). The study included 18,149 participants (7,541 men and 10,608 women) aged 19 years and older who completed the Patient Health Questionnaire (PHQ-9). Seafood intake levels were assessed using a oneday 24-hour dietary recall, and participants were categorized into three tertiles by gender. Depression status was determined using the PHQ-9 scores and the self-report of the doctor's diagnosis and treatment. Multivariable logistic regression analysis was performed to assess the association between seafood consumption and depression in both genders. Results: Participants with a higher seafood intake had a significantly lower nutritional density of total fat, while the nutritional density of omega-3 polyunsaturated fatty acids was significantly higher. The prevalence of depression was significantly lower in the highest tertile of seafood consumption compared to the lowest tertile in both men (p < 0.001) and women (p < 0.001). After adjusting for confounding factors, the highest tertile of seafood consumption demonstrated a decreased risk of depression compared to the lowest tertile in men (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.51-0.99; p-trend = 0.020) and women (OR, 0.73; 95% CI, 0.59-0.91; p-trend = 0.004). Conclusion: The findings of this study suggest that consuming seafood rich in omega-3 fatty acids may potentially reduce the risk of depression in the adult population.

The Impact of Entrepreneurs' Cognitive Biases on Business Opportunity Evaluation Depending on Social Networks (기업가의 인지편향이 사회적 네트워크에 따라 사업 기회 평가에 미치는 영향)

  • Jang, Hyo Shik;Yang, Dong Woo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.5
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    • pp.185-196
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    • 2023
  • This paper investigates the effects of entrepreneurs' cognitive biases on business opportunity evaluation, given their strong entrepreneurial spirit, which is characterized by innovation, proactivity, and risk-taking. When making decisions related to business activities, entrepreneurs typically make rational judgments based on their knowledge, experience, and the advice of external experts. However, in situations of extreme stress or when quick decisions are required, they often rely on heuristics based on their cognitive biases. In particular, we often see cases where entrepreneurs fail because they make decisions based on heuristics in the process of evaluating and selecting new business opportunities that are planned to guarantee the growth and sustainability of their companies. This study was conducted in response to the need for research to clarify the effects of entrepreneurs' cognitive biases on new business opportunity evaluation, given that the cognitive biases of entrepreneurs, which are formed by repeated successful experiences, can sometimes lead to business failure. Although there have been many studies on the effects of cognitive biases on entrepreneurship and opportunity evaluation among university students and general people who aspire to start a business, there have been few studies that have clarified the relationship between cognitive biases and social networks among entrepreneurs. In contrast to previous studies, this study conducted empirical surveys of entrepreneurs only, and also conducted research on the relationship with social networks. For the study, a survey was conducted using a parallel survey method using online mobile surveys and self-report questionnaires from 150 entrepreneurs of small and medium-sized enterprises. The results of the study showed that 'overconfidence' and 'illusion of control', among the independent variables of entrepreneurs' cognitive biases, had a statistically significant positive(+) effect on business opportunity evaluation. In addition, it was confirmed that the moderating variable, social network, moderates the effect of overconfidence on business opportunity evaluation. This study showed that entrepreneurs' cognitive biases play a role in the process of evaluating and selecting new business opportunities, and that social networks play a role in moderating the structural relationship between entrepreneurs' cognitive biases and business opportunity evaluation. This study is expected to be of great help not only to entrepreneurs, but also to entrepreneur education and policy making, by showing how entrepreneurs can use cognitive biases in a positive way and the influence of social networks.

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On the present bamboo groves of Cholla-nam-do and their proper treatment -No. 1. On the growing stock of reprsentative phyllostachys reticulata grove by county (전라남도(全羅南道)의 죽림현황(竹林現況)과 그 개선대책(改善對策) -제일(第一), 각군별대표고죽림(各郡別代表苦竹林)의 몇가지 죽간형질(竹桿形質)과 축적(蓄積)에 대하여)

  • Chung, Dong Oh
    • Journal of Korean Society of Forest Science
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    • v.2 no.1
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    • pp.19-28
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    • 1962
  • Total area of bamboo groves in Korea which is limited to $37^{\circ}$ north latitude, i.e., to southern part of Chungchung-nam-do Province and Kangwon-do Province, is 3,235ha., but this country must import about 3,000 metric ton's bamboo culms from Japan every year. It may be true that the country is not so fit for economical cultivation of bamboo groves from the view point of climatic condition, but the author believes that self-sufficiency in bamboo is not impossible if some scientific method for improving bamboo groves is introduced to our primitive groves. Keeping this point in his mind the auther tried to study on the bamboo groves in the country, and as the first step set about to investigate the actual state of twenty good bamboo groves located in Cholla-nam-do Province from March, 1961 to January, 1962. This is a report on some characters of bamboo culms and growing stock with samples collected in the present investigation. 1) Numbers of bamboo culm per 0.1ha. are 1,183 in average, 1,840 in maximum and 87.5 in minimum before harvesting. 2) According to owners' saying, 1960 was such an off-year that they could hardly see any yearling bamboos in groves, but in 1961 very many new bamboos are produced as follows: the proportion of the number of yearling bamboos produced this year to that of mature bamboos (over 2 years old) is 58.7% in average; the highest 110.5% and the lowest 16.8%. 3) the average diameter of culms at eye height is 6.5cm, but the biggest diameter comes to 11.2 cm, and the average diameters of yearling and mature bamboos are 6.5cm and 6.6cm respectively. 4) Internode length records 29.4 cm in average, the shortest 21.3 cm and the longest 38.4 cm. Average internode lengths of new culms and mature culms are 27.6 cm and 29.4 cm respectively. This shows that the internode length of new culms is in the decrease to that of maturer's. 5) Through this investigation, it was found that internode length is in the influence of the exposure and density of bamboo groves, i. e., the more the dencity of bamboo groves is and the more the exposure nears the north-east, the longer the internode length becomes (see Table 7 and 8). 6) In the growing stock of bamboo groves, bundles per 0.1ha. amount to 271 sok (unit of bundle) in total average, 445 sok in maximum and 126 sok in minimum. 7) Among twenty typical bamboo groves, chosen in each County in Cholla-nam-do Province, only one passes perfectly by Veda's standard rule* prescribing the good bamboo grove, but the eight groves shown in Table 9 could be recommended as good ones in Cholla-nam-do Province, because the auther believes that those groves may be improved better, if we pay more attention to the management of them. 8) Considering that they have managed their groves carelessly and primitively, and that unfortunately their groves must have faced almost on clear felling over the entire area at the time of the Korean War, we can surely expect much more increments in bamboo groves, if we introduce some scientific methods in managing their groves.

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6-Month Short-Course Chemotherapy for Tuberculous Pleural Effusion (결핵성 흉막염에서의 6개월 단기 치료)

  • Kim, Tae-Hyung;Kim, Kyoung-A;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.509-518
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    • 1998
  • Background: Short-course chemotherapy for 6 months is well established for pulmonary tuberculosis. However, little is known about the efficacy of the short-course chemotherapy for tuberculous pleural effusion. Tuberculous pleural effusion itself may be self-limiting without any treatment, but about two thirds of the patients with tuberculous pleural effusion may subsequently develop pulmonary tuberculosis within 5 years. After completing treatment for tuberculous pleural effusion. prolonged follow-up is necessary for evaluating the efficacy of the treatment There is still no report on the efficacy of 6-month regimens for tuberculous pleural effusion in Korea, where the incidence of tuberculous disease and drug resistance is high. We studied the efficacy of 6 month short-course chemotherapy comparing with 9 month chemotherapy. Method : Retrospective study was done through medical record review in 238 patients with tuberculous pleural effusion who admitted to Asan Medical Center during May 1989-May 1993. The diagnosis of tuberculous pleural effusion was made by bacteriologic or histopathologic study. Results: Among 238 patients, 38 patients were dropped out during follow-up period. In 2 patients, second line drugs were prescribed according to known drug resistance results. And, in 23 patients, treatment longer than 9 months was done due to accompanying extrapulmonary tuberculosis or durg resistance. In 8 patients, treatment regimen was changed due to hepatotoxicity. Remaining 167 cases (70.2%) completed the treatment as scheduled ; 6 month chemotherapy in 88 cases and 9 month chemotherapy in 79 cases. In 60 patients (35.9%) with pleural effusion only in chest X-ray finding, sputum smear or culture for M.tuberculosis was positive in 6 cases (10.0%), and in 63 patients (37.7%) with radiologically inactive pulmonary tuberculosis, sputum smear or culture was positive in 18 cases (28.6%). In 44 patients (26.3%) with radiologically active pulmonary tuberculosis, the sputum smear or culture was positive in 24 cases (54.5%). In 6-month chemotherapy group (n=88), during mean 23 months (range; 1~61months) follow-up period, pulmonary tuberculosis developed in 1 case (1.4%). In 9-month chemotherapy group(n=79), during mean 23 months (range; 3~70months) follow-up period, pulmonary tuberculosis developed in 2 cases (2.5%). All the cases who developed pulmonary tuberculosis also showed active pulmonary tuberculosis on initial chest X-ray before treatment Conclusion: In patients with tuberculous pleural effusion, the incidence of pulmonary tuberculosis after 6 month chemotherapy showed no difference from that after 9 month chemotherapy. Thus, 6 month short-course chemotherapy seems to be an effective treatment for tuberculous pleural effusion.

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The Research on Online Game Hedonic Experience - Focusing on Moderate Effect of Perceived Complexity - (온라인 게임에서의 쾌락적 경험에 관한 연구 - 지각된 복잡성의 조절효과를 중심으로 -)

  • Lee, Jong-Ho;Jung, Yun-Hee
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.147-187
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    • 2008
  • Online game researchers focus on the flow and factors influencing flow. Flow is conceptualized as an optimal experience state and useful explaining game experience in online. Many game studies focused on the customer loyalty and flow in playing online game, In showing specific game experience, however, it doesn't examine multidimensional experience process. Flow is not construct which show absorbing process, but construct which show absorbing result. Hence, Flow is not adequate to examine multidimensional experience of games. Online game is included in hedonic consumption. Hedonic consumption is a relatively new field of study in consumer research and it explores the consumption experience as a experiential view(Hirschman and Holbrook 1982). Hedonic consumption explores the consumption experience not as an information processing event but from a phenomenological of experiential view, which is a primarily subjective state. It includes various playful leisure activities, sensory pleasures, daydreams, esthetic enjoyment, and emotional responses. In online game experience, therefore, it is right to access through a experiential view of hedonic consumption. The objective of this paper was to make up for lacks in our understanding of online game experience by developing a framework for better insight into the hedonic experience of online game. We developed this framework by integrating and extending existing research in marketing, online game and hedonic responses. We then discussed several expectations for this framework. We concluded by discussing the results of this study, providing general recommendation and directions for future research. In hedonic response research, Lacher's research(1994)and Jongho lee and Yunhee Jung' research (2005;2006) has served as a fundamental starting point of our research. A common element in this extended research is the repeated identification of the four hedonic responses: sensory response, imaginal response, emotional response, analytic response. The validity of these four constructs finds in research of music(Lacher 1994) and movie(Jongho lee and Yunhee Jung' research 2005;2006). But, previous research on hedonic response didn't show that constructs of hedonic response have cause-effect relation. Also, although hedonic response enable to different by stimulus properties. effects of stimulus properties is not showed. To fill this gap, while largely based on Lacher(1994)' research and Jongho Lee and Yunhee Jung(2005, 2006)' research, we made several important adaptation with the primary goal of bringing the model into online game and compensating lacks of previous research. We maintained the same construct proposed by Lacher et al.(1994), with four constructs of hedonic response:sensory response, imaginal response, emotional response, analytical response. In this study, the sensory response is typified by some physical movement(Yingling 1962), the imaginal response is typified by images, memories, or situations that game evokes(Myers 1914), and the emotional response represents the feelings one experiences when playing game, such as pleasure, arousal, dominance, finally, the analytical response is that game player engaged in cognition seeking while playing game(Myers 1912). However, this paper has several important differences. We attempted to suggest multi-dimensional experience process in online game and cause-effect relation among hedonic responses. Also, We investigated moderate effects of perceived complexity. Previous studies about hedonic responses didn't show influences of stimulus properties. According to Berlyne's theory(1960, 1974) of aesthetic response, perceived complexity is a important construct because it effects pleasure. Pleasure in response to an object will increase with increased complexity, to an optimal level. After that, with increased complexity, pleasure begins with a linearly increasing line for complexity. Therefore, We expected this perceived complexity will influence hedonic response in game experience. We discussed the rationale for these suggested changes, the assumptions of the resulting framework, and developed some expectations based on its application in Online game context. In the first stage of methodology, questions were developed to measure the constructs. We constructed a survey measuring our theoretical constructs based on a combination of sources, including Yingling(1962), Hargreaves(1962), Lacher (1994), Jongho Lee and Yunhee Jung(2005, 2006), Mehrabian and Russell(1974), Pucely et al(1987). Based on comments received in the pretest, we made several revisions to arrive at our final survey. We investigated the proposed framework through a convenience sample, where participation in a self-report survey was solicited from various respondents having different knowledges. All respondents participated to different degrees, in these habitually practiced activities and received no compensation for their participation. Questionnaires were distributed to graduates and we used 381 completed questionnaires to analysis. The sample consisted of more men(n=225) than women(n=156). In measure, the study used multi-item scales based previous study. We analyze the data using structural equation modeling(LISREL-VIII; Joreskog and Sorbom 1993). First, we used the entire sample(n=381) to refine the measures and test their convergent and discriminant validity. The evidence from both the factor analysis and the analysis of reliability provides support that the scales exhibit internal consistency and construct validity. Second, we test the hypothesized structural model. And, we divided the sample into two different complexity group and analyze the hypothesized structural model of each group. The analysis suggest that hedonic response plays different roles from hypothesized in our study. The results indicate that hedonic response-sensory response, imaginal response, emotional response, analytical response- are related positively to respondents' level of game satisfaction. And game satisfaction is related to higher levels of game loyalty. Additionally, we found that perceived complexity is important to online game experience. Our results suggest that importance of each hedonic response different by perceived game complexity. Understanding the role of perceived complexity in hedonic response enables to have a better understanding of underlying mechanisms at game experience. If game has high complexity, analytical response become important response. So game producers or marketers have to consider more cognitive stimulus. Controversy, if game has low complexity, sensorial response respectively become important. Finally, we discussed several limitations of our study and suggested directions for future research. we concluded with a discussion of managerial implications. Our study provides managers with a basis for game strategies.

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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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