• 대한방사선기술학회지:방사선기술과학
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• 제45권3호
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• pp.263-272
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• 2022

This study investigated small and medium-sized hospital workers' knowledge of COVID-19, the infection-control-related fatigue and stress levels, and the factors that impacted their performance during the COVID-19 pandemic. Using a cross-sectional design, data were collected from 137 hospital workers from four small and medium-sized hospitals in S and C cities. Data were analyzed using descriptive statistics, a t-test, analysis of variance(ANOVA), Pearson's correlation coefficient, and multiple linear regression analysis. Small and medium-sized hospital workers' knowledge of COVID-19 revealed a correct answer rate of 66%. An average of 3.00 points out of 4 for infection control performance and 3.32 and 3.17 points out of 5 for infection-control-related fatigue and stress, respectively, were found. The level of knowledge regarding COVID-19 significantly differed by age and marriage (p<0.05), while infection control performance significantly differed by age, marriage, and infection control education experience (p<0.05). Infection-control-related fatigue and stress differed depending on the COVID-19 control education experience, economic and social prejudice, and fear of discrimination. There were positive correlations between knowledge and infection control performance, and infection control performance and infection-control-related fatigue and stress (p<0.001). This study showed that the factors that affected small and medium-sized hospital workers' performance included knowledge of "environmental management," "difficulties due to new role requirements," "presence or absence of infection education experience," "job type," and "age." These results suggest that practical and detailed education programs should be systematically developed and implemented for effective infection control.

• 융합정보논문지
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• 제10권3호
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• pp.22-30
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• 2020

본 연구의 목적은 중소병원 간호사의 사회적 지지와 직무만족이 직무배태성에 미치는 영향을 확인하는 것이다. G시에 소재한 중소병원 간호사를 대상으로 하였으며, 197명의 자료를 분석하였다. 자료는 기술적 통계, t-test, ANOVA, Pearson 상관분석, 위계적 회귀분석을 실시하였다. 연구결과 직무배태성은 사회적 지지 중 상사 지지, 동료지지, 직무만족과 정적 상관관계를 보였다. 연구모델은 직무배태성의 28.0%를 설명하였고, 이 중 직무배태성에 영향을 미치는 가장 강력한 변인은 직무만족(β=.33 p<.001)이었으며, 사회적 지지 중 상사지지가 직무배태성에 영향을 미치는 것으로 나타났다. 따라서 중소병원 간호사의 직무배태성을 촉진하기 위해 직무만족 및 사회적 지지의 상사지지를 증진시키기 위한 방안 마련이 필요함을 시사한다.

• 한국병원경영학회지
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• 제17권2호
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• pp.1-20
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• 2012

This study aims to suggest managerial strategies for strengthening their competitiveness via analyzing and determining factors to help improve customer orientation and internal customer satisfaction. Furthermore, this study aims to find out the factors of internal service quality affects job satisfaction and customer orientation. The data was collected in 5 small and medium hospitals on 215 workers who had direct interactions with customers. Through regression analysis, all factors of internal service quality affects job satisfaction, however only two factors, credibility and sympathy appeared to affect customer orientation.

• 한국콘텐츠학회논문지
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• 제18권5호
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• pp.191-214
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• 2018

본 연구는 급격한 사회 경제적 여건의 변화에 따라 중소병원의 설립에 대한 선택요인 및 입지 선정 요인의 중요성이 점점 커짐에 따라 의료서비스 시설의 선택요인 및 입지선정 요인에 대해 실증 분석하였다. 본 연구는 중 소 병원 선택요인 및 입지선정요인에 관한 연구를 통하여 각 평가항목 요인들 간의 중요도에 따른 우선순위를 분석하고, 부동산 입지적 요인과 비입지적 요인을 구분하여 기존 중소병원의 경쟁력에 미치는 중요 요인이 무엇인지 도출하여, 신규 중 소 병원 개원을 준비하고 있는 의료 공급자에게 중소병원 선택요인의 중요 요인에 따른 입지특성을 고려한 중소병원의 개원전략의 기초 자료로 할용 하는데 목적이 있다. 기존의 선행연구와 사례연구 결과를 바탕으로 의료수준, 의료서비스, 병원의 접근성, 병원의 편리성, 물리적 환경 측면에서 28개의 평가요인을 도출 하였으며, 수집된 28개의 세부평가요인은 관련 전문가들과의 인터뷰를 통하여 의료수준, 의료서비스, 병원의 전문성, 병원의 편리성, 물리적환경 등 5개 요인을 상위 계층 평가요인으로 선정하였고 각 상위 계층에 따라 총 28개의 하부 평가 요인을 선정하였다. 선정된 최적 정평가요인들은 의료전문가 200명을 대상으로 AHP 설문조사를 실시하여 최적 입지요인을 선정하였다. AHP 분석결과는 선행연구의 사례와 유사하게 의료수준, 의료서비스, 병원의 접근성, 물리적 환경, 편리성의 순으로 중요도가 나타났으며, 병원의 시설과 관련된 요인은 낮게 나타났다. 본 연구의 결과는 향후 중 소병 입지선정 의사 결정을 위한 기초를 제공하는데 응용할 수 있을 것이다.

• 가정간호학회지
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• 제29권2호
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• pp.216-224
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• 2022

Purpose: This study aimed to investigate the influence of the perception of the importance of patient safety management and culture on employees' safety performance in small and medium -sized hospitals. Methods: The participants comprised 119 hospital employees, including nurses, doctors, and medical technicians. Data were analyzed through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis using the SPSS program. Results: The mean safety performance was 4.09±0.34, mean safety compliance was 4.12±0.44, and safety participation was 4.06±0.38. There were significant differences in safety performance by gender and job. Safety performance and its assocation with both perception of importance on patient safety management and, perception of patient safety culture showed a positive correlation. Safety performance was influenced by the perception of patient safety culture. The explanatory power was 15.7%. Conclusion: Based on these results, improving the perception of patient safety culture is necessary to increase safety performance. To this end developing and applying an interprofessional safety performance education program for employees in small and medium-sized hospitals is vital.

• 보건의료산업학회지
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• 제6권3호
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• pp.39-52
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• 2012

Main purpose of this study is to provide some managerial suggestions for local small and medium-sized hospitals that are in poorer business environment than large hospitals such as university hospitals, in managing the manpower efficiently, improving business performance and enhancing competitiveness, by empirically investigating the relationship among competency, organizational structure and business performance. Major results are as follows: First, regression analysis for the effects of hospital competency on nonfinancial performance revealed that marketing competency, intangible resource competency and financial resource competency, in that order of importance, had significant influence on nonfinancial performance. Second, regarding the analysis of the effects of hospital competency on financial performance, financial resource competency, marketing competency and intangible resource competency, in that order of importance, significantly affected financial performance. Third, as for the moderating effect, significant result was obtained in an interaction between hospital competency and organizational structure. Financial resource competency had a positive significant impact on nonfinancial performance. However, it had negative significant impact on it by interactive effect with organizational structure.

• 임상간호연구
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• 제24권1호
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• pp.67-73
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• 2018

Purpose: This study was done to explore the relationship between expectations of the clinical ladder system (CLS), career commitment and turnover intention in nurses employed in small-medium sized hospitals. Methods: Participants were 154 nurses from 3 small-medium sized hospitals in Gyeonggi Province and Gwangju City. From February, 8 to April, 14, 2017, self-report questionnaires were collected and analyzed using frequency, t-test, ANOVA, $Scheff{\acute{e}}$ test, and Person correlation coefficients. Results: Of the participant nurses, 61% perceived the CLS as needed. The mean score for expectation of CLS, career commitment, and turnover intention on 5-point scale were 3.38, 3.17, 3.21, respectively. There were no significant differences in expectation of CLS according to general characteristics, but career commitment and turnover intention did show significant differences depending on age, position, type of work shift. Expectation of CLS correlated positively with career commitment (r=.23, p=.005), and career commitment correlated negatively with turnover intention (r=-.49, p<.001). Conclusion: The results of this study show that there is a need to adopt the clinical ladder system to improve career commitment.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.983-994
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• 2021

Objective : The effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). Methods : We analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1-3 and 3-5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. Results : After GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0-17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150-0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5-11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. Conclusion : The small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.

• 산경연구논집
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• 제10권4호
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• pp.67-76
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• 2019

Purpose - This study attempted to construct and validate a structural model of the relationship between the quality of medical services, perceived risk, reputation and customer satisfaction, which is the main concept of the relationship between large hospitals as well as small and medium hospitals and medical consumers. Through this verification, the small and medium hospitals are to find the way for wise coping in competitive situation with large hospitals. Research design, data, and methodology - This research developed a hypothesis by constructing a structural equation that reaches the satisfaction and the relationship between reputation of perceived risk and perceived risk of service quality perceptions of customers of small and medium hospitals. Research data were collected through a questionnaire survey of respondents who had medical service experience from small and medium hospital. A total data of 252 respondents were used as the sample for the final analysis and analyzed using SPSS 23.0 and AMOS 23. Results - As a result, the relationship of quality of medical service, reputation, and customer satisfaction among small and medium hospitals was consistent with the results of precedent studies, and the perceived risk has a significant impact on reputation, so the greater the perceived risk, the higher the preference for reputable medical institutions as large hospitals. In addition, it was found that the direct route from perceived risk to customer satisfaction was not significant, and reputation was found to have a full mediating effect on perceived risk and customer satisfaction. Customers who use small and medium hospitals prefer to use reputable medical institutions if their perceived risk is high, which is different from risk perception when specific targets are specified. Conclusions - In terms of the effect from customer satisfaction, not only the path of perceived risk → reputation → customer satisfaction, but also the quality of service quality → reputation → customer satisfaction. These findings suggest that small and medium hospitals are appropriately responding to competition with large hospitals, rather than focusing on the perceived risks and reputation of customers in establishing and utilizing competitive strategies to create new customers and preserve existing customers.

• 한국직업건강간호학회지
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• 제21권3호
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• pp.258-265
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• 2012

Purpose: The purpose of this study is to identify the influence of job stress and empowerment on nursing performance of clinical nurses working in small and medium hospital. Methods: The empirical data were collected from a self-administered survey using a structured questionnaire with 404 nurses working in 4 medium-sized hospitals (less than 300 beds), located in I-city. The data were analyzed using stepwise multiple regression with the SPSS/WIN 17.0 program. Results: There were significant differences in nursing performance depending on general characteristics (age, marital status, religion, shift work, education level, position, clinical experience, department, and monthly salary). Empowerment correlated with nursing performance. Factors influencing on nursing performance were empowerment, clinical experience, job stress, and marital status with $R^2$ value of 36.3%. The most influencing factor was empowerment (${\beta}$=.47), followed by clinical experience (${\beta}$=.24), job stress (${\beta}$=.20), and marriage (${\beta}$=.12). Conclusion: It is needed to implement specific empowerment strategy, control job stress, and reward experienced and married nurses working in medium-sized hospital for improving nursing task performance.