• 보건행정학회지
• /
• 제12권2호
• /
• pp.115-135
• /
• 2002

Many tertiary hospitals have started to establish cooperative relationships with small and medium sized hospitals in Korea. But the performance of the relationship is not satisfactory to both of partners. The relationship and performance of cooperation for small and medium sized hospitals are analyzed according to the framework of inter-organizational cooperation. Data are collected by 4 focal hospital and 34 small and medium sized hospitals through interview and questionnaire. The findings are : a) The cooperation is focused on management area, such as healthcare technology transfer and information sharing, rather than patient referral. b) Patient referral is not yet active in cooperative relationship. But some partner hospitals which is located close and managing internal organization for cooperation show a significant number of referrals. c) The characteristics of high performers are positive attitude about cooperation, and recognition of the relationship as flexible, experiences of cooperation, internal and external management activities.

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

• 기본간호학회지
• /
• 제22권1호
• /
• pp.7-15
• /
• 2015

Purpose: This study was done to investigate the correlation among emotional labor, nursing professional values, and job satisfaction and identify factors that affect job satisfaction of nurses working in small and medium-sized hospitals. Methods: Data were collected from 214 nurses in S city. The following measurement tools were used: Emotional labor by Morris et al. (1996), Nursing Professional Values Scale by Yeun et al. (2005), and Index of Work Satisfaction by Stamps et al. (1978). Collected data were analyzed with SPSS/WIN 18.0 using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression. Results: Participants' scores for emotional labor, nursing professional values and job satisfaction were $3.11{\pm}0.48$, $3.46{\pm}0.39$, and $3.02{\pm}0.29$ respectively. Emotional labor showed a negative correlation with job satisfaction (r=-.33, p<.001), while nursing professional values showed a positive correlation with job satisfaction (r=.58, p<.001). Emotional labor and nursing professional values were identified as factors influencing job satisfaction. The model explained about 39% of the variance in job satisfaction (F=67.40, p<.001). Conclusion: The results of this study suggest that it is important to manage emotional labor as well as to improve professional values and job satisfaction of nurses working in small and medium-sized hospital.

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

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

• 근관절건강학회지
• /
• 제28권1호
• /
• pp.18-29
• /
• 2021

Purpose: This study examined the knowledge and education needs of nurses in charge of adequacy evaluation in small and medium-sized hospitals. Methods: Study participants included 198 nurses in charge of adequacy evaluation in small and medium-sized hospitals. Data were collected from November 19 to 28, 2020 through an online survey. The data were analyzed by independent t-test and one way ANOVA analysis using the SPSS. Results: The knowledge score for the adequacy evaluation of small and medium-sized hospitals was 11.61±4.10 (total of 20 points), and the educational demand was 3.87±0.88 points on a 5-point scale. Regarding the necessity of education for adequacy evaluation of small and medium-sized hospitals, 80.3% of the participants claimed education as being necessary. "Online video lectures" were the most preferred (22.7%) education method, and "2 times" was the most frequent education (47.0%); "1 hour" was the usual duration of class (48.5%). Conclusion: It is necessary to develop and apply an educational program reflecting the measure of educational needs to improve the knowledge level of nurses in charge of adequacy evaluation in small and medium-sized hospitals.

• 보건의료산업학회지
• /
• 제6권3호
• /
• pp.39-52
• /
• 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
• /
• 제24권1호
• /
• pp.67-73
• /
• 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.

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

• 한국산학기술학회논문지
• /
• 제15권5호
• /
• pp.2695-2702
• /
• 2014

본 연구의 목적은 중소병원 간호사의 간호전문직관, 직무만족도 및 이직의도와의 관계를 파악하기 위해 2011년 10월부터 2012년 6월까지 "I"시에 위치한 100-400병상 규모의 8개 중소병원에 근무하는 간호사 240명을 대상으로 설문조사하였다. 대상자의 평균 간호전문직관 점수는 $3.23{\pm}.44$, 평균 직무만족 점수는 $2.81{\pm}.47$점, 평균 이직의도 점수는 $2.70{\pm}.87$점으로 대상자의 일반적 특성과 직무 관련 특성 중 유의한 차이가 있었던 변수는 연령, 결혼상태, 임상경력, 근무형태, 밤 근무 횟수였고, 대상자의 이직의도는 직무만족과 양의 상관관계, 간호전문직관 과의 관계는 정적인 상관관계를 보였다. 이직의도를 설명하는 주요 변수는 직무만족도, 임상경력, 연령이며, 이중 직무만족도(${\beta}$=.533)가 다른 관련요인보다 가장 영향력이 많은 것으로 나타났다. 본 연구결과 여전히 직무만족도가 중소병원 간호사의 이직의도에 영향을 주는 주요 변수인 것이 확인 되었고, 이로써 중소병원 간호사의 이직의도를 이해하고, 그 수를 줄이는데 있어 중소병원 간호사에 대한 직무 만족도에 관해 계속적으로 연구하는 것이 필요하겠다.