• Title/Summary/Keyword: Special needs patient

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The Needs for Rehabilitation Day Care Center in Stroke Patients (뇌졸중 환자의 주간 재활간호센터에 대한 요구)

  • Ko, Sun-Hwa;Lee, Myung-Ha
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.9 no.2
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    • pp.114-128
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    • 2002
  • In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.

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SOME CONSIDERATIONS ON ESTABLISHING DENTAL CARE DELIVERY SYSTEM AND DENTAL SPECIALTY SYSTEM IN KOREA (의료전달체계(醫療傳達體系)와 전문치의제(專門齒醫制)에 관(關)한 소고(小考))

  • Han, Young-Chul
    • Restorative Dentistry and Endodontics
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    • v.24 no.4
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    • pp.639-646
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    • 1999
  • The dental care delivery system and the dental specialty system have a very close relationship each other. Compared to Korea. Western European countries with predominant public sector in dental service have recognized merely 2 or 3 dental specialties, while North American countries with predominant private sector, 8 or 9 ones. It is desirable to adopt the dental specialty system as soon as possible in Korea to encourage scientific development in various dental specialties and qualitative advance in dental service. We, however, have to establish equitable dental care delivery system which can use limited dental resources efficiently as follows. 1. clarifying the different roles in assignments between general dentists and specialists by the amendment of the related laws such as the Medical Act and establishing the organic patient-referral system. 2. adopting the dental specialty system and expanding personnel and equipments so that the dental college hospitals, especially dental divisions of general hospitals, night function as secondary care facilities with specialties. 3. determining the size of dental specialists according to the national needs for dental specialized service's, whose number is to be not more than 10% of the total dentists. 4. transferring the function of accredating dental specialists to the efficient, self-controlled professional organization such as the Korean Dental Association rather than putting it under the governmental control. 5. conducting a comprehensive review of specialty education and practice for re-recognition, and maintaining competence of specialists by re-accredating them periodically. I expect this article to contribute to further discussion about the dental specialty system in Korea in productive and practical way. I am sure that we can Establish this system in the near future when people in every walks of life-the academic circle, the press, the authority concerned, consumer groups and the Korean Dental Association-take part in the discussion with special concern.

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Analysis of user's satisfaction for 119 emergency medical service quality improvement (119구급서비스 질 향상을 위한 이용자 만족도 분석)

  • Ahn, Hee-Jeong;Shim, Gyu-Sik;Song, Hyo-Suk;Bang, Sung-Hwan;Choi, Gil-Soon
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.67-77
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    • 2020
  • Purpose: The study aims to improve the quality of emergency medical services by surveying the user's satisfaction of 119 emergency medical services nationwide. Methods: From December 21 to December 27 each year from 2015 to 2017 a total of 5,889 people were surveyed by phone call in fire station. Results: The average degree of satisfaction with the emergency medical services was 4.17±0.70, with 85.1% respondents reporting being 'satisfied'. Factors like being a patient, injuries, residential area, and scene arrival time affected satisfaction. From 2015 to 2017, the satisfaction degree decreased every year, with factors affecting this results including "first aid guidance of phone call" and "rapidity of emergency medical services." The highest satisfaction factors were 'friendly acting of emergency medical services' and 'appropriate offer of emergency medical services', while the lowest satisfaction factors were 'first aid guidance of phone call' and 'adequacy of emergency medical team'. Conclusion: The quality of emergency medical services needs to be improved by managing the quality of phone call first aid guidance and the assignment of adequate emergency medical teams to increase user satisfaction.

Analysis of Mission, Vision and Core values in Korean Tertiary General Hospitals Through Text Mining (텍스트 마이닝을 통한 상급종합병원의 미션, 비전, 핵심가치 분석 연구)

  • Ji-Hoon Lee
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.32-43
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    • 2023
  • Purposes: This research is conducted to identify main features and trends of mission, vision and core values in Korean tertiary general hospitals by using text-mining. Methodology: For the study, 45 mission, 112 vision and 190 core values are collected from 45 tertiary general hospitals' homepages in 2022 and use word frequency analysis and Leyword co-occurrence analysis. Findings: In the tertiary general hospitals' mission, there are high frequency words such as 'health', 'humanity', 'medical treatment', 'education', 'research', 'happiness', 'love', 'best', 'spirit', and mission mainly includes the content of contributing humanity's health and happiness with these words. In case of vision, high frequency words are 'hospital', 'medical treatment', 'research', 'lead', 'trust', 'centered', 'patient', 'best', 'future'. By using these words in vision, it represents the definition and characteristics of vision such as ideal organizations in the future, goals and targets. As a result of the Leyword co-occurrence analysis, vision includes the content of 'high-tech medical treatment', 'special care for patients', 'leading education and research', 'the highest trust with customer', 'creative talents training'. -astly, the high frequency word-pairs in core values are 'social distribution', 'innovation pursuit', 'cooperation and harmony', and it defines standards of behavior for organizations. Practical Implication: To correct the problems of vision, mission and core values from findings, firstly, it needs for Korean tertiary general hospitals to use the words that can explain organization's identity and differentiate others in their mission. Secondly, considering strengthening the role of hospitals in their community and the importance of members in organizations, it is necessary to establish vision with considering community and members to activate vision effectively. Thirdly, because there are no specific guidelines of establishing mission, vision and core values for healthcare organizations, this research concepts and results could be utilized when other organizations establish mission, vision and core values.

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The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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Study on the Realities in Seoul Subway Crimes: Criminal Psychology (서울지하철 범죄 실태에 대한 범죄심리학적 연구)

  • Rim, Sang-Gon
    • Korean Security Journal
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    • no.7
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    • pp.233-285
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    • 2004
  • ‘Defined legally as a violation of law' (Sutherland, E. H. Principles of Criminology, Lippincott, Chicago, 1939) Crime within the group is essentially and primarily antisocial in that the criminal who is welfare of his group acts instead against it and breaks the principles of social solidarity not merely by not doing what these principles prescribe, but by doing something exactly opposites. Any program set up to attack crime and delinquent behavior at their sources. A program of his nature needs the constant and comprehensive collaboration of psychiatrists, social works, educations, lawmakers, and public officials, since crime is a social problem and it should be treated as such. Some crime preventives which should be mentioned are as follows, (1) The insurance that every child will be decently born and that his home life be socially and economically adequate; without socially mature parents the chid is handicapped at the start; thus parental education, integrated with the public school system, should be developed now. (2) A more meaningful educational program which would emphasize ideals of citizenship, moral integrity, and respect for the law and the police. (3) A periodic check made for potential delinquents throughout the public schools and treatment provided if possible; and if not, proper segregation in institutions. (4) Careful attention paid to press, movies, and radio so that crime may no longer appear to be glamorous. This can be done by women's clubs, civic bodies, and other educational groups exerting pressure on the movie syndicates and broadcasting companies to free their productions of the tawdry and lurid characteristics of crime and criminals. Aggression associated with the phallic stage of development, The child ordinarily comprehends sexual intercourse as an aggressive and sadistic act on the part of the male, and specifically on the part of the penis. Evidence that the penis is phantasied as a weapon of violence and destruction come from unconscious productions of normal adults. Limerick, for instance, often refer to the penis as square, or too large, etc., so that intercourse is dangerous and painful for the partner, This may wall be a projection of the male's own fear of coitus. A certain portion of the death-instinct always remains within the person; it is called 'primal sadism' and according to Freud is identical with masochism. 'After the chief part of it(the death instinct) has been directed outwards towards objects, there remains as a residuum within the organism the true erotogenic masochism, which on the one hand becomes a component of the libido and on the other still has the subject itself for a object.' Criminalism, compulsive-neurotic frequent repetition of criminal acts in a compulsive manner. Like most symptoms of the compulsive-neurotic, such antisocial act are closely rated to feelings of hostility and aggression, often against the father. Because these acts are symptomatic, they afford only temporary relief and are therefore repeated. One patient with compulsive-neurotic criminalism was apprehended after breaking into hardware store and stealing money. He later confessed to many similar incidents over the preceding two years. At the same time it was apparent that he stole only for the sake of stealing. He did not need the money he thus obtained and had no special plans for using it.

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Case Analysis of Pulmonary Sequestration (폐격리증에 대한 임상적 고찰)

  • Jeon, Yang-Bin;Shin, Sung-Ho;Chung, Tae-Yul;Kim, Hyuk;Ham, Si-Young;Lee, Chul-Bum;Chung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1206-1211
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    • 1998
  • Background: Pulmonary sequestration is not common and it's diagnosis needs special care such as an aortogram ar tomography. Material and Method: We have experienced 13 patients who had pulmonary sequestration from January 1990 to September 1997. Result: Six men and seven women were treated and their mean age was 25.8±14.3 years. Their chief complaints were coughing, chest pain, and no symptoms in decreasing order. There were nine intralobar(ILS) and three extralobar(ELS) pulmonary sequestrations and one patient had both. There was no preference in location of either left or right. They were mainly diagnosed by aortography and their feeding arteries commonly originated from the lower thoracic aorta. The patients with ILS were treated by lobectomy and those with ELS by sequestrectomy. Conclusion: to treat pulmonary sequestration properhy, aortogram or chest CT is warranted to iidenty the abnormal origin of feeding artery.

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Efficient Transmission Structure and Key Management Mechanism Using Key Provisioning on Medical Sensor Networks (의료 센서 네트워크에서의 효율적인 전송 구조 및 Key Provisioning을 사용한 키 관리 기법 연구)

  • Seo, Jae-Won;Kim, Mi-Hui;Chae, Ki-Joon
    • The KIPS Transactions:PartC
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    • v.16C no.3
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    • pp.285-298
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    • 2009
  • According to the development of ubiquitous technologies, sensor networks is used in various area. In particular, medical field is one of the significant application areas using sensor networks, and recently it has come to be more important according to standardization of the body sensor networks technology. There are special characteristics of their own for medical sensor networks, which are different from the one of sensor networks for general application or environment. In this paper, we propose a hierarchical medical sensor networks structure considering own properties of medical applications, and also introduce transmission mechanism based on hierarchical structure. Our mechanism uses the priority and threshold value for medical sensor nodes considering patient's needs and health condition. Through this way Cluster head can transmit emergency data to the Base station rapidly. We also present the new key establishment mechanism based on key management mechanism which is proposed by L. Eschenauer and V. Gligor for our proposed structure and transmission mechanism. We use key provisioning for emergency nodes that have high priority based on patients' health condition. This mechanism guarantees the emergency nodes to establish the key and transmit the urgent message to the new cluster head more rapidly through preparing key establishment with key provisioning. We analyze the efficiency of our mechanism through comparing the amount of traffic and energy consumption with analysis and simulation with QualNet simulator. We also implemented our key management mechanism on TmoteSKY sensor board using TinyOS 2.0 and through this experiments we proved that the new mechanism could be actually utilized in network design.

Space Usage and Satisfaction with Privacy in General Hospital Inpatients (종합병원 입원환자의 공간사용 및 프라이버시 만족도)

  • Choi, In Young;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.36
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    • pp.391-400
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    • 2018
  • To ensure a user-centered treatment environment, hospital construction needs an approach that is not centered on functional aspects such as efficiency or economic feasibility but on the consideration of needs as reflected in user psychology and behavior. Patients who are physically and psychologically vulnerable experience psychological pressure when they are placed in an unfamiliar environment. Most of existing studies however focus on the evaluation of the physical environment, without paying attention to the psychological or behavioral approach to anxiety and stress that patients may experience in a special environment that a hospital may be to them. This study examines general hospital inpatients to understand the usage of major space available and their satisfaction with privacy. This study provides useful primary information needed for the user-centered design of general hospital for improved patient health and welfare. For the purpose of the study, literature review, site investigation, and survey were conducted. Major functional space and privacy in general hospitals were studied, and the site investigation was performed to identify the plans and their status. Survey was also performed to understand the usage of functional space and satisfaction with such space usage as well as satisfaction with privacy. The findings were as follows: (1) Space usage was rated as average in general. It was found that patients used their rooms and lobby on a daily basis. By age, the usage was highest in the group in their 40s; the usage was relatively lower in the groups in their 30s or younger. (2) Space satisfaction was above average, indicating that patients were fairly satisfied. Satisfaction was highest in the lobby space designed with distinct features. By case, satisfaction was highest in Case B, characterized by its wide horizontal space in the rural settings. (3) Satisfaction with privacy in hospital was average, indicating that the demand for privacy was relatively higher but what patients receive in return was lower than their expectation. It was also found that satisfaction with privacy was a crucial element that affected the overall satisfaction with hospital.