A Study of 'Emotion Trigger' by Text Mining Techniques (텍스트 마이닝을 이용한 감정 유발 요인 'Emotion Trigger'에 관한 연구)
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- Journal of Intelligence and Information Systems
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- v.21 no.2
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- pp.69-92
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- 2015
The explosion of social media data has led to apply text-mining techniques to analyze big social media data in a more rigorous manner. Even if social media text analysis algorithms were improved, previous approaches to social media text analysis have some limitations. In the field of sentiment analysis of social media written in Korean, there are two typical approaches. One is the linguistic approach using machine learning, which is the most common approach. Some studies have been conducted by adding grammatical factors to feature sets for training classification model. The other approach adopts the semantic analysis method to sentiment analysis, but this approach is mainly applied to English texts. To overcome these limitations, this study applies the Word2Vec algorithm which is an extension of the neural network algorithms to deal with more extensive semantic features that were underestimated in existing sentiment analysis. The result from adopting the Word2Vec algorithm is compared to the result from co-occurrence analysis to identify the difference between two approaches. The results show that the distribution related word extracted by Word2Vec algorithm in that the words represent some emotion about the keyword used are three times more than extracted by co-occurrence analysis. The reason of the difference between two results comes from Word2Vec's semantic features vectorization. Therefore, it is possible to say that Word2Vec algorithm is able to catch the hidden related words which have not been found in traditional analysis. In addition, Part Of Speech (POS) tagging for Korean is used to detect adjective as "emotional word" in Korean. In addition, the emotion words extracted from the text are converted into word vector by the Word2Vec algorithm to find related words. Among these related words, noun words are selected because each word of them would have causal relationship with "emotional word" in the sentence. The process of extracting these trigger factor of emotional word is named "Emotion Trigger" in this study. As a case study, the datasets used in the study are collected by searching using three keywords: professor, prosecutor, and doctor in that these keywords contain rich public emotion and opinion. Advanced data collecting was conducted to select secondary keywords for data gathering. The secondary keywords for each keyword used to gather the data to be used in actual analysis are followed: Professor (sexual assault, misappropriation of research money, recruitment irregularities, polifessor), Doctor (Shin hae-chul sky hospital, drinking and plastic surgery, rebate) Prosecutor (lewd behavior, sponsor). The size of the text data is about to 100,000(Professor: 25720, Doctor: 35110, Prosecutor: 43225) and the data are gathered from news, blog, and twitter to reflect various level of public emotion into text data analysis. As a visualization method, Gephi (http://gephi.github.io) was used and every program used in text processing and analysis are java coding. The contributions of this study are as follows: First, different approaches for sentiment analysis are integrated to overcome the limitations of existing approaches. Secondly, finding Emotion Trigger can detect the hidden connections to public emotion which existing method cannot detect. Finally, the approach used in this study could be generalized regardless of types of text data. The limitation of this study is that it is hard to say the word extracted by Emotion Trigger processing has significantly causal relationship with emotional word in a sentence. The future study will be conducted to clarify the causal relationship between emotional words and the words extracted by Emotion Trigger by comparing with the relationships manually tagged. Furthermore, the text data used in Emotion Trigger are twitter, so the data have a number of distinct features which we did not deal with in this study. These features will be considered in further study.
Increased sanitation management of foodservice establishments is required because most of the reported foodborne-disease outbreaks were in the foodservice industry. The purpose of this study was to determine the important control points for good sanitation. In this study, we inspected twenty foodservice establishments in Seoul, Kyunggi, Kyungnam with a self-developed monitoring tool. These foodservice establishments included secondary schools, universities, and industries. Six of them had appointed as the HACCP-certified establishments from the Korea Food and Drug Administration. The inspection was conducted from June to August in 2002. The inspection tool consisted of nine dimensions and sixty-five items. The dimensions were 'personal sanitation', 'supply of raw food', 'food storage', 'handling of raw food and ready-to-eat', 'cleaning and sterilization', 'waste control', 'pest control', and 'control of establishment and equipment' The highest possible score of this inspection tool is 105 points. Statistical data analysis was completed using the SPSS Package(11.0) for descriptive analysis Kruskal-Wallis. The score for the secondary schools (83.6 points) was higher than for the others and number of in compliance item was 50.9 on average. Therefore, we concluded that the secondary schools' sanitation condition was good. The foodservice establishments acquired HACCP certification was 89.7 points, which was significantly higher than that of establishments not applying foodservices in total score. Instituting the HACCP system in a foodservice is very effective for sanitation management. Many out of the compliance observations were found in the dimensions of 'waste control', 'control of establishment and equipment', and 'supply of raw food' 'Clean condition of refrigerator' item was
The 3D printing technology, which started from the patent registration in 1986, was a technology that did not attract attention other than from some companies, due to the lack of awareness at the time. However, today, as expiring patents are appearing after the passage of 20 years, the price of 3D printers have decreased to the level of allowing purchase by individuals and the technology is attracting attention from industries, in addition to the general public, such as by naturally accepting 3D and to share 3D data, based on the generalization of online information exchange and improvement of computer performance. The production capability of 3D printers, which is based on digital data enabling digital transmission and revision and supplementation or production manufacturing not requiring molding, may provide a groundbreaking change to the process of manufacturing, and may attain the same effect in the character merchandise sector. Using a 3D printer is becoming a necessity in various figure merchandise productions which are in the forefront of the kidult culture that is recently gaining attention, and when predicting the demand by the industrial sites related to such character merchandise and when considering the more inexpensive price due to the expiration of patents and sharing of technology, expanding opportunities and sectors of employment and cultivating manpower that are able to engage in further creative work seems as a must, by introducing education courses cultivating manpower that can utilize 3D printers at the education field. However, there are limits in the information that can be obtained when seeking to introduce 3D printers in school education. Because the press or information media only mentions general information, such as the growth of the industrial size or prosperous future value of 3D printers, the research level of the academic world also remains at the level of organizing contents in an introductory level, such as by analyzing data on industrial size, analyzing the applicable scope in the industry, or introducing the printing technology. Such lack of information gives rise to problems at the education site. There would be no choice but to incur temporal and opportunity expenses, since the technology would only be able to be used after going through trials and errors, by first introducing the technology without examining the actual information, such as through comparing the strengths and weaknesses. In particular, if an expensive equipment introduced does not suit the features of school education, the loss costs would be significant. This research targeted general users without a technology-related basis, instead of specialists. By comparing the strengths and weaknesses and analyzing the problems and matters requiring notice upon use, pursuant to the representative technologies, instead of merely introducing the 3D printer technology as had been done previously, this research sought to explain the types of features that a 3D printer should have, in particular, when required in education relating to the development of figure merchandise as an optional cultural contents at cartoon-related departments, and sought to provide information that can be of practical help when seeking to provide education using 3D printers in the future. In the main body, the technologies were explained by making a classification based on a new perspective, such as the buttress method, types of materials, two-dimensional printing method, and three-dimensional printing method. The reason for selecting such different classification method was to easily allow mutual comparison of the practical problems upon use. In conclusion, the most suitable 3D printer was selected as the printer in the FDM method, which is comparatively cheap and requires low repair and maintenance cost and low materials expenses, although rather insufficient in the quality of outputs, and a recommendation was made, in addition, to select an entity that is supportive in providing technical support.
Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.
This study examines the status quo of Korean archives and records management from the Governmental as well as professional activities for the development of the field in relation to the new legislation on records management. Among many concerns, this study primarily explores the following four perspectives: 1) the Government Archives and Records Services; 2) the Korean Association of Archives; 3) the Korean Society of Archives and Records Management; 4) the Journal of Korean Society of Archives and Records Management. One of the primary tasks of the
Ginseng has a unique production system that is different from those used for other crops. It is subject to the Ginseng Industry Act., requires a long-term cultivation period of 4-6 years, involves complicated cultivation characteristics whereby ginseng is not produced in a single location, and many ginseng farmers engage in mixed-farming. Therefore, to bring the production of Ginseng in line with GAP standards, it is necessary to better understand the on-site practices of Ginseng farmers according to established control points, and to provide a proper action plan for improving efficiency. Among ginseng farmers in Korea who applied for GAP certification, 77.6% obtained it, which is lower than the 94.1% of farmers who obtained certification for other products. 13.7% of the applicants were judged to be unsuitable during document review due to their use of unregistered pesticides and soil heavy metals. Another 8.7% of applicants failed to obtain certification due to inadequate management results. This is a considerably higher rate of failure than the 5.3% incompatibility of document inspection and 0.6% incompatibility of on-site inspection, which suggests that it is relatively more difficult to obtain GAP certification for ginseng farming than for other crops. Ginseng farmers were given an average of 2.65 points out of 10 essential control points and a total 72 control points, which was slightly lower than the 2.81 points obtained for other crops. In particular, ginseng farmers were given an average of 1.96 points in the evaluation of compliance with the safe use standards for pesticides, which was much lower than the average of 2.95 points for other crops. Therefore, it is necessary to train ginseng farmers to comply with the safe use of pesticides. In the other essential control points, the ginseng farmers were rated at an average of 2.33 points, lower than the 2.58 points given for other crops. Several other areas of compliance in which the ginseng farmers also rated low in comparison to other crops were found. These inclued record keeping over 1 year, record of pesticide use, pesticide storages, posts harvest storage management, hand washing before and after work, hygiene related to work clothing, training of workers safety and hygiene, and written plan of hazard management. Also, among the total 72 control points, there are 12 control points (10 required, 2 recommended) that do not apply to ginseng. Therefore, it is considered inappropriate to conduct an effective evaluation of the ginseng production process based on the existing certification standards. In conclusion, differentiated certification standards are needed to expand GAP certification for ginseng farmers, and it is also necessary to develop programs that can be implemented in a more systematic and field-oriented manner to provide the farmers with proper GAP management education.
In addition to stakeholders including managers, employees, creditors, and investors of bankrupt companies, corporate defaults have a ripple effect on the local and national economy. Before the Asian financial crisis, the Korean government only analyzed SMEs and tried to improve the forecasting power of a default prediction model, rather than developing various corporate default models. As a result, even large corporations called 'chaebol enterprises' become bankrupt. Even after that, the analysis of past corporate defaults has been focused on specific variables, and when the government restructured immediately after the global financial crisis, they only focused on certain main variables such as 'debt ratio'. A multifaceted study of corporate default prediction models is essential to ensure diverse interests, to avoid situations like the 'Lehman Brothers Case' of the global financial crisis, to avoid total collapse in a single moment. The key variables used in corporate defaults vary over time. This is confirmed by Beaver (1967, 1968) and Altman's (1968) analysis that Deakins'(1972) study shows that the major factors affecting corporate failure have changed. In Grice's (2001) study, the importance of predictive variables was also found through Zmijewski's (1984) and Ohlson's (1980) models. However, the studies that have been carried out in the past use static models. Most of them do not consider the changes that occur in the course of time. Therefore, in order to construct consistent prediction models, it is necessary to compensate the time-dependent bias by means of a time series analysis algorithm reflecting dynamic change. Based on the global financial crisis, which has had a significant impact on Korea, this study is conducted using 10 years of annual corporate data from 2000 to 2009. Data are divided into training data, validation data, and test data respectively, and are divided into 7, 2, and 1 years respectively. In order to construct a consistent bankruptcy model in the flow of time change, we first train a time series deep learning algorithm model using the data before the financial crisis (2000~2006). The parameter tuning of the existing model and the deep learning time series algorithm is conducted with validation data including the financial crisis period (2007~2008). As a result, we construct a model that shows similar pattern to the results of the learning data and shows excellent prediction power. After that, each bankruptcy prediction model is restructured by integrating the learning data and validation data again (2000 ~ 2008), applying the optimal parameters as in the previous validation. Finally, each corporate default prediction model is evaluated and compared using test data (2009) based on the trained models over nine years. Then, the usefulness of the corporate default prediction model based on the deep learning time series algorithm is proved. In addition, by adding the Lasso regression analysis to the existing methods (multiple discriminant analysis, logit model) which select the variables, it is proved that the deep learning time series algorithm model based on the three bundles of variables is useful for robust corporate default prediction. The definition of bankruptcy used is the same as that of Lee (2015). Independent variables include financial information such as financial ratios used in previous studies. Multivariate discriminant analysis, logit model, and Lasso regression model are used to select the optimal variable group. The influence of the Multivariate discriminant analysis model proposed by Altman (1968), the Logit model proposed by Ohlson (1980), the non-time series machine learning algorithms, and the deep learning time series algorithms are compared. In the case of corporate data, there are limitations of 'nonlinear variables', 'multi-collinearity' of variables, and 'lack of data'. While the logit model is nonlinear, the Lasso regression model solves the multi-collinearity problem, and the deep learning time series algorithm using the variable data generation method complements the lack of data. Big Data Technology, a leading technology in the future, is moving from simple human analysis, to automated AI analysis, and finally towards future intertwined AI applications. Although the study of the corporate default prediction model using the time series algorithm is still in its early stages, deep learning algorithm is much faster than regression analysis at corporate default prediction modeling. Also, it is more effective on prediction power. Through the Fourth Industrial Revolution, the current government and other overseas governments are working hard to integrate the system in everyday life of their nation and society. Yet the field of deep learning time series research for the financial industry is still insufficient. This is an initial study on deep learning time series algorithm analysis of corporate defaults. Therefore it is hoped that it will be used as a comparative analysis data for non-specialists who start a study combining financial data and deep learning time series algorithm.
Aspect Based Sentiment Analysis (ABSA), which analyzes sentiment based on aspects that appear in the text, is drawing attention because it can be used in various business industries. ABSA is a study that analyzes sentiment by aspects for multiple aspects that a text has. It is being studied in various forms depending on the purpose, such as analyzing all targets or just aspects and sentiments. Here, the aspect refers to the property of a target, and the target refers to the text that causes the sentiment. For example, for restaurant reviews, you could set the aspect into food taste, food price, quality of service, mood of the restaurant, etc. Also, if there is a review that says, "The pasta was delicious, but the salad was not," the words "steak" and "salad," which are directly mentioned in the sentence, become the "target." So far, in ABSA, most studies have analyzed sentiment only based on aspects or targets. However, even with the same aspects or targets, sentiment analysis may be inaccurate. Instances would be when aspects or sentiment are divided or when sentiment exists without a target. For example, sentences like, "Pizza and the salad were good, but the steak was disappointing." Although the aspect of this sentence is limited to "food," conflicting sentiments coexist. In addition, in the case of sentences such as "Shrimp was delicious, but the price was extravagant," although the target here is "shrimp," there are opposite sentiments coexisting that are dependent on the aspect. Finally, in sentences like "The food arrived too late and is cold now." there is no target (NULL), but it transmits a negative sentiment toward the aspect "service." Like this, failure to consider both aspects and targets - when sentiment or aspect is divided or when sentiment exists without a target - creates a dual dependency problem. To address this problem, this research analyzes sentiment by considering both aspects and targets (Target-Aspect-Sentiment Detection, hereby TASD). This study detected the limitations of existing research in the field of TASD: local contexts are not fully captured, and the number of epochs and batch size dramatically lowers the F1-score. The current model excels in spotting overall context and relations between each word. However, it struggles with phrases in the local context and is relatively slow when learning. Therefore, this study tries to improve the model's performance. To achieve the objective of this research, we additionally used auxiliary loss in aspect-sentiment classification by constructing CNN(Convolutional Neural Network) layers parallel to existing models. If existing models have analyzed aspect-sentiment through BERT encoding, Pooler, and Linear layers, this research added CNN layer-adaptive average pooling to existing models, and learning was progressed by adding additional loss values for aspect-sentiment to existing loss. In other words, when learning, the auxiliary loss, computed through CNN layers, allowed the local context to be captured more fitted. After learning, the model is designed to do aspect-sentiment analysis through the existing method. To evaluate the performance of this model, two datasets, SemEval-2015 task 12 and SemEval-2016 task 5, were used and the f1-score increased compared to the existing models. When the batch was 8 and epoch was 5, the difference was largest between the F1-score of existing models and this study with 29 and 45, respectively. Even when batch and epoch were adjusted, the F1-scores were higher than the existing models. It can be said that even when the batch and epoch numbers were small, they can be learned effectively compared to the existing models. Therefore, it can be useful in situations where resources are limited. Through this study, aspect-based sentiments can be more accurately analyzed. Through various uses in business, such as development or establishing marketing strategies, both consumers and sellers will be able to make efficient decisions. In addition, it is believed that the model can be fully learned and utilized by small businesses, those that do not have much data, given that they use a pre-training model and recorded a relatively high F1-score even with limited resources.
Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.
This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However,