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Medical disputes related to advanced endoscopic procedures with endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the management of pancreas and biliary tract diseases

  • Yoon Suk Lee;Jae-Young Jang;Jun Yong Bae;Eun Hye Oh;Yehyun Park;Yong Hwan Kwon;Jeong Eun Shin;Jun Kyu Lee;Tae Hee Lee;Chang Nyol Paik
    • Clinical Endoscopy
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    • v.56 no.4
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    • pp.499-509
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    • 2023
  • Background/Aims: This study aimed to evaluate the characteristics of endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasonography (EUS)-related adverse events (AEs) that eventually lead to medical disputes or claims on medical professional liability. Methods: Medical disputes for ERCP/EUS-related AEs filed in the Korea Medical Dispute Mediation and Arbitration Agency between April 2012 and August 2020 were evaluated using corresponding medical records. AEs were categorized into three sections: procedure-related, sedation-related, and safety-related AEs. Results: Among a total of 34 cases, procedure-related AEs were 26 (76.5%; 12 duodenal perforations, 7 post-ERCP pancreatitis, 5 bleedings, 2 perforations combined with post-ERCP pancreatitis); sedation-related AEs were 5 (14.7%; 4 cardiac arrests, 1 desaturation), and safety-related AEs were 3 (8.8%; 1 follow-up loss for stent removal, 1 asphyxia, 1 fall). Regarding clinical outcomes, 20 (58.8%) were fatal and eventually succumbed to AEs. For the types of medical institutions, 21 cases (61.8%) occurred at tertiary or academic hospitals, and 13 (38.2%) occurred at community hospitals. Conclusions: The ERCP/EUS-related AEs filed in Korea Medical Dispute Mediation and Arbitration Agency showed distinct features: duodenal perforation was the most frequent AE, and clinical outcomes were fatal, resulting in at least more than permanent physical impairment.

Research on Service Development Plans for the National Center for Medical Information and Knowledge: Comparison and analysis with the U.S. National Library of Medicine (국립의과학지식센터 서비스 발전 방안을 위한 연구 - 미국 국립의학도서관과의 비교·분석을 통해 -)

  • Hey-Young Rhee
    • Journal of the Korean BIBLIA Society for library and Information Science
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    • v.35 no.1
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    • pp.243-272
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    • 2024
  • This study was conducted with the purpose of providing suggestions for improvement through a comparison and analysis of the services of the U.S. National Library of Medicine, the world's largest medical library, and the National Center for Medical Information and Knowledge, Korea's national medical library. Core services that need to be improved are topic-specific services, community services, services by user type, educational services, technology, facility/space services, research support services, and marketing and public relations and cooperation services. Specialized libraries are also increasingly interested in topic-specific services and public services. Efficiency in access through services for each type of user is needed, and various types of educational services that do not limit the target audience are also needed. Marketing through AI, virtual reality, and technology, facility, and space services to support the disabled, research support services centered on research ethics, research grants, and programs, and collaborative services with domestic and international libraries, academic societies, institutions, and local communities in other related fields and publicity are also needed.

The Influence of High School Students' Entrance Exam Stress on Their Mental Health (대입 준비생의 입시스트레스가 정신건강에 미치는 영향)

  • Lee, Hee-Ja;Park, Yung-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.8 no.1
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    • pp.43-54
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    • 2007
  • This study aimed at investigating the level of high school students' entrance exam stress and mental health first and also investigating if the entrance exam stress and mental health are related to gender, grade, character type, parenting style and economic status. This is expected to be used as a fundamental data for the development of health education program on high school students' stress and diagnosis of their mental health. To achieve those goals above, the questionnaire was used and the sample consisted of 600 students from general high schools in a large city, C and in a smaller city, A in Chungnam province through questionnaire and the conclusion, which was based on 582 proper questionnaires from the 600 questionnaires, through variable analysis, correlation analysis and multi-regression, is below. First, according to the information provided by respondents, the result showed the relationship between those background variables and the entrance exam stress and mental health level. As the students are more introverted and the parenting style is more authoritative, the entrance exam stress is higher and the mental health level is higher as the parenting style is more authoritative and the economic status is lower. In gender, the entrance exam stress level was high for male students in regard to parents pressure. For female students, it was due to the insufficient free time. In test performance, the good grade group showed high stress level when they don't have enough free time and the poor grade group showed high stress level when they have test tension and poor test performance. In character style, the introverted group showed high stress level in future uncertainty. In parenting style, the authoritative group showed significantly high level in all four sub-factors and there is no significant relationship with the stress level and economic statue. Female students reported higher mental health level than male students in somatization and depression. In academic achievement, the poor grade group showed high level in obsession, fear-anxiety and psychotism. In character style, the introverted group showed high level in sensitivity towards others and depression. And in parenting style, the authoritative group is higher in 9 sub-factors than the other two groups in the factor, economic status. The lower economic status group showed high mental health problem level in this order; in obsession, sensitivity towards others, depression, paranonia and psychotism. Second, the results revealed that there is a significant difference among the groups after comparing and analyzing the relationship between the mental health level according to the three groups, the first, second and third group divided by the degree of entrance exam stress. And the higher the entrance exam stress is, the higher the mental health problem level is. Verification showed that there was obvious difference among the groups. the entrance exam stress was positively correlated with the mental health level. The lack of free time, future uncertainty, test anxiety/poor test performance and parents pressure, these factors, in that order, were correlated with the mental health level. when the prediction variables which influenced on mental health are analyzed, test-anxiety/poor test performance was found to be related to mental health most. And after the factor, test-anxiety, future uncertainty and the lack of free time were listed(ranked), however results did not show any correlation with parents' pressure.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Comparative analysis of RN-BSN Program in Korea and U. S. A. (간호학사 편입학제도의 교과과정 비교분석)

  • Lee Ok-Ja;Kim Hyun-Sil
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.99-116
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    • 1997
  • In response of the increasing demand for professional degree in nursing, some university in Korea offers RN-BSN program for R. N. from diploma in nursing. However, RN-BSN program in Korea is in formative period. Therefore, the purpose of this survey study is for the comparative analysis of RN-BSN curriculum in Korea and U.S.A. In this study, subjects consisted of 18 department of nursing in university and 5 RN-BSN programs in Korea and 18 department of nursing in university and 12 RN-BSN programs in U.S.A. For earn the degree of Bachelor of Science in Nursing, the student earns 134 of mean credits in U.S.A., whereas 150.3 of mean credits in Korea. The mean credit for clinical pratice is 30.1 in U.S.A., whereas 23.9 in Korea. Students are assigned to individually planned clinical experiences under the direction of a preceptor in U.S.A. In RN-BSN program, total mean credits through lecture and clinical practice for earn the degree of BSN is 35.5(lecture : 27.7, practice ; 7.8)in U.S.A., whereas,48.1 (lecture;42.1, practice;6.0) in Korea. RN-BSN program can be taken on a full-or-part time basis in U.S.A., whereas didn't in Korea. Especially, emphasis is place on the advanced nursing practicum that focus on the role of the professional nurse in providing health care to individuals, families, and groups in community setting in U.S.A. 27.7 of mean credits was earned through lecture in U.S.A., whereas 42.1 of mean credits in Korea. It means that RN-BSN program in Korea is the lesser development in teaching method and appraisal method than in U.S.A. Students of RN-BSN program in U.S.A. can earns credit through CLEP, NLN achievement test, portfolio review session etc as well as lecture. Therefore, the authors suggests some recommendations for the development of curriculum of RN-BSN program in Korea based on comparative analysis of RN-BSN curricula in U.S.A. and Korea. 1. The curriculum of RN-BSN Program in nursing was required to do some alterations. Nursing care, today, is complex and ever changing. According to change of public need, RN-BSN curriculum intensified primary care program in community setting, geriatric nursing, marketing skill, computer language. 2. The various and new methods of earning credit should be developed. That is, the students will earn credits through the transfer of previous nursing college credits, accredited examination of university, advanced placement examination, portfolio review session, case study, report, self-directed learning and so on. Flexible teaching place should ile offered. 3. Flexible teaching place should be offered. The RN-BSN curriculum should accommodate each RN student's geographical needs and school/work schedule. Therefore, the university should search a variety of teaching places and the RN students can obtain their degrees comfortably throughout the teaching place such as lecture room inside the health care agency and establishment of the branch school in each student's residence area. 4. The RN-BSN program should offer a long distance education to place-bound RN student in many parts of Korea. That is, from the main office of university, the RN-BSN courses are delivered to many areas by Internet, EdNet (satellite telecommunication) and other non-traditional methods. 5. For allowing RN student to take nursing courses, program length should be various, depending upon the student's study/work schedule. That is, the various term systems such as semester, three terms, quarter systems and the student's status like full time or part time should be considered. Therefore, the student can take advantage of the many other educational and professional opportunities, making them available during the school year.

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The Relationship Between High School Teachers Health Perception and Health Promotion Behavior (고등학교 교사의 건강지각과 건강증진행위의 관계)

  • Kim, Dong-Hwan;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.4
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    • pp.21-41
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    • 2003
  • The purposes of this study were to ; first, investigate High School Teachers health promotion behavior types; second, explore the effects High School Teachers perceived benefits and perceived barriers have on their health promotion behavior ; third, suggest a desirable course that will increase teachers health. To this end, this researcher conducted a survey on health promotion behavior, perceived benefits, and perceived barriers to 329 High School teachers working in Goyang-si, Gyonggi-do. The results of the survey are as follows: Health Promotion Behavior A closer look at high school teachers health promotion behavior shows that male teachers, compared with female teachers, more actively promote their health. However, female teachers are more aware of their personal hygiene and disease risks. Older teachers, rather than younger teachers, are more willing to promote their health through better eating habits and more frequent exercise. A comparison between married and single teachers revealed that married teachers promote their health through better eating habits, and single teachers receive less stress and are better at managing their stress. Teachers working in technical high schools are better at managing their stress and personal hygiene than academic high schools teachers. Teachers working after 8 o'clock show better health promotion behavior through proper eating habits, stress management, regular exercise, disease prevention: however, teachers working before 7:30 are poor at managing their stress. Teachers not teaching supplementary lessons and not supervising night self-study are better at managing their stress, exercise schedule, and disease prevention than teachers who are. Perceived Benefits, Perceived Barriers, and Health Promotion Behavior A Comparison between male and female teachers shows that female teachers firmly believe improved eating habits and regular exercises would greatly enhance their health. However, female teachers felt more discomfort in their working environment and in utilizing medical institutes. Teachers in the 20s and 40s perceived health benefits through regular lifestyle and exercise. Teachers with less experience feel more pressure from their work environment. Teachers below their 30s feel more dissatisfaction towards using medical facilities. Teachers working in Technical High Schools are more aware of promoting their health through regular health checkups, exercise, and lifestyle ; however, teachers from Academic High Schools feel more pressure from their work environment. Teachers not performing supplementary lessons and supervising night self-study sessions are more willing to go through regular health checkups than those performing them. Also, teachers with supplementary lessons and night self-study supervisions claimed lack of leisure time, pressure from work environment, and inconvenience in using medical facilities a deterrent to promoting their health behavior. The Relationship between Health Promotion Behavior, Perceived Benefits, and Perceived Barriers The correlation ratio between Health Promotion Behavior and Perceived Benefits shows a positive relationship. The results show that High School teachers believed regular health checkups are necessary in maintaining their health. This research shows that teachers consider the following factors important in the order shown ; regular lifestyle and exercise, prevention of geriatric diseases, improving ones eating habits. In short, teachers who are more aware of the importance of regular health checkups are also more aware of the importance of promoting their health. The correlation ratio between Health Promotion Behavior and Perceived Barriers shows negative relationship. High School Teachers believe that lack of leisure activity, pressure from work environment, familys financial burden, fear of diseases, inconvenience in using medical facilities are a deterrent in promoting their health behavior. In other words, teachers with less leisure time and negative pressures from their work environment were less active in promoting their health behavior. This study shows that High School teachers will be able to promote their health behavior by maintaining regular health checkups, lifestyle, exercise, and preventing geriatric diseases. However, teachers believed that insufficient leisure time and negative pressure from their work environment acted as a deterrent to maintaining their health behavior. Most High School teachers believe they are at present healthy, and they were actively engaged in Preventative Health Promotion. The result of this study demonstrates that External factors have a large impact on teachers, which in turn acts negatively on their Health Promotion Behavior. In order to guarantee teachers health promotion behavior, systematic health checkups and increased leisure time, improvement in their work environment are necessary. Teachers also need to take a more active interest in their health.

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Differences in Sleep Patterns are Related to Behavior, Emotional Problems, Attention and Academic Performance in Elementary School Students of a South Korean Metropolitan City (일 도시의 초등학교 학생의 수면습관과 행동, 정서, 주의력, 학습과의 관계)

  • Tak, Hee-Jong;Lee, Ji-Ho;Lee, Chang-Myung;Chung, Seok-Hoon;Lee, Jae-Won;Sim, Chang-Sun;Yoon, Jae-Goog;Sung, Joo-Hyeon;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.3
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    • pp.182-191
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    • 2011
  • Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

Relationship of Oral Health Awareness to Oral Health Indexes among Adults (성인의 구강건강인식과 구강보건지수와 관계)

  • Shin, Myong-Suk;Hwang, Mi-Yeong;Kim, Soo-Kyung
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.607-616
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    • 2012
  • The purpose of this study was to examine the self-rated oral health status and oral health concern of 6,094 adults over the age of 19, which were both related to subjective oral health awareness, based on the second-year (2008) raw data of the 4th National Health and Nutrition Survey. 1. As for subjective oral health awareness, 49.4 percent replied they were in bad oral health when they were asked about self-rated oral health status. Regarding oral health concern, 62.6 percent answered they were sort of concerned about oral health. 2. As to oral health indexes by sociodemographic characteristics, there were statistically significant differences in oral health indexes according to gender, age, academic credential, monthly mean household income, frequency of eating between meals and toothbrushing frequency. Smoking made no statistically significant differences to oral health indexes (p<0.000). 3. Concerning self-rated oral health status by sociodemographic characteristics, no significant differences were found according to gender, age and academic credential, and there were statistically significant differences according to monthly mean household income and smoking (p<0.000), frequency of eating between meals (p<0.018), toothbrushing frequency (p<0.003). 4. In relation to oral health concern by sociodemographic characteristics, gender and smoking made no significant differences, and statistically significant differences were found according to age (p<0.003), academic credential, monthly mean household income, frequency of eating between meals and toothbrushing frequency (p<0.000). 5. In regard to the relationship between subjective oral health awareness and oral health indexes, none of the oral health indexes had a significant relationship to self-rated oral health status, and there were statistically significant differences in oral health concern according to functioning teeth index (p<0.011) and community periodontal index (p<0.017).

The Effect of Information Service Quality on Customer Loyalty: A Customer Relationship Management Perspective (정보서비스품질이 고객로열티에 미치는 영향에 관한 연구: 고객관계관리 관점)

  • Kim, Hyung-Su;Gim, Seung-Ha;Kim, Young-Gul
    • Asia pacific journal of information systems
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    • v.18 no.1
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    • pp.1-23
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    • 2008
  • As managing customer relationship gets more important, companies are strengthening information service using multi-channels to their customers as a part of their customer relationship management (CRM) initiatives. It means companies are now accepting such information services not as simple information -delivering tools, but as strategic initiatives for acquiring and maintaining customer loyalty. In this paper, we attempt to validate whether or not such various information services would impact on organizational performance in terms of CRM strategy. More specifically, our research objective is to answer the next three questions: first, how to construct the instruments to measure not information quality but information service quality?; second, which attributes of information service quality can influence corporate image and customer loyalty?; finally, does each information service type have unique characteristics compared with others in terms of influencing corporate image and customer loyalty? With respect to providing answers to those questions, the previous studies had been limited in that those studies failed to consider the variety of types of information service or restricted the quality of information service to information quality. An appropriate research model answering the above questions should consider the fact that most companies are utilizing multi channels for their information services, and include the recent strategic information service such as customer online community. Moreover, since corporate information service could be regarded as a type of products or services delivered to customer, it is necessary to adopt the criteria for assessing customer's perceived value when to measure the quality of information service. Therefore, considering both multi-channels and multi-traits may enable us to tell the detailed causal routes showing which quality attributes of which information service would affect corporate image and customer loyalty. As information service channels, we include not only homepage and DM (direct mail), which are the most frequently applied information service channels, but also online community, which is getting more strategic importance in recent years. With respect to information service quality, we abstract information quality, convenience of information service, and timeliness of information service through a wide range of relevant literature reviews. As our dependant variables, we consider corporate image and customer loyalty that both of them are the critical determinants of organizational performance, and also attempt to grasp the relationship between the two constructs. We conducted a huge online survey at the homepage of one of representative dairy companies in Korea, and gathered 367 valid samples from 407 customers. The reliability and validity of our measurements were tested by using Cronbach's alpha coefficient and principal factor analysis respectively, and seven hypotheses were tested through performing correlation test and multiple regression analysis. The results from data analysis demonstrated that timeliness and convenience of homepage have positive effects on both corporate image and customer loyalty. In terms of DM, its' information quality was represented to influence both corporate image and customer loyalty, but we found its' convenience have a positive effect only on corporate image. With respect to online community, we found its timeliness contribute significantly both to corporate image and customer loyalty. Finally, as we expected, corporate image was revealed to provide a great influence to customer loyalty. This paper provides several academic and practical implications. Firstly, we think our research reinforces CRM literatures by developing the instruments for measuring information service quality. The previous relevant studies have mainly depended on the measurements of information quality or service quality which were developed independently. Secondly, the fact that we conducted our research in a real situation may enable academics and practitioners to understand the effects of information services more clearly. Finally, since our study involved three different types of information service which are most frequently applied in recent years, the results from our study might provide operational guidelines to the companies that are delivering their customers information by multi-channel. In other words, since we found that, in terms of customer loyalty, the key areas would be different from each other according to the types of information services, our analysis would help to make decisions such as selecting strengthening points or allocating resources by information service channels.

A Study on Culture Studies for the Circuit of Culture of Policy Discourse: Focus on Cultural Representations and Signifying Practices (정책담론의 문화흐름에 대한 문화연구: 문화적 표상과 의미의 실체를 중심으로)

  • Kim, Man-Ki
    • Journal of Digital Convergence
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    • v.9 no.3
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    • pp.69-79
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    • 2011
  • This study is the text discourse of agenda setting through media policy on the three communities. The materials of subjects are the 71 text discourses that appeared in the columns, the special manuscripts, and the comments on the contemporary topics in 33 media. The subjects focuses on the metaphor, metonymy, and binary transposition. This kind of connotation tends to be imploded into people through media, so that it produces hyperreality. This process produces the regulation and strengthens the reality through the circuit of culture. Thus this research tries to develop the theoretical foundation for analysing the text discourse produced by the media. Also it focuses on widening the research scope to study the effects that the circuit of culture provides on the politics, society, and economics. Therefore The first, the objective meanings(denotation)which the referents of the community as T'PALACE, I'PARK, and STARCITY are 'larger scale', 'high and skyscraper', 'the rich people and the plutocrats who have very high academic career' and ' the residence place for the famous stars and successful CEOs', etc. and the subjective meanings, connotations which the referents of the community are 'The first street' transposes '1%' 'their own space' into the characteristics of the wealth of Gangnam district or Korean wealth', the additional significations which the metaphors such as 'the noble community', 'the sample for the high -level residential space', and 'the greed of 1%'. Conclusion, The significations of the symbols became imploded into the population and circulated along with the cultural streams through the media. The referents are recreated and consumed among the other communities such as the named 'PALACE', 'I'PARK', 'STARCITY' in the other areas. This kind of ideology tends to create the myths such as 'the 1% rich people of Gangnam', 'the first street of Korean wealth', and create the regulation such as 'the compound taxes for the real-estates', 'the policy of reducing the taxes for the rich', 'the policy of reducing the taxes for the 1% of the rich'. Also these regulations make the politicians operate new policies and are being utilized as 'slogan' for the politicians.