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A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance - (병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 -)

  • Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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A Study on the Working Environment Recognition and the Caracter Disposition of Nurse Aides (간호조무사의 근무환경인식과 성격성향에 관한 연구)

  • Lee Sun Yi
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.57-74
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    • 1990
  • As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

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A Study on Gradual Attitudes Change College of Nursing Students (간호대학생의 학년별 태도 변화에 관한 연구)

  • 한정석
    • Journal of Korean Academy of Nursing
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    • v.3 no.2
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    • pp.121-132
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    • 1973
  • Introduction : Nursing as a profession is gelling wide acceptance today, especially among independent -minded women with necessary physical, mental and academic qualifications. This is particularly true of "comprehensive nursing", which requires to total dedication on the part if the nurse herself-physical, mental and sociocultural. Such comprehensive approach is like-wise called for in the institutional training of professional nurses. Undergraduate nursing courses nowadays place an increasing emphasis on the microscopic approach of training a nurse as an intelligent and well-balanced human being with an optimum degree of cultural sophistication. Greater attention then ever before is now paid to close observation of the individual traits and aptitude of nursing students, so as to permit full development of individual capabilities, interests and propensities within the concept of "comprehensive human education. " Purpose of study 1. To determine the degree of understanding of the part of nursing students of the various aspects of the subject taught in undergraduate nursing course. 2. To determine the motivation of nursing students in choosing the profession and possible subsequent change or attitude and outlook in the course of under graduated studies, as a means of presenting a new practical approach in nursing training based on the concept of "comprehensive human education. " Problems of study 1. The environments of nursing training will impinge on individual nursing students with different psychological impacts from lower to upper classes of under graduated studies. 2. Educational environments will have varying psychological impacts on students: a. Difference in religious faith among students. b. Difference in campus environments. c. Difference in domestic (family) circumstances. d. Difference in innate capabilities of students, 3. The understanding and attitude of individual nursing students towards the science of nursing will Have a close correlation with their respective motivations in choosing-nursing as a profession, and will also be closely influenced by the peculiarities of the subject taught, tile campus environments, etc, Delimitations of the study 1. Two universities offering 4-year nursing courses were selected. Due to the limited number of potential subjects, the optimum conditions of sample collection could not be fulfilled. 2. Subjects were confined to two classes in each university (sophomores and seniors) but without regard to the ages or scholastic achievements of individual students. 3. The conclusions derived from this study should be limited in application to the subject groups covered by the present study: they should not in any event be extended or applied to other groups. Procedures 1. Subjects: 40 nursing students each from the sophomore and senior classes of the "Y" and "K" universities situated in Seoul, aggregating 160 students altogether. 2. Instruments: Use has been made of questionnaires on (1) family backgrounds and (2) general information concerning. 3. Statistical Method: The findings of the present survey have been subjected to critical analysis as to the means, percentages, Cgi squares (X), standard deviations and the significance of the difference in means. Findings 1. Nursing students have chosen their subject of study with a confident outlook towards their future in society. 2. Horsing students have the necessary abilities to complete the prescribed courses of study. 3. The campus life of nursing students has been judged as very constructive, not with-standing certain in adequacies in the available educational facilities and the shortages of teaching staff. 4. The achievement levels of nursing trainees varied greatly according to their respective educational environments as well as their school years. 5. Clear and definite distinctions were discernible between the two universities as regards certain aspects of this survey, while no signifiant difference was observed in other: a. Sophomores and seniors in both universities gave nearly identical answers to questions concerning (1) motivation in choosing nursing as a profession, and (2) the way of spending leisure hours. b. Both universities revealed similar respective differences between sophomores and seniors as regards the abilities of fulfilling academic requirements ill the basic subjects. c. Educational environments have been found to be somewhat superior in the "Y"university to those of the "K" university, particularly as regard general campus and dormitory conditions. d. The high degree of dissatisfaction with the faculty, found in both universities, was considered to be a consequence of the universal phenomenon of "brain drain" and the relative neglect of the "comprehensive approach"in education.

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Successful Management and Operating System of a UNESCO World Heritage Site - A Case Study on the Wadi Al-Hitan of Egypt - (유네스코 세계자연유산의 성공적인 관리와 운영체계 - 『이집트 Wadi Al-Hitan』의 사례 -)

  • Lim, Jong Deock
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.106-121
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    • 2011
  • The number of World Natural Heritage Sites is smaller than that of World Cultural Heritage Sites. As of 2010, the total number of natural sites was 180, which is less than 1/3 of all cultural sites. The reason why the number of natural sites is smaller can be attributed to the evaluating criteria of OUV(outstanding universal value). Only 9 fossil related sites were designated as World Heritage Sites among 180 Natural Sites. This study compares their OUVs including the academic value and characteristics of the 9 World Heritage Sites to provide data and reference for KCDC(Korean Cretaceous Dinosaur Coast) to apply as a World Natural Heritage Site. This study was carried out to obtain information and data on the Wadi Al-Hitan of Egypt which was designated as a World Natural Heritage Site. The study includes field investigation for whale fossils, interviews of site paleontologists and staff, and inspections of facilities. Three factors can likely be attributed to its successful management and operating system. First, there is a system for comprehensive research and a monitoring plan. Secondly, experts have been recruited and hired and professional training for staff members has been done properly. Finally, the Wadi Al-Hitan has developed local resources with specialized techniques for conservation and construction design, which matched well with whale fossils and the environment at the site. The Wadi Al-Hitan put a master plan into practice and achieved goals for action plans. To designate a future World Natural Heritage Site in Korea, it is important to be recognized by international experts including IUCN specialists as the best in one's field with OUV. Full-time regular-status employees for a research position are necessary from the preparation stage for the UNESCO World Heritage Site. Local government and related organizations must do their best to control monitoring plans and to improve academic value after the UNESCO World Heritage Site designation. As we experienced during the designation process of Jeju Volcanic Island and Lava Tubes as the first Korean World Natural Heritage Site, participation by various scholars and specialists need to be in harmony with active endeavors from local governments and NGOs.

User Behavior and Improvement for Kumgang Pine Eco-Forest in Uljin (울진금강송 생태숲의 이용자 행태분석과 개선방안)

  • Oh, Nam-Hyun
    • Korean Journal of Environment and Ecology
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    • v.22 no.3
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    • pp.249-259
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    • 2008
  • The purpose of this study was to analyze the users' behaviors and to suggest development strategies in Uljin Kumgang pine tree(Pinus densiflora for. erecta) eco-forest(UKPEF), which is located in Kyeongbuk. The data were collected by interviewing 122 visitors to september 3 from august 29, 2007 with a constructed questionnaire. The results of the analysis are as follows. 1. The major visitors of UKPEF are male and the age between 20 to 30, the residents of the Uljin county with relatively high academic background. 2. The motive of visiting UKPEF is mainly by the beauty and taste of Kumgang pine tree and the condition of the forest. The visitors are mainly composed of family, not big group. 3. The visitors of UKPEF have obtained information about the Kumgang fine tree forest mainly from friends, not from the internet or travel agency. 4. The visitors of UKPEF pointed out lack of convenient facilities such as toilets and water-supply facilities. However, visitors are satisfied by the condition of the forest. 5. The visitors of UKPEF set a high value on Kumgang fine tree, So, more active marketing strategy about Uljin Kumgang pine tree has to be established. 6. The visitors of UKPEF are more satisfied by the Uljin Kumgang pine tree forest than expected. The development strategies of UKPEF are suggest as follows. (1) Auto tram system has to be set up and new trail should be constructed to attract more visitors and people of other regions. (2) To attract group tourists, new program should be developed. (3) Advertisement through internet or travel agency has to be developed. (4) Government(local) should make a plan to register the forest as World natural heritage. (5) Monitoring and evaluation system has to be developed to satisfy tourists. In conclusion, the efforts of taking care of and preserving the UKPEF should be made at the national level. I hope that more Koreans can have chance to feel and experience the value and excellence ofthe Uljin Kumgang pine tree(Pinus densiflora for. erecta)

Comparative Study of Security Services Industry Act and Police Assigned to Special Guard Act - Focused on special guards and police assigned to special guard duty - (경비업법과 청원경찰법의 비교 연구 특수경비원과 청원경찰을 중심으로)

  • Noh, Jin-keo;Lee, Young-ho;Choi, Kyung-cheol
    • Korean Security Journal
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    • no.57
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    • pp.177-203
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    • 2018
  • Police Assigned to Special Guard Act was legislated in 1962 to solve issues regarding the protection of various staple industrial installations, and in 2001, the Security Services Industry Act was revised to establish an effective security system for important national facilities. Thereby the Special Guards System was instituted. The current law has two parts, with the Police Assigned to Special Guard System and Special Guards System, and many scholars have actively discussed the appropriateness of the integration of both systems to solve problems caused by a bimodal system. However, in spite of these discussions taking place in the academic world, the idea of unification lost its power when the guarantee of status regulation was established for the police assigned to special guard. Strictly speaking, police assigned to special guard is a self-guard, and a special guard is a contractual guard. So, both of them have pros and cons. Thus, it would be desirable to give a legal, constitutional guarantee for both systems by strengthening each of them and making up for the weakness of each of them rather than trying to unify police assigned to special guard and special guard. To begin this process, we need to revise unreasonable legal provisions of Security Services Industry Act and Police Assigned to Special Guard Act as below. First, since the actual responsibilities of special guards and police assigned to special guard duty are the same, we need to make the facilities which they use equal. Second, legal provisions need to be revised so that a special guard may perform the duties of a police officer, according to the Act on the Performance of Duties by Police Officers, within the facility that needs to be secured in order to prevent any vacancy in the guarding of an important national facility. Third, disqualifications for the special guards need to be revised to be the same as the disqualifications for the police assigned to special guard duty. Fourth, it is reasonable to unify the training institution for special guards and for police assigned to special guard duty, and it should be the training institution for police. On-the-job education for a security guard needs to be altered to more than 4 hours every month just like the one for police assigned to special guard duty. Fifth, for a special guard, it is not right to limit the conditions in their using weapons to 'use of weapon or explosives' only. If one possesses 'dangerous objects such as weapon, deadly weapon, and so on' and resists, a special guard should be able to use their weapon against that person. Thus, this legal provision should be revised. Sixth, penalty, range of fines, and so on for police assigned to special guard duty need to be revised to be the same as the ones for a special guard. If we revise these legal provisions, we can correct the unreasonable parts of Security Services Industry Act and Police Assigned to Special Guard Act without unifying them. Through these revisions, special guards and police assigned to special guard duty may develop the civilian guard industry wholesomely under the law, and the civilians would have a wider range of options to choose from to receive high quality security service.

The Relationships among Patient's Perception, Patient's Satisfaction of Nursing Service Quality and Revisiting intention (간호서비스 질에 대한 환자의 인식과 만족도 및 재방문의도와의 관계)

  • Lee, Sun-Ah
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.307-319
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    • 1998
  • This study is an empirical investigation and study on the measurement of nursing service quality as perceived by patients. A series of H1. H2. H3 alternative hypotheses were tested using a sample of 250 patients in Taegu City. Korea. HI hypothese were tested for application of five component of service quality (SERVQlTAL and SE RPERF : tangiblity. reliability. responsiveness. accessibility. understandability) in Taegu area Hospitals. Validity test - the five components of service quality were rearranged into two components of service quality (personal factor. nonpersonal factor). Although SERVQUAL was verified in USA. application for five components of service quality in Korea indicated that it need more analytical studies. Nobody can deny the fact that the recent growth of the nursing service quality is one of the most important driving forces of hospital management. In many hospitals. the nursing quality charges more than 50% of the medical service quality. As a result. many hospital managers should be enormous interests in the investment potentiality of the nursing service. However. doesn't many researchers invest their time and effort on the research of the quality control in nursing service. Nursing service management is the process to satisfy customer's desires and expectations through the various service activities. Presently nursing service are being faced with three Common tasks of improving quality of nursing service. competitively differential advantage and productivity because of quantitative expansion of Nursing service. Such a phenomenon is also found in our medical service industry. resulting from increasing demands for medical service owing to national medical insurance policy and consumer's attitude change emphasizing prevention of illness. excessiveness of medical facilities in large cities and increasing medical lawsuits due to influence of consumerism. Therefore. under such circumstances. this research on nursing service is conducted from nursing managements to improve the nursing service quality problems faced by medical institutions. The results of this theoretical/empirical research are as follows: 1. Nursing service Quality is regarded as patients' perceived quality and evaluated on the basis (5 dimension) of technical and functional quality. 2. Nursing service Quality is a concept of patients evaluation on the measurable multi-dimensions intrinsic and extrinsic attributes of service. 3. Nursing service Quality is conceptually defined as the difference between the perceived service and the expected service. 4. Korean consumers trend to evaluate nursing service quality based on such dimensions as responsiveness and reliability. understandability. accessibility. tangibility. 5. After analyzing whether or not there are some differences in respective medical institution. it was found that there are significant difference on understandability. reliability. communicability. courtesy. competence. 6. After analyzing the difference between the expected nursing service and the nursing perceived service, it was found that the expected nursing service is higher than the perceived service in every medical institution. 7. HI hypothesis was tested with regard to the validity test between SERVQUAL and SERVPERF in nursing service quality. The result of validity test between SERVQUAL and SERVPERF was found to have differential result. That is the R2 of SERVPERF is higher than that of SERVQUAL. Therefore. HI was verified in nursing management. H2. H3 hypotheses were tested whether or not the nursing service quality and patient satisfaction is the preceding variable. The result of H2 hypothes is that the nursing service quality is the preceding variable of patient satisfaction and the patient satisfaction is that of revisiting intention. After analyzing whether or not there is any differences on the demographic variable of five nursing service quality factor. it was found that there are statistically significant differences on communicability and courtesy at the sex. understand ability. accessibility and tangibility at the age. understandability at the academic background respectively.

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The Evaluation of Midwifery Program Through the Midwifery Leadership Training Program (조산수습과정 지도자 강습회를 통한 조산교육 평가조사연구)

  • 이경혜
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.23-32
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    • 1981
  • The purpose of the study was to evaluate the educational content which had been given by midwifery training program. It was hoped that this result would help. It was sponsored by com-munity health worker plan effective health education. College of Nursing Ewha Womans University and The Korean Nurses Academic Society during the November 19 thru 24, 1979. It was carried out on July through on September 1980, and involved 22 community health workers. The results were as follows: 1. Most of the community health workers came from Seoul & Pusan areas and have been working at the hospitals. There were 31.82% of Head Nurses, 27.2% of Staff Nurses, 22.73% Nurse Supervisons, 13.6% of Nurse Directors and 4.5% of educational coordinator for Nurses. These participant had nurse-midwifery lincences by 63.64%. None of there had just midwifery lincences. 2, Age structures of the study population shows 31.82% of whom are.26-30 years and 22.73% of whom are 36. 40 years of age. This shown that seniority proportion is higher than the younger. There are 31.82% of 1-5 years, 27.27% of 6-10 year and 11-15 years, respectively by work career. 3. There are 54.55% of the institutions have opened their own midwifery training course for their nursing staff members. Because of lack of the facilities, shortage of instructors, and problems of administrative process. 4. According to the institution which opened for midwifery training courses, the participant was responsible for “midwifery”“Infant care”“MCH”“practice of midwifery”“Nursing adjustment”and“F. P.”5. During the midwifery couse, there were 8 institution who used the textbook and 4 institution who did not. Least of there referned to content matinals which was given by the sponsored. 6. There are 7 insititues who kept their training courses with other professional helps such as physicians., professiors and nurses. Some problems are pointed out by respondents such as“conflict with residents”“poor suportive administration”and“lake of manpower”. 8. The participant showed that they learned new knowledge as trends during this programs for there quality work so it need (one or twice times) a year. But they suggested that it needed more emphasis on the“maternal health care”and“role of the nurse-midwifery”. 9. The analysis of the results are as follows within the 6 areas which are given by the sponsored: There are highest ranks between“basic theory & family planning”“role of midwifery & nursing practice”. In the prenatal care the highest rank ware related to“health risk”on“idenify of risk symtoms”. In the health care areas which related to delivery, the responsers were related to“general conditions”or“high risk criteria”. In the health care area which related to high risk maternity care. In the neonatal health care, the highest rank was related to”health assessment of normal infant”. In the infant health care the responses was related to“abnormal symptoms”and“risk symptoms”. Actually, the participants show that they are more interested in“role of midwifery”“health assessment”and “high risk maternity care”are which emphasised on health promotion, health maintenance & disease preventive. 1) The midwifery training program need higher education for midwifery on a regular basis. 2) Within the open institution of midwifery training program, the nurses must be supported by their own institution and administry of social welfare must give systematic support. Also non-open institution must be open very soon. 3) All health workers including the residents & other workers, must cooperate for their phased common good of impovement of the maternity health. 4) Administration agonies & education institutions must provide the curriculum facilitis and administration systems which are needed for training of nurse-midwifery.

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A Study on Health Behaviors and Problems of Female Retail Workers (유통업 여성 근로자의 건강 문제와 건강 행위에 관한 연구)

  • Kim, Souk-Young;Yun, Soon-Nyung
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.127-145
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    • 2000
  • The objectives of this study are to identify health behaviors and health problems. and the relations between health behaviors and health problems of female workers in the retail business. The number of subjects were 200 female workers of 6 department stores in Seoul and Kyonggi area, whose jobs last more than 6 months as retail employees. The data was collected during 2 months from July 1 to August 30, 1998. The Cornell Medical Index Health Questionnaire(CMI) was used to measure their health problems, while health behaViorn were investigated in terms of 'smoking', 'alcohol', exercise', 'diet', and 'sleeping'. The data were analyzed with frequency. percentage, t-test, ANOVA test, and $X^2-test$ by SPSS PC+ program. The results of this study are as follows: 1. Out of health problems. Digestive symptoms occupied the highest percent number. nervous ones the second and cardiovascular ones the third among physical health problems of retail female workers. The most frequent mental health problem was 'adequacy' and the next, 'tension' and 'anger', 2, Health problems according to general characteristics of subjects were shown that the younger or the unmarried complained more than the older or the married, especially in the items of 'eye and ear', 'respiratory system', 'cardiovascular system', 'digestive tract', 'nervous system', 'adequacy', and 'depression'. The longer working duration they have had, the more they complained of 'respiratory system' and 'adequacy'. The lower academic careers complained of 'nervous' than the higher ones with statistical significance. 3. The analysis of daily health clinic notes showed that respiratory complaints were the highest percent, successively followed by digestive tract, nervous one, external injury, musculoskeletal system, urinary-reproductive system and others. 4. The level of their health practice was generally low in smoking, diet habit and alcohol intake, exercise, sleeping, very low especially in smoking, diet, alcohol intake, and exercise among them all. 5. Present smokers and ones with past experience complained of physical and mental health problems of 'respiratory system', 'digestive tract', 'skin', 'nervous', 'urinary-reproductive system', 'fatigability', adequacy', 'depression', 'anxiety', 'anger' and 'tension', than non smokers, with statistical difference. Workers without having breakfast and with irregular diet had more complaints on 'digestive tract', 'adequacy' and 'tension', than those who had regular dietary habit. The less the subjects slept, the more they complained of eye and ear, cardiovascular system. The subjects who drank alcohol complained more digestive problem. However, whether they exercise or not did not affect physical and mental health problems in a significant manner. 6. The subjects' age and marital status were statistically significant relating to health behaviors, as the younger or unmarried recorded a low level of health practice in smoking, drinking, dietary habit. Based on the results, the suggestions are made as follows: 1. Health education program on smoking, alcohol intake, diet habit is needed to improve health problems and health behavior of female retail workers. 2. The unmarried workers of late teen and twenties, who are transitional period from teenagers to adulthood are important targets for health promotion program especially for maternal health. 3. Better working environment with sufficient time and facilities for workers to relax is required to promote female sales workers' health. 4. Further research is required to identify the relation between workers' visual fatigue and intense lights for the display of goods.

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