• Journal of Korean Academy of Nursing Administration
• /
• v.16 no.4
• /
• pp.497-506
• /
• 2010

Purpose: The purpose of this study was to examine the causal relationships among quality of health care service, service value, satisfaction and loyalty as perceived by hospital inpatients. Methods: A survey using a structured questionnaire was conducted with 654 hospital inpatients. Analysis of the data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model. Results: The modified model yielded Chi-square=7.96 (p=.019), df=2, $x^2$/df=3.98, GFI=.99, AGFI=.96, RMSEA=.07, NFI=.99, CFI=.99, TLI=.98 and showed good fit indices. Three dimensions of quality had significant direct effects on service value. Functional quality, technical quality and service value had significant direct effects on customer satisfaction. Technical quality, service value, and customer satisfaction had significant direct effects on customer loyalty. Conclusion: These results suggest that quality of health care is an important element in service value, and through both quality and service value, customer satisfaction and customer loyalty can be enhanced. Further study with a larger sample from various hospitals and a longitudinal design is necessary.

• Safety and Health at Work
• /
• v.15 no.1
• /
• pp.102-109
• /
• 2024

Background: In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods: This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results: The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion: Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.

• Journal of the Korean Home Economics Association
• /
• v.49 no.10
• /
• pp.15-27
• /
• 2011

The predominant concern of the study consists in:(1)the positive direct effects of both individual's intimacy toward parents and individual's self-efficacy of care-giving roles on individual's care-giving commitment; (2)the positive mediating effect of individual's self-efficacy of care-giving on individual's care-giving commitment; (3)the moderating effect of the degree of unhealthy condition of individual's elderly parents on each causal relationship. For conducting this study, a survey method was used on 318 males with parents at the aged of 45-60, residing in Daegu and KyungPook. In order for subjects to verify research questions, structural equation models were explored. The findings of the study supported the direct, indirect effect and moderating effects, which suggested in research questions. Participants with unhealthy parents showed greater tendency in terms of influencing their intimacy toward parents on care giving commitment than participants with healthy parents did. The above findings claimed our attention in that provided a range of practical implication.

• Journal of Korean Academy of Nursing
• /
• v.17 no.1
• /
• pp.9-23
• /
• 1987

Nursing service, as the largest user of labor resources, has become concerned about appropriate allocation of staffing resources. Therefore, this project was designed to measure quantitatively the direct nursing care provided to patients and to develop a new patient classification system based on the direct nursing care activities. The initial step in the development of the classification instrument was to identify the content of direct nursing activities. The frequency with which these activities were carried out, the total time spent in carrying them out and the average time for one performance of each of the nursing activities was calculated. The next step was to select the items for the classification instrument taking into account these direct nursing activities. A list of 40 items was prepared. These items were then classified into 8 major categories: personal hygiene, moving ＆ exercise, nutrition & elimination, observation, medication, treatment, collecting specimens and other care activities for severity ill patients. Each item was assigned a value unit based on the average time required by the nursing staff to complete the specific item. The third step was to determine the practicality of the items and value units, so an attempt was made to establish content validity for these items and units by obtaing a consensus from 8 head nurses, representing eight different departments. The 4th step was to conducted a pilot study to establish the score range for the classification boundaries. For this purpose an instrument was designed using the list of items and value units and a prepared classification criteria as a guideline to validate the patient classification. A judgment group consisting of 52 supervisory nurses and head nurses were asked to select the proper patient to fit each classification criteria and to fill out the instrument for each patient. The total value unit and the frequency for each classification group was calculated. According to the frequency distribution, the score range for the classification group was determined as follows : 0~15 for groupI, 16~30 for group II, 31~50 for group III, and above 51 for group IV. Finally a patient classification form was developed.

• Korean Journal of Childcare and Education
• /
• v.12 no.2
• /
• pp.41-55
• /
• 2016

The purpose of this study was to examine the effects of parenting behavior and peer interaction on externalizing problem behaviors of preschoolers. The data of 953 49~55 month old preschoolers and their parents were extracted from the Korean Children Panel Survey of Child-Care Policy Research Institute(2012). This study was conducted with Structural Equation Modeling(SEM). The results of this study were as follows. First, parenting behavior had a direct influence on externalizing problem behaviors of preschoolers. Second, parenting behavior had a direct influence on preschoolers' peer interaction. Third, preschoolers' peer interaction had a direct influence on externalizing problem behaviors of preschoolers. Fourth, preschoolers' peer interaction had mediating effects on the relationship between parenting behavior and externalizing problem behaviors of preschoolers.

• Korean Journal of Childcare and Education
• /
• v.14 no.6
• /
• pp.1-18
• /
• 2018

Objective: The purpose of this study was to investigate relationships among child care teachers' role conflict, organizational commitment and teacher's sensitivity. It also aimed to test the mediating effect of organizational commitment on the pathway from child care teachers' role conflict on teacher's sensitivity. Methods: A self-report survey was conducted on 301 child care teachers in Chungbuk. Descriptive, means, standard deviations, correlations using SPSS 18.0, and Structural Equation Modeling using AMOS 18.0 were all conducted in order to analyze the collected data. Results: The results indicated that child care teachers' role conflict and organizational commitment had significant direct effects on teacher's sensitivity. This study also confirmed the significant mediating role of organizational commitment on the pathway from child care teachers' role conflict to sensitivity. Conclusion/Implications: The significance of role conflict and organizational commitment suggests that the integration of individuals with less conflict and more dedication will contribute more qualitative child care services by improving sensitive interactions with young children.

• Korea Journal of Hospital Management
• /
• v.25 no.2
• /
• pp.14-24
• /
• 2020

Purposes: The purpose of this study is to analyze the factor of affecting on job satisfaction by mediating attitude of care service. Methodology: (1)Identify socio-demographic characteristics, work characteristics, the elderly support period, the presence of education related to the elderly, the presence of service associated with the elderly, and significant factors of the research subjects. (2)Identify changes in the number of education and services before and after obtaining a caregiver qualification. (3)Identify the attitude of providing care services and job satisfaction according to the characteristics of the research subjects. (4)Identify the direct and indirect factors influencing job satisfaction by mediating the service attitudes of the research subjects. Findings: First, age factors have positive effects and the volunteering experience have negative effects on job satisfaction by mediating attitude of care service. Although the number of education class has increased after qualification, educational factors had no significant effect. Second, the longer elderly support period had a positive effect on job satisfaction. Practical Implications: This study is meaningful in that it identifies the direct and indirect impacts on job satisfaction through care attitudes. In the future, it will be necessary to pay attention to improving the quality of long-term care services by analyzing the influence factors more.

• Journal of muscle and joint health
• /
• v.3 no.1
• /
• pp.4-22
• /
• 1996

Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.

• Journal of Korean Foot and Ankle Society
• /
• v.15 no.3
• /
• pp.165-169
• /
• 2011

Purpose: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. Materials Methods: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. Results: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. Conclusion: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.

• Journal of Korean Public Health Nursing
• /
• v.33 no.3
• /
• pp.311-325
• /
• 2019

Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.