• 지역사회간호학회지
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• 제6권1호
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• pp.5-33
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• 1995

The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant($\beta=1.535$, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found in rural health centers(Rc=.578, P=.069), 10. Relationships between job satisfaction and health care productivity was not found significant. Through these results, the assumed relationship between environment and organizational structure was not supported in health centers. Therefore, the relationship between the organizational effectiveness and the congruence between environment and organizational structure that contingency theory proposes to exist was not able to be tested. However decision-making authority was found as an important variable of organizational structure affecting family planning services and job satisfaction in urban health centers. Thus it was suggested that decentralized decision making among health professionals would be a valuable strategy for improvement of organizational effectiveness in public health centers. It is also recommended that further studies to test contingency theory would use variability and uncertainty to define environment of public health centers instead of complexity.

• 디지털융복합연구
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• 제16권5호
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• pp.309-315
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• 2018

본 조사는 일부지역 종합병원 행정직원들의 조직공정성, 자아존중감 및 자기효능감과 직무스트레스 간의 관련성을 파악하고 직무스트레스에 미치는 융복합적 영향을 분석하였다. 자료수집은 2016년 11월 1일부터 2017년 1월 31일까지 구조화된 무기명 자기기입식 설문지를 통하여 시행되었으며, 조사대상은 임의로 선정된 J시의 11개 종합병원 행정직원 221명으로 하였다. 직무스트레스는 조직공정성의 절차공정성과 분배공정성, 자아존중감 및 자기효능감과는 음의 상관관계를 보였다. 공분산구조분석 결과, 종합병원 행정직원들의 조직공정성, 자아존중감, 자기효능감 및 직무스트레스의 인과관계를 확인하였으며, 조직공정성의 절차공정성 및 분배공정성이 높아질수록, 자아존중감이 높아질수록, 자기효능감이 높아질수록, 직무스트레스를 감소시키는 효과가 있는 것으로 나타났다. 이러한 결과를 볼 때, 종합병원 행정직원의 직무스트레스와 관련된 조직공정성, 자아존중감 및 자기효능감을 관리하는 노력이 필요하다. 분석결과는 종합병원 행정직원의 직무스트레스를 낮추는 조직 및 인사관리에 활용될 수 있다. 추후연구에서는 종합병원 행정직원의 직무스트레스에 영향을 미치는 융복합적인 추가요인에 대한 조사가 필요하다.

• 디지털융복합연구
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• 제15권7호
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• pp.239-246
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• 2017

병원행정직 근무자들의 자기효능감, 직무특성 및 직무스트레스와 직무만족도 간의 관련성을 파악하고 직무만족도에 미치는 융복합적 영향을 조사하였다. 조사대상은 임의로 선정된 11개 종합병원의 재직자 221명으로 하였으며, 자료수집은 2016년 11월 1일부터 2017년 1월 31일까지 구조화된 무기명 자기기입식 설문지를 통해 이루어졌다. 직무만족도는 자기 효능감, 직무특성의 3가지 하위요인과는 양의 상관관계를, 직무스트레스의 7가지 하위요인과는 음의 상관관계를 보였다. 공분산구조분석 결과, 직무스트레스는 자기효능감 및 직무특성보다는 직무만족도에 더 큰 영향을 미쳤으며, 자기효능감 및 직무특성이 높아질수록, 직무스트레스가 낮아질수록 직무만족도를 증가시키는 효과가 있는 것으로 나타났다. 이러한 결과를 볼 때, 병원행정직의 직무만족도와 관련된 자기효능감, 직무특성 및 직무스트레스를 관리하는 노력이 필요하다. 분석결과는 병원행정직의 직무만족도를 높이는 조직인사관리에 활용될 수 있다. 추후연구에서는 병원행정직의 직무만족도에 영향을 미치는 융복합적인 추가요인에 대한 분석이 필요하다.

• 디지털융복합연구
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• 제16권3호
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• pp.345-351
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• 2018

병원행정직 근무자들의 조직헌신, A형행동유형 및 우울과 직무소진 간의 관련성을 파악하고 직무소진에 미치는 융복합적 영향을 조사하였다. 조사대상은 임의로 선정된 J지역 9개 종합병원의 재직자 201명으로 하였으며, 자료수집은 2017년 7월 3일부터 2017년 7월 29일까지 구조화된 무기명 자기기입식 설문지를 통해 이루어졌다. 직무소진은 A형행동유형 및 우울과는 양의, 조직헌신과는 음의 상관관계를 보였다. 공분산구조분석 결과, 우울은 조직헌신 및 A형행동유형보다 직무소진에 더 큰 영향을 미쳤으며, A형행동유형 및 우울이 높아질수록, 조직헌신이 낮아질수록 직무소진을 증가시키는 효과가 있는 것으로 나타났다. 이러한 결과를 볼 때, 병원행정직의 직무소진과 관련된 조직헌신, A형행동유형 및 우울을 관리하는 노력이 필요하다. 분석결과는 병원행정직의 직무소진을 낮추는 조직인사관리에 활용될 수 있다. 추후연구에서는 병원행정직의 직무소진에 영향을 미치는 추가요인에 대한 분석이 필요하다.

• 한국식품위생안전성학회지
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• 제18권4호
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• pp.202-210
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• 2003

두부는 양질의 단백질을 주성분으로 한 대중 식품으로 소비량이 계속 증가하고 있다. 두부는 변질 발생 가능성이 높은 고위험 식품에 해당되지만, 두부제조업체는 82.4%가 종업원 5인 이하 소규모로 체계적인 식품안전관리를 기대하기 어려운 실정이다. HACC(Hazard Analysis Critical Control Point : 위해요소 중점관리제도)는 식품안전성과 비용절감을 ㅎ율적으로 확보할 수 있는 체계적, 지속적인 공정관리 방법이다. 본 연구는 두부제조업체의 실정에 맞는 HACCP시스템을 개발하여 적용하고 그 성과를 확인함으로써 두부 HACCP 시스템의 일반적 모델을 확정하고 다른 중소업체 및 대기업으로 이를 확산시키려고 시행하였다. 규모별 4개 두부제조업체를 대상으로 판 두부와 포장 판 두부의 HACCP 계획을 Codex의 HACCP 적용 지침에 따라 현장 실부자와 협력하여 수립하였다. HACCP 팀 편성, HACCP 범위 및 목적의 설정, 제품 기술 및 사용자 의도의 결정, 공정도 작성 및 현장 검증, 위해 분석 및 예방책 식별, CCP(중요관리점)의 식별, CL(관리할계기준) 설정, CCP 모니터링 시스템 수립, 개선조치 설정, 검증절차 수립, 기록 및 문서화의 순서로 HACCP 계획을 작성하였다. 공정 중 CCP는 선별 공정, 냉각 공정, 열처리 공정(판 두부는 제외)으로 결정하였고, 각각의 HACCP 계획에 따라 관리하였다. 제정된 HACCP시스템을 3개월간 시행한 후 그 성과를 HACCP 적용 이전과 이후의 미생물 검사를 통하여 확인하였다. 검사결과 HACCP 적용 이전의 판두부 플라스틱 상자, 포장재, 완제품의 일반 세균수가 HACCP 적용 이후에 크게 감소되었다.(P<0.1) 두부제조업체의 실정에 맞는 HACCP 시스템을 적용함으로써 위생관리 및 식품안정성 확보에 큰 성과가 있음이 확인되었다.

• 한국산학기술학회논문지
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• 제21권5호
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• pp.485-494
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• 2020

본 연구는 종합병원 간호사의 의사소통 인식과 직무성과 영향 관계를 파악하여 인적자원관리 효율화와 병원경영의 기초자료 제공을 목적으로 수행된 연구이다. 자료조사는 광주·전남지역 소재 14개 종합병원에서 근무하는 간호사 392명을 대상으로 2019년 8월 5일부터 2019년 8월 23일까지 자료를 수집하였다. 자료 분석은 t-검정과 분산분석, 사후검정, 상관관계 및 다중회귀분석을 실시하였다. 연구결과 인구사회학적 특성 및 건강 특성과 직무성과 차이를 검정한 결과 연령, 근무년수, 급여수준, 직업만족, 소재지, 건강상태, 건강교육 경험, 만성질환, 우울경험에서 통계적으로 유의한 차이가 있었다. 간호사 의사소통 인식과 직무성과 영향 요인으로 30대 연령, 직업만족도(보통, 불만족)에서 부(-) 영향을 미쳤고, 소재지에서 긍정적인 영향을 미쳤으며, 의사소통 하부요인인 수평적 의사소통이 가장 큰 영향을 미쳤으며, 하향, 비공식, 상향 의사소통이 직무성과에서 영향관계가 있었으며 설명력은 45.2%이었다. 이러한 연구결과를 토대로 종합병원에서 간호사의 직무성과를 높이기 위해서는 간호사 근무환경 개선, 직업만족도를 향상시켜 상황 변화에 대응할 수 있는 수평, 하향, 비공식, 상향적 의사소통이 원활히 이루질 수 있도록 간호 조직문화 개선과 인적자원관리의 제도적 장치가 마련되어야 할 것이다.

• 대한간호학회지
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• 제11권2호
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• 한국환경보건학회지
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• 제10권2호
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• pp.9-40
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• 1984

This thesis purports to overview the diverse administrative and organizational factors and plannings developed by the government organizations, municipal or otherwise, to tackle the Han River water pollution issues in the past years. This thesis also looks into the ever-worsening Han River water pollution problems, in particular, in terms of the various government plans ostensibly designed to reduce the pollution level but with little success. Also dealt with are the efficiencies with which the laws and decrees on water pollution the administrative organizations put to use in the prosecution of the diverse antiwater pollution projects involving the Han River basin. From the early 1960's up to the 1970's the government had concentrated on the growth-oriented economic policy with the result that little attention had been paid to the water pollution and other environmental issues that are bound to arise from the massive economic growth. Belatedly, the five-year Hah River Development Project was initiated in 1982 with emphasis on reducing the water pollution level at Hah River to the minimum. The following are the gists of the thesis and recommendations for the future antiwater pollution plans by the administrative organizations: 1. Documents to date indicate that the irrigation projects along the Han River area had been the main focus of attention during the Yi Dynasty and under the Japanese rule of the country. 2. Despite that the water pollution issue became the subject of many debates among the academic and research institutions in the 1960's and in the 1970's, the administrative organizations in charge of the Han River water quality control failed to come up with a concrete plan for the river's water quality control. 3. Nevertheless, the water pollution of the Han River area in fact began in the 1950's, with the unprecedented concentration into Seoul of population and the industrial facilities on a larger scale, in particular, enforced by the government's strong growthoriented policy in its Economic Development plans in the 1960's. 4. Starting in the 1960's, the Han River water pollution level dramatically increased, but the government was reluctant to promulgate or put into effect strong measures to curb the many factors contributing to the river water pollution, thus worsening the environmental issues along the Han River basin. 5. The environmental protection law and other laws and decrees relating to the antiwater and air pollution issues that were subsequently put into effect underwent so many changes that efficient anti-water pollution policies could not be effected for the Han River basin. The frequent organizational reshuffle within the administrative units concerned with environmental problems has resulted in the undue waste in personnel management and finance. 6. The administration on the environmental protection could not be efficiently carried out due to the organizational overlapping. Under the existing law, frequent organizational frictions and inefficiency are bound to occur among the central government offices themselves, as well as between the central government and the Seoul city administration, and among the city's administrative offices over the conservation of the Han River basin and over the river's anti-water pollution issue. 7. In the planning and prosecution of the Han River project, political influences from the president down to the lower-level politicious appear to have been involved. These political influences in the past had certainly had negative influence on the project, nevertheless, it appears that in the recent years, these political influences are not all that negative in view of the fact that they serve as a positive contributing factor in developing a better water quality control project along the Han River basin. The following are a few recommendations based on the data from the thesis: First, officials in charge of the Han River water quality control should pay attention to a careful screening of the opinions and recommendations from the academic circles and from the public should be made so that the government could better grasp the core issues in the environmental problems that require preventive and other necessary measures. Second, vigorous redistribution policies of population and industrial facilities away from the Seoul area should be pursued. Third, the government should refrain from revising or revamping too frequently the laws and decrees on the anti-water pollution, which is feared to cause undue inconveniences in the environmental administration. Fourth, a large-scale streamlining should be made to the existing administrative organization in an effort to do away with the inter- and intra-organizational friction. It is recommended that a secretariat for the Hah River basis conservation be established. Fifth, High-level administrative officials, with a thorough knowledge and vision on the Han River water quality control, should be prepared to better deal with the budgeting and personnel management for the Han River water pollution control not only at the control government, but also at the Seoul city municipal government levels. Environmental issues should be kept distinct from political issues. Environmental issues should not serve as a window-dressing for sheer political purposes. Sixth, the Hah River proiect should also include, along with the main Han River basin, those areas covering North Han River, South Han River, and the tributaries to the main river basin. The 'Han River Basin Water Quality Control Board' should be established immediately as a means of strengthening the current Han River basin water quality control policy. Seventh, in drawing up the Han River proiect, the administrative officials should be aware that Han River basin is a life line for those people in the region, providing them with not only a sheer physical space, but with a psychological living space for their everyday life.

• 한국병원경영학회지
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• 제8권4호
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• pp.59-75
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• 2003

This study was conducted to investigate the degree of utilization of outsourcing in large hospitals in Korea. We also investigated the outcome and the level of satisfaction for adopting outsourcing in these hospitals. Types of work areas that were currently operated by outsourcing and were planned to adopt outsourcing in the future were identified. A total of 83 hospitals were eligible for this study, which had more than 500 beds, and were identified from the 2003 National Hospital List published by the Korean Hospital Association. A self-administered Questionnaire survey was conducted between April 25th and May 20th in 2003 with a personnel being charged of arrangement of outsourcing in each hospital. Among the 58 hospitals responding the survey(response rate=69.9%), 49 hospitals(84.5%) utilized outsourcing in at least one work field in their organizations. The largest proportion of the hospitals(85.7%) using outsourcing responded that the biggest outcome after introducing outsourcing were cost reduction(49.0%), followed by improved efficiency in operating the organization or human resources(34.7%) and the improved quality of the work(6.1%). The degree of satisfaction for outsourcing among the hospital managers(3.43) was significantly higher than that among the employees(3.l4) on a S-point Likert-type scale(p<0.05). Among the 7 work areas, the hospitals used outsourcing most frequently in facility management(housekeeping, building maintenance, hospital security and parking management), followed by non-medical profit business(funeral, convenient store, and cafeteria), logistics(provision of patient meal, in-house delivery, and purchasing), and information and computing system(hospital information system, maintenance of personal computers and printers). The work areas that the hospitals planned to adopt or expand the outsourcing in the future most frequently were facility management, non-medical profit business, logistics, and information and computing systems. In conclusion, outsourcing was highly diffused in large Korean hospitals, particularly in the work field of facility management and non-medical profit business. The satisfaction for outsourcing was not high yet in Korean hospitals.

• 시큐리티연구
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• 제9호
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• pp.99-131
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• 2005

테러리즘의 최종 목적은 대량살상 자체가 목표이기 때문에 효과적인 테러활동을 억제하기 위해서는 테러의 위협환경과 그 경로를 차단해야 하며, 이에 대한 적극적인 대응방안이 강구되어야 한다. 그러면 위의 위협에 대한 구체적은 대응방안으로서, 첫째, 국제사회는 테러의 근본 원인보다는 테러의 주체, 수단과 방법을 제거하거나, 테러의 대상을 보호하는데 많은 노력을 해온 것이 사실이다. 하지만 향후 테러 방지를 위해서 테러의 발생 원인을 제거하는데 보다 적극적이고 장기간의 노력이 필요하다 하겠다. 둘째, 예방적인 차원의 대응방안이 모색되어야 한다. 테러리즘의 근절을 위해 가장 효과적인방법은 예방이다. 이를 위해서는 테러리즘의 발생원이이 되는 객관적인 환경오소 자체를 제거하고, 테러리스트의 활동 근거지를 추적, 섬멸하여 대량살상무기 및 지원자금의 유입 등을 봉쇄하여 조직을 무력화 시켜야 한다. 셋째, 테러 대응 조직체계를 정립하여 통합된 위기관리기구나 기능이 작동될 수 있도록 장애요인의 지속적인 제거와 국제적 연대를 강화하고, 국내에서 발생 가능한 테러유형을 분석하여, 특성, 대응체계, 전략, 법 적용, 테러피해의 산정, 그리고 대응 프로그램 개발이 시급히 이루어져야 하며, 또한 새로운 테러수단과 양상에 대한 대책수립을 지원할 연구 기반을 구축하고, 이를 활성화시킬 방안이 모색되어야 할 것이다. 넷째, 대(對)테러 대비 총괄적인 정부종합대책 강구를 위해 기관간 업무 분장 등 현장대응체제 발전을 위해 무력테러(행자부), 화학테러(환경부), 생물테러(복지부), 핵${\cdot}$방사능테러(과기부) 등 분야별 테러대응 세부대책을 보완${\cdot}$발전시켜나가야 한다.나 TDT에서는 유의한 차이가 관찰되지 않았다. 또 뚜렛 장애 환아군의 세 가지 서로 다른 유전형 사이에 틱 장애의 가족력, 주의력결핍 과잉행동장애, 강박증, 약물에 대한 반응, 공존 질환 여부 등에 있어서 유의한 차이는 없었다. 결 론：본 연구에 있어 사례 수가 적고 TDT에서 유의한 결과가 발견되지 않았기 때문에 해석에 조심을 기할 필요는 있겠으나, 본 연구는 COMT유전자의 기능적 다형성과 뚜렛 장애 간에 연관 관계가 있음을 밝혀 낸 최초의 보고라 하겠다.산수, 토막짜기 점수도 유의하게 높았다. 약물치료력에 있어서는 임상가가 평가한 약물 반응이 순응군에서 유의하게 높았고, 약물 용량도 순응군이 유의하게 높았으며, 오후 약물 순응율(2003년 3월 평가)도 유의하게 순응군이 높았다. 또한 주치의의 지휘에 따라서도 순응율에 차이를 보였다. 결 론：국내에서는 최초로, 외래 치료를 받고 있는 ADHD 아동에 대한 MPH-IR 순응도를 조사하였다. 평균 1년 치료기간동안의 순응도는 62%로 외국에서의 연구결과와 유사하였으며, 지능이 높을 때, 약물반응이 우수하고, 약물용량이 높으며, 오후약물에 대한 순응이 초기에 높을 때 약물 순응률이 보다 높았다. 결국 약물치료 효과에 대한 만족도가 순응률 결정에 가장 중요한 요인이라고 생각되며, 약물치료효과를 높이기 위한 다양한 전략을 사용하여, 약물 순응도를 향상 시킬 필요가 있다고 생각된다.으나, 주의력에서는 전두엽의 실행능력(executive function)과 관련되는 검사들에서 산소흡입이 특이한 효과를 보여준다는 것이 확인되었고, 기억능력에서는 단기기억능력 평가에서 산소흡입군이 대조군보다 유의한 효과를 보여주는 것으로 평가되었다. 이러한 연구결과는 산소흡입이