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A Study on the Nurses' Contingent Employment and Related Factors (간호사의 비정규직 고용실태 및 관련요인에 관한 연구)

  • Choi, Sook-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.477-500
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    • 1999
  • Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

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A Study on Qulity Perceptions and Satisfaction for Medical Service Marketing (의료서비스 마케팅을 위한 품질지각과 만족에 관한 연구)

  • Yoo, Dong-Keun
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.97-114
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    • 1996
  • INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

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A Study on the Goal-Orientation of QI Performers in the Medical Centers (의료기관 QI 담당자의 목표추구몰입에 관한 연구)

  • Kim, Mi-Sook;Park, Jae-Sung
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.105-124
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    • 2008
  • The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

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Performance Analysis of Top-K High Utility Pattern Mining Methods (상위 K 하이 유틸리티 패턴 마이닝 기법 성능분석)

  • Ryang, Heungmo;Yun, Unil;Kim, Chulhong
    • Journal of Internet Computing and Services
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    • v.16 no.6
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    • pp.89-95
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    • 2015
  • Traditional frequent pattern mining discovers valid patterns with no smaller frequency than a user-defined minimum threshold from databases. In this framework, an enormous number of patterns may be extracted by a too low threshold, which makes result analysis difficult, and a too high one may generate no valid pattern. Setting an appropriate threshold is not an easy task since it requires the prior knowledge for its domain. Therefore, a pattern mining approach that is not based on the domain knowledge became needed due to inability of the framework to predict and control mining results precisely according to the given threshold. Top-k frequent pattern mining was proposed to solve the problem, and it mines top-k important patterns without any threshold setting. Through this method, users can find patterns from ones with the highest frequency to ones with the k-th highest frequency regardless of databases. In this paper, we provide knowledge both on frequent and top-k pattern mining. Although top-k frequent pattern mining extracts top-k significant patterns without the setting, it cannot consider both item quantities in transactions and relative importance of items in databases, and this is why the method cannot meet requirements of many real-world applications. That is, patterns with low frequency can be meaningful, and vice versa, in the applications. High utility pattern mining was proposed to reflect the characteristics of non-binary databases and requires a minimum threshold. Recently, top-k high utility pattern mining has been developed, through which users can mine the desired number of high utility patterns without the prior knowledge. In this paper, we analyze two algorithms related to top-k high utility pattern mining in detail. We also conduct various experiments for the algorithms on real datasets and study improvement point and development direction of top-k high utility pattern mining through performance analysis with respect to the experimental results.

Kinematical Analysis of Woman Javelin Throwing (창던지기 동작의 kinematic적 특성분석)

  • Lee, Jong-Hoon
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.345-359
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    • 2002
  • The purpose of the study was to provide the fundamental data to instruct athletes through the analysis athletes' movement in javelin. Three athletes in the level of national representative were participated in this study. The study analyzed kinematic variables(lead foot and releasing javelin) through 3-D analysis and obtained the following results. 1. During withdrawal, it is important to maintain of running horizontal velocity. 2. It was showed that throng average height was $84{\pm}3.3%$ and javelin adequative degree, Among the athletes, $S_2$ who had the best record was released the javelin with the fast velocity, but throw the javelin with the less releasing velocity. 3. $S_2$ released after lead foot were completely landed and therefore it is no problem in a kinematic aspect. However, $S_1$ angle was too small. it caused increase of release velocity to be prevented. 4. $S_2$ showing the best result indicated shorter in duration time. Generally, the shorter duration time in release phase showed the longer release distance. Especially $S_1$ and $S_3$ showing the worse result indicated the longer duration time in preparatory phase, causing the breakup of force. Therefore to improve the record, it should be decreased the duration time in preparatory phase. 5. Compared with $S_1$ and $S_3$, $S_2$ showing the best record indicated the higher velocity in center of mass, trunk, upper arm, lower arm and hand That is the higher velocity of upper arm at release leaded the better velocity transfer from upper arm to following lower arm and hand, these action should be considered to be helpful of better record. According to the above conclusion, when the athletic leaders cauch athletes, they should focus on maintaining knee angle, upper body and hip angle in a previous stage of release and throwing angle, throwing height, throwing velocity in a release stage.

Development and application of a Teaching and Learning Plan and Practical Performance Assessment Tools to Promote Communication Between Teenagers Children and Their Parents: focusing on conversation analysis of real conversation in UCC video projects (청소년 자녀와 부모간 의사소통 개선을 위한 교수학습 과정안과 실제 상황적 수행평가 개발 및 적용 - 부모자녀의 실제대화 UCC동영상을 활용한 대화분석을 토대로 -)

  • You, Hye-Jung;Cho, Byung-Eun
    • Journal of Korean Home Economics Education Association
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    • v.23 no.3
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    • pp.139-160
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    • 2011
  • The purpose of this study is twofold: (i) to develop a teaching and learning plan and practical performance assessment tools for the improvement of teenager-parent communication and relationships as well as explore their effects on the communication in the everyday family life; and (ii) to find the underlying problems of teenager- parent communication through conversation analysis and to provide a improved dialogue model. We provided the experimental group with a performance task of communication training between teenagers and their parents in the real family situation while the control group practiced communication skills in a learning situation. However for both classes, before and after performance tasks were equally provided. The experimental group exhibited a longer conversation time with their parents, better communication skills, and higher degrees of relational satisfaction than the control group. Conversation analysis revealed that the experimental group reduced the use of blocking techniques in the teenager-parent conversations more than the control group, and all so raised the frequency of functional communications more than the control group. In both areas of communication in the experimental group was significantly improved, Most notably, a problem-solving case through no-lose conflict resolution methods was effective, succeeding by 70% in the e experimental group and 43.3% in the control group. Parents use blocking techniques like admonition, lecturing, blaming. sarcastic remarking, ordering and so forth, while teenagers use dispute, avoidance, blaming, and teasing in this order. The communication problems during the conversation process, teenagers' evasive and rebellious way of speaking instigates adverse communication responses from parents, so their conversation tends to unfold as ambiguous evasion opposed to: inquiring or evasion by short answers vs. ordering-preaching, or disputing vs. criticizing-making sarcastic, disputing vs. disputing-teaching, and criticizing vs. criticizing.

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The Change of Total Scan Time in Accordance with the Time of the Decision of Scan Time (스캔 시간의 결정시기에 따른 총 스캔 시간 변화에 관한 연구)

  • Lee, Jong-Hun;Ryu, Jae-Kwang;Chung, Woo-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.81-85
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    • 2009
  • Purpose: The examination of nuclear medicine observes the change in accordance with the time elapsed in the same region purposed and there are many examinations to acquire the image during the same term. At this time, the same parameter should be applied. The hepatobiliary scan, lung scan etc, are the acquired examination in the divided time with a regular term. Pre-set time that is applied in continued next image is set in order to acquire the fixed counts. The same scan time should be applied for each image. This study will look for the rational plan and analyze the change of scan time in accordance with the time of the decision of scan time at examination that pre-set time is applied. Methods: The hapatobiliary scan that use the radio pharmaceutical $^{99m}Tc$-mebrofenin is choosed as compensation from Jan. 2009 to Mar. 2009 in the department of nuclear medicine in ASAN MEDICAL CENTER. Scan is started after 5 minutes from when 222 MBq (6 mCi) is injected to patient. We let patient stand up between both detectors, and possibly close to the front of detector. When scan time reach 10%, 25%, 50%, 75% of total scan time, we measured the expected total scan time. After finishing all of scan, we compared the total scan time and the expected total scan time, while image is acquiring. and we observed the change of scan time in accordance with radio activity by using phantom. Results: After starting scan, a difference of when scan time reach 10%, 25%, 50%, 75% of total scan time is that the biggest difference is 5 seconds on 10%. There statistically is difference between 25% (t:2.88, p<0.01) and 50% (t:2.05, p<0.01). Conclusions: When the same the scan time is applied in the examination that acquire the many frame, concluding the same scan time has a important effect on a quantitative analysis. Although method that decide the scan time after finish all of the examinations, there is a few problem to apply practical affairs. This may cause an inaccurate result on the examination that need a quantitative analysis. We think that operator should try to improve it. At least, after reach 50% of total scan time, deciding the total scan time mean that you can minimize error of a quantitative analysis caused by unmatched scan time from a gap of image.

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The Influence of Stress on Smoking and Drinking of High School Students (스트레스가 고등학생의 흡연.음주에 미치는 영향)

  • Kim, Jong-Mun;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.3
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    • pp.35-58
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    • 2002
  • This research attempted to investigate the real state of adolescent smoking and drinking, and to study how stress influences on smoking and drinking of high school students. This data was collected from 837 first and second grade students in a vocational high school in Go-yang city, Gyeonggi province. Data analysis consisted of frequency, percentage, Chi-square, T-test, step-wise regression analysis, using SPSSWIN. The results of analysis were as follows: First, 51.7% of the students have never smoked, while 48.3% have experienced smoking. Most students started smoking in the second year of the middle school, though 17.6% of the smokers already started in the elementary school. The strongest motive of initial smoking was curiosity, next the inducement of friends, and 10.9% of them smoked to get rid of stress. Their favorite place for smoking was in the order of the entertainment centers, schools, and private academies. They personally purchased cigarettes mostly at the store. Most of them smoked less than 5 cigarettes a day, but 3.7% smoked more than a pack of cigarettes a day, usually with friends rather than alone. Second, the ratio of drinking was relatively high 78.1%, and their initial drinking experience was most frequent at the third year of the middle school. The initial motive of drinking was mostly curiosity and the inducement of friends, but 10.7% of them started drinking to reduce stress and anxiety. The places for buying alcohol and drinking were bars or restaurants. The ratio of habitual drinking was 45.1%, and the ratio of irregular drinking was 53.3%. 1.8% of the drinking students enjoyed drinking everyday. The amount of drinking varied from half a bottle to two bottles of Soju, and the drinking problem was serious to see that 11% of them drank more than two bottles at a time. Because 84.4% drank in groups with friends, a thorough and systematic supervision and education of the peer group drinking is essential. Third, as for the relationship between personal matters and smoking, it was found that there was a positive relation between smoking and sex, but there was no correlation between smoking and school years. Adolescent smoking was also related with scholastic achievement, the number of friends, and the existence of parents. Fourth, as for the relationship between personal matters and drinking, it was found that there was no correlation between drinking and sex, but there was a positive relation between drinking and school years. Fifth, the average index of stress was students themselves(2.58), school life(2.53), family life(2.19), friends(2.00), and the total index of stress was 2.33. Sixth, there appeared a marginal negative correlation between stress and 'drinking and smoking' in Pearson coefficient of correlation r to see the influence of stress on smoking and drinking. The difference of the average index of stress according to smoking and drinking bears meaningful difference for all students, smokers and non-smokers, drinkers and abstainers in students themselves, school life, family life, friends, and total stress. Smoking has an effect on family life most, school life next, and drinking has an effect on school life most, family life next, with the explanation power of 11% and 9% respectively, in a regression analysis to analyze the factors influencing on smoking and drinking among the factors of stress.

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Implementation of Reporting Tool Supporting OLAP and Data Mining Analysis Using XMLA (XMLA를 사용한 OLAP과 데이타 마이닝 분석이 가능한 리포팅 툴의 구현)

  • Choe, Jee-Woong;Kim, Myung-Ho
    • Journal of KIISE:Computing Practices and Letters
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    • v.15 no.3
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    • pp.154-166
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    • 2009
  • Database query and reporting tools, OLAP tools and data mining tools are typical front-end tools in Business Intelligence environment which is able to support gathering, consolidating and analyzing data produced from business operation activities and provide access to the result to enterprise's users. Traditional reporting tools have an advantage of creating sophisticated dynamic reports including SQL query result sets, which look like documents produced by word processors, and publishing the reports to the Web environment, but data source for the tools is limited to RDBMS. On the other hand, OLAP tools and data mining tools have an advantage of providing powerful information analysis functions on each own way, but built-in visualization components for analysis results are limited to tables or some charts. Thus, this paper presents a system that integrates three typical front-end tools to complement one another for BI environment. Traditional reporting tools only have a query editor for generating SQL statements to bring data from RDBMS. However, the reporting tool presented by this paper can extract data also from OLAP and data mining servers, because editors for OLAP and data mining query requests are added into this tool. Traditional systems produce all documents in the server side. This structure enables reporting tools to avoid repetitive process to generate documents, when many clients intend to access the same dynamic document. But, because this system targets that a few users generate documents for data analysis, this tool generates documents at the client side. Therefore, the tool has a processing mechanism to deal with a number of data despite the limited memory capacity of the report viewer in the client side. Also, this reporting tool has data structure for integrating data from three kinds of data sources into one document. Finally, most of traditional front-end tools for BI are dependent on data source architecture from specific vendor. To overcome the problem, this system uses XMLA that is a protocol based on web service to access to data sources for OLAP and data mining services from various vendors.

Study of Failure Mode and Effect Analysis in Brachytherapy (근접방사선치료에 관한 사고유형과 영향분석 연구)

  • Lee, Soon Sung;Park, Dong Wook;Shin, Dong Oh;Kim, Dong Wook;Kim, Kum Bae;Oh, Yoon-Jin;Kim, Juhye;Kwon, Na Hye;Kim, Kyeong Min;Choi, Sang Hyoun
    • Journal of the Korean Society of Radiology
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    • v.11 no.7
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    • pp.627-635
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    • 2017
  • Brachytherapy is generally performed in conjunction with external radiation therapy, and the treatment course is very complicated, which can lead to radiation accidents. In order to solve this problem, we designed the process map by applying the failure mode and effects analysis (FMEA) method to the Brachytherapy and scored the risk priority number (RPN) for each treatment course based on this process map. The process map consisted of five steps, Patient consulting", "Brachytherapy simulation", "CT simulation", "Brachytherapy treatment planning" and "Treatment". In order to calculate the RPN, doctor, medical physicist, dose planners, therapist, and nurse participated in the study and evaluated occurrence, severity, and lack of detectability at each detail step. Overall, the process map is preceded by a patient identification procedure at each treatment stage, which can be mistaken for another patient, and a different treatment plan may be established to cause a radiation accident. As a result of evaluating the RPN for the detailed steps based on the process map, overall "Patient consulting" and "Brachytherapy treatment planning" step were evaluated as high risk. The nurses showed a tendency to be different from each other, and the nurses had a risk of 55 points or more for all the procedures except "Treatment", and the "Brachytherapy simulation" step was the highest with 88.8 points. Since the treatment stage differs somewhat for each medical institution performing radiotherapy, it is thought that the risk management should be performed intensively by preparing the process map for each institution and calculating the risk RPN.