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한국 의료제도와 유전상담 서비스의 구축 (Genetic Counseling in Korean Health Care System)

  • 김현주
    • Journal of Genetic Medicine
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    • 제8권2호
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    • pp.89-99
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    • 2011
  • 유전상담이 왜 국내 의료 현장에서는 필요한 의료서비스로 제공되고 잇지 않은 지에 대한 문제점과 해결책을 모색하고자 미국과 일본에서 유전상담이 필요한 유전 의료 서비스의 일환으로 정착되는 배경과 과정을 비교 고찰하였다. 동시에 국내 유전의료서비스의 현황과 유전상담 서비스 제공에 있어서 장애가 되는 요인들을 고찰하였다. 미국의 경우에는 1970년대 초에 산전 진단이 보편화되면서 유전상담의 수요가 늘게 되어 새로운 직종의 전문 유전상담사를 양성하게 되는 계기가 되었으며, 현재 29개의 양성과정의 교육을 통해서 3,000명에 가까운 전문유전상담사가 배출되어 임상유전 의료팀의 일원으로 임상유전학 전문의의 감독 하에 유전상담을 제공하고 있으며, 21세기 유전의료시대에 요구되는 생명유전정보관리를 위해서 유전상담의 필요성과 그 역할이 확대되고 있다. 일본에서는 정부주도하에 HGP 유전체 연구사업 이후 21세기 유전의료시대의 도래를 준비하는 밀레니엄 프로젝트 차원에서 <유전의료시스템의 구축과 운영> 및 <유전 카운슬링 체제의 구축>을 위한 대규모의 연구단을 구성하여 임상유전 전문의의 제도화와 본격적인 임상유전 전문 분야의 서비스가 의료기관에 개설되는 동시에 비의사를 위한 인정 유전카운슬러의 양성과 자격에 대한 연구를 거쳐서 2003년 7개의 대학원에서 유전상담사 양성 과정이 인정되어 2012년까지 110명의 유전카운슬러 배출을 목표로 현재 100명이 넘는 유전상담사가 인증되었다. 사회적 의료 수요에 부응하는 의학유전 유관학회와 교육기관의 전문가 그룹이 선도한 미국의 유전상담사 양성 프로그램과 정부 주도 하의 시대적 의료 변화에 부응하는 연구에 전문가들의 참여로 체계적인 유전상담 프로그램개발을 정착시킨 일본의 경우, 모두 비의사 유전상담사에 의한 유전상담 서비스에 대한 보험급여 등의 제도적인 보완 없이 선행되었다는 점은 우리에게 시사하는 점이 크다고 본다. 한국의료 현장에서 유전상담 서비스가 시도되지 않는 주 장애요소로는 유전상담에 대한 이해 부족과 무관심, 국내 의료 제도 하에서 의사의 진료 수가가 너무 낮아서 그 결과 외래에서 한 환자의 진료에 할애할 수 있는 시간은 10분을 초가 할 수 없는데, 유전상담 서비스는 장시간이 소요되기 때문이다(최소30분이상). 또한, 건강보험 급여제도에서 '유전상담'을 필요한 의료 행위로 인정하지 않고 있어서 아직 code 조차 생성되어 있지 않기 때문이다. 또한, 무엇보다도 근본적인 요인으로 유전상담 서비스를 제공할 수 있는 임상유전 전문의가 절대 부족하고, 최근까지도 국내 의과대학 교육 curriculum에 유전상담을 실제적으로 이해하고 습득할 기회가 없었기 때문에 일반 의료인에게는 유전상담에 대한 이해 부족과 무관심 등이 유전상담 서비스의 걸림돌로 파악되었다. 그러나, 대한의학유전학회에서 2007년 전문가들을 대상으로 실시한 유전상담과 전문 유전상담사 수요에 대한 전국 조사 연구에서 유전의료 현장과 연구 부분에서 유전상담과 전문 유전상담사가 매우 필요하다는 것이 확인되었다. 또한, 정부는 희귀난치성질환센터 Help Line의 유전질환 정보 제공을 통해서 유전상담을 받을 것을 권고하고 있지만, 실제로 의료 현장에서는 유전상담이 제공되고 있지 않기 때문에, 한국근육장애인협회, 저신장장애인협회, 코헴회등, 유전성환자들로 구성된 국내 자조회 등에서는 유전상담의 필요성을 제기하며, 서비스를 요구해오고 있다. 최근 한국희귀질환재단에서 유전성 희귀질환 환자와 가족들에게 유전상담 교육 강좌를 제공한 후 설문조사에 응한 283명의 81%가 이전에 유전상담에 대해서 접해 본 적이 없었고, 96%에서 유전상담이 희귀난치성질환 환자에게 도움이 될 것이라고 응답했다. 한편, 2009년 실시한 국내 실정에 맞는 유전상담사 양성을 위한 교육 프로그램과 교육기관의 인정 및 전문 자격 인증제도 수립에 대한 연구에서 관련 업무 전문 종사자 총 117명(의사52명, 전문 연구원30명, 간호대학 교수 26명 포함) 중 설문조사에 응한 88%가 대한의학유전학회에서 주관하고 유전상담위원회를 구성하여 교육 프로그램 개발과 인증제도를 구체화 할 것을 촉구하였다. 전문 인력의 양성을 위한 교육 수련 및 인증 프로그램을 개발하고 수행하는 것은 전문학회의 역할인 동시에 "사회적책임"이라고 생각한다. 새로운 분야(신기술)의 전문 임상 인력을 양성하는 데는 시간이 걸리기 때문에(유전상담사의경우, 2년의 대학원 과정과1년의clerkship, 임상수련과정 등으로 적어도 3년) 대한의학유전학회에서는 전문 유전상담사 양성을 위한 선 교육, 후 제도적 보완을 추진하는 것이 바람직한 방향이다. UNESCO에서는 이미 1995년 Report에서 유전상담은 유전자 검사의 보급이 증가하고 있는(21세기 유전의료시대) 의료현장에서 가장 빠르게 성장하고 있는 전문 분야로서 유전정보와 기법을 환자 진료에 연결하는 것을 돕는다고 하였다. 유전상담은 21세기 post-genome의 맞춤의료시대에서 그 역할과 적응범위가 확대되어가는 유전의료서비스의 일환이라는 것을 국내 의료계와 정부 의료 정책 부서에서 인지할 필요가 있다. 특히, 국내 저진료 수가의 의료정책 제도 하에서는 의사가 환자를 위해 충분한 진료시간을 확보하기 힘든데, 비의사전문유전상담사를유전의료팀의일원으로 유전상담에 참여하게 함으로써 환자와 가족들에게 정확한 유전정보에 대한 충분한 이해를 통해서 맞춤 유전 의료 서비스를 원활하고 효율적으로 제공하는데 도움이 될 것이다. 이를 위해서는 국내에서도 종합적인 유전의료 서비스의 구축 사업의 일환으로 유전상담 서비스 공급을 위한 전문 인력(유전상담사포함) 수급에 대한 지원 사업과 유전상담에 대한 건강보험 급여 인정 등 제도적인 뒷받침이 필요하다.

서울지역 국민학교(國民學校) 양호교사의 학교간호업무(學校看護業務) 수행정도(遂行程度)에 관(關)한 연구(硏究) (A Study on status of school health and analysis of factors affecting school nursing activities in the secondary school in Seoul)

  • 김은희
    • 한국학교보건학회지
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    • 제1권2호
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    • pp.50-65
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    • 1988
  • This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

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가정학교육과 취업방안연구 (A Study on Home Economist Education with Refrence to the Business Activities in Korea)

  • 한상순
    • 대한가정학회지
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    • 제27권2호
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    • pp.163-185
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    • 1989
  • Korean home economics education has around 100 years history. The main aims of home economics education up 1950 had not been changed, they were mainly for the improvement of household-skill to raise both standard of living and life quality as well as womanhood. After 1960's the standard of living drastically improved and the industrialization of Korean society was quite rapidly proceeded from simple to complex one. Because of these changes, I considered that the aims and the contents of home economics education should be reexamined and reshaped. This study motivated me that especially home economics major should be trained to be competent enough to work in industrialized society as much as the input to her college education. As industialization was made progress, family member's diverse role differentiation also occurred from past simple role such as house wife or girl's high school teacher among by home economics major. In this current societal change, most of the home economics major have wish to have opportunities obtaining new kinds of employment rather than obtaining merely teaching work. With this in mind I made a study on college level home economics education of the new adjustment to current and future industrialized Korean society. (1) The full number of officially admissible home economics major in 169 Korean colleges, 70 junior colleges, and one open university were as follows, 7139, 6080, and 230 respectively. The percentages of employed of employed numbers of them for the college and junior college graduates were 26.5 and 39.0 respectively. (2) The certificate qualifications issued to college home economics major are nutritionist (1st grade and 2nd grade), clothes and textilist, home economics teacher (2nd grade for high school) and kindergartener (2nd grade), The qualifications are certified after majoring each field from major departments of college of home economics by Ministrys of Labour and Education of the Korean government. The percentages of their employment are low as mentioned earlier. (3) To find out new employment opportunity for home economics graduates in home economist in business (henceforce/HEIB) status quo of consumer division for mational enterprise was surveyed. According to govermment decree of general law of consumer protection (1980), enterprise should organize bureau (offics, subdivision) on liability to consumer's complaint. Of 89.6% of the enterprise established th subdivision in which 96.2% of employee was male (3.8% was female). Of the employee college graduate and high school graduate were 93.2% and 6.8% respectively. On the employee's major acadmic backgroud (%), economics and business administration, engineering and low-political science were 39.5, 26.2 and 11.2 respectively. (4) To study on the relation between home economics and home economist in business, the aspect of historical development of HEIB, group of HEIB employing enterprise and their nature of business were tried to find out as well as perception and evaluation by enterprise on HEIB. (a) In the united States of America employed home economics major to enterprise was organized autonomously HEIB subdivision within American Home Economics Association since 1920's and the membership of HEIB was 3,000 of the AHEA membership 50,000. (b) In Japan the Japanese founder HEIB had three times the bilateral congress with the U.S.HEIB and had 10th anniversary celebration in 1988. Japanese HEIB member are not necessary to be home economics graduates but should have certificate as consumer adviser effected by the Minister of Trade and Industry. Japanese subdivision of consumer affaire within Japanese enterprise employ the consumer adviser with the certificate. Because of this different system from the United Sates, Japanese HEIB call their title "HEEB" instead of HEIB. The Japanese consumer adviser certificate system had initiated since 1980 and it belongs to 2nd level national qualification certificate. Currently active membership of Japanese "HEEB" association had increased from 115 (in 1979) to 319 in 1988. (5) For the opening of the future new employment of home economics graduates to enterprise and qualification required for the HEIB by national enterprise in Korea, I studied on the courses which seem to be important and required by employee in the field of HEEB in the United States of America and preliminary curriculum for home economics related major student aimning to be the future "HEEB" by Japanese HEEB study group of Japanese Association of Home Economics. It is suggested that it is very important and urgent to realize as home economics educator to have common deep concern and endeavors on opening new employment for our home economics major student1), we should try to publicize strongly and let enterprise and consumer protection board realize that employee in the subdivision of consumer protection should be the one who well experienced home economics major graduates2), we, home economics educator, should try to develop actively new curriculum in line of the suggestion made earlier for our future home economics major student of open broadly their future employment opportunities3), we, home economics educators, should try to have consensus on whether we should have support from government in terms of receiving national qualification certificate on consumer pretection or not4), and I would appreciate if the Korean Home Economics Association and Korean Home Management Society paydeep and positive concern on this matter.

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KODISA 학술지 성장전략: 2017 개관 및 미래 성장개요 (Future Development Strategies for KODISA Journals : Overview of 2017 and Strategic Plans for the Future)

  • 황희중;신동진;이정완;김동호;이종호;김병구;김태중;이용기;서응교;강민수;서원재;김종진;장범;소수;윤명길
    • 유통과학연구
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    • 제16권5호
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    • pp.83-90
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    • 2018
  • Purpose - Journals of Korea Distribution Science Association (KODISA) made great efforts in responding to the constant shifts in academic paradigms and in producing synergetic effects among KODISA journals to achieve the goal of maintaining their status in the world's reputable scholarly journals. The aim of this study is to analyze the current practice and performance of KODISA journals and develop strategies that will continuously meet and respond to the changes and success in the future. Research design, data, and methodology - This is a case study, an analytical approach, which focuses on analyzing current and previous strategies, practices, and performances of the four major journals of KODISA and the association. The organizational structure, including election and terms of KODISA officers, new membership, and members of editorial board, is discussed and analyzed. The citation, submission, publication, and rejection rates of all four journals are examined, and the progress, including the status of indexing of each journal, is discussed. Results - The analysis indicates that KODISA has significantly invested its resources into improving its journals and attracting new members. The analysis also shows the strategy of the organizational structure, which includes election and terms of officers and editorial board members that implemented over the years, was successful. Both Journal of Distribution Science (JDS) and Journal of Finance, Economics, and Business (JAFEB) are indexed in SCOPUS, with East Asian Journal of Business Management (EAJBM) in the final stage of the SCOPUS indexing evaluation, and International Journal of Industrial Distribution and Business (IJIDB) will complete and submit their indexing evaluation materials to SCOPUS this summer. Conclusions - The success and progress of KODISA and its journals clearly support the need for continuous development, analysis, revision, and implementation of strategies. Based on the analysis, conducting the annual performance reviews of the association and its journals and planning and strategizing based on the reviews since 2011 have greatly contributed to the overall success. In terms of meeting the short term strategy, KODISA has to continue developing relationships with relevant and appropriate scholarly/academic associations to expand the scope of its business, establishing independence of each journal and its respective procedures and practices and improving the quality of the journals and their publications through KODISA's international conferences.

Are you a Machine or Human?: 소셜 로봇의 인간 유사성과 소비자 해석수준이 의인화에 미치는 영향 (Are you a Machine or Human?: The Effects of Human-likeness on Consumer Anthropomorphism Depending on Construal Level)

  • 이준식;박도형
    • 지능정보연구
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    • 제27권1호
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    • pp.129-149
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    • 2021
  • 최근 인간과 사회적으로 상호작용할 수 있는 소셜 로봇(Social Robot)에 대한 관심이 커지고 있다. ICT 기술 발전에 힘입어 소셜 로봇이 개인에게 맞춤형 서비스와 정서적 교감을 제공하기 쉬워졌으며, 현대의 사회문제들과 이로 인한 개인의 삶의 질 저하를 해소하기 위한 수단으로 소셜 로봇의 역할이 주목받고 있다. 소셜 로봇에 대한 관심에 힘입어 소셜 로봇 보급 또한 크게 늘고 있다. 많은 기업이 다양한 목표시장을 겨냥하기 위한 로봇 제품들을 시장에 선보이고 있으나, 현재까지 시장을 선도하는 명확한 흐름은 부재하다. 이에 따라 소셜 로봇의 디자인을 통해 로봇을 차별화하고자 하는 시도가 늘고 있다. 특히 의인화는 소셜 로봇 디자인에서 중요하게 연구되고 있으며, 소셜 로봇을 의인화하여 긍정적인 효과를 발현하려는 접근이 많이 시도되었다. 그러나 소셜 로봇에 대한 의인화가 형성되는 메커니즘을 체계적으로 설명하는 연구는 부족하다. 의인화에 대한 모호한 이해는 소셜 로봇의 의인화를 형성하기 위한 디자인 최적점의 도출을 어렵게 하고 있다. 본 연구는 소셜 로봇의 의인화가 형성되는 메커니즘을 검증하는 것을 목적으로 한다. 본 연구는 3×2 Mixed Design의 실험 연구를 통해 소셜 로봇의 인간 유사성(Human-likeness)과 개인의 해석수준(Construal Level)이 의인화 형성에 미치는 영향을 확인하였다. 의인화가 형성되는 메커니즘에 대한 6개의 연구 가설을 제시하고, 206명 표본의 데이터를 분석하여 가설을 검증하였다. 분석 결과 소셜 로봇의 인간 유사성 수준에 따라 로봇 의인화 수준이 높아지며, 소비자 해석수준에 따라 인간 유사성이 의인화에 미치는 영향이 다르게 나타남을 확인하였다. 본 연구는 소셜 로봇의 디자인 속성인 인간 유사성과 개인의 사고방식인 해석수준을 함께 고려하여 의인화가 형성되는 메커니즘을 설명하였다는 점에서 시사점이 있다. 본 연구의 결과를 소셜 로봇 의인화 형성을 위한 디자인 최적화의 기준으로 활용할 수 있을 것으로 기대한다.

CDMA2000 1X-EVDO망을 이용한 이동형 응급 의료영상 전송시스템의 설계 (The Design of Mobile Medical Image Communication System based on CDMA 1X-EVDO for Emergency Care)

  • 강원석;양건호;장봉문;남궁욱;정해조;유선국;김희종
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2004년도 제29회 추계학술대회 발표논문집
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    • pp.53-55
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    • 2004
  • 본 연구에서는 병원에서 멀리 떨어진 교통사고, 낙상에 의한 두개골이나 경추, 척추등의 골절을 동반한 심각한 외상이 있거나 기흉등의 육안으로 진단하기 힘든 응급환자에 있어서는, 구급차를 이용하여 후송중이라 하더라도 방사선검사를 하여 전문의로부터 적절한 진단을 받고 응급조치를 할 필요가 있다. 본 연구의 목적은 응급상황에 사용할 수 있도록 CDMA 1X EVDO 방식의 통신망을 기반으로 하는 이동형 의료영상 전송장치의 프로토타입을 구현하고 성능을 평가하는 것이다. 설계된 시스템은 영상을 전송하기 위한 DICOM 영상전송 클라이언트로 노트북 컴퓨터에 CDMA 1X EVDO 방식을 지원하는 셀룰러폰을 연결하였으며, 병원에는 영상을 받기 위한 DICOM 영상수신 서버를 설치하였다. DR영상을 영상전송 클라이언트의 저장소에 저장한 후, JPEG2000형식으로 압축하여 수신서버로 전송하였다. 모든 영상은 progressive하게 전송되어지고 디스플레이에 표시되었다. 영상의 질을 평가하기 위하여 PSNR을 계산하였으며, 전송품질을 측정하기 위하여 차량의 속도에 따른 CDMA2000 1X-EVDO의 전송률 및 영상의 전송속도를 측정하였다.

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무리행동과 지각된 유용성이 이러닝 컨텐츠 구매의도에 미치는 영향: 구매경험에 의한 비교분석 (The Effect of Herding Behavior and Perceived Usefulness on Intention to Purchase e-Learning Content: Comparison Analysis by Purchase Experience)

  • 유철우;김용진;문정훈;최영찬
    • Asia pacific journal of information systems
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    • 제18권4호
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    • pp.105-130
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    • 2008
  • Consumers of e-learning market differ from those of other markets in that they are replaced in a specific time scale. For example, e-learning contents aimed at highschool senior students cannot be consumed by a specific consumer over the designated period of time. Hence e-learning service providers need to attract new groups of students every year. Due to lack of information on products designed for continuously emerging consumers, the consumers face difficulties in making rational decisions in a short time period. Increased uncertainty of product purchase leads customers to herding behaviors to obtain information of the product from others and imitate them. Taking into consideration of these features of e-learning market, this study will focus on the online herding behavior in purchasing e-learning contents. There is no definite concept for e-learning. However, it is being discussed in a wide range of perspectives from educational engineering to management to e-business etc. Based upon the existing studies, we identify two main view-points regarding e-learning. The first defines e-learning as a concept that includes existing terminologies, such as CBT (Computer Based Training), WBT (Web Based Training), and IBT (Internet Based Training). In this view, e-learning utilizes IT in order to support professors and a part of or entire education systems. In the second perspective, e-learning is defined as the usage of Internet technology to deliver diverse intelligence and achievement enhancing solutions. In other words, only the educations that are done through the Internet and network can be classified as e-learning. We take the second definition of e-learning for our working definition. The main goal of this study is to investigate what factors affect consumer intention to purchase e-learning contents and to identify the differential impact of the factors between consumers with purchase experience and those without the experience. To accomplish the goal of this study, it focuses on herding behavior and perceived usefulness as antecedents to behavioral intention. The proposed research model in the study extends the Technology Acceptance Model by adding herding behavior and usability to take into account the unique characteristics of e-learning content market and e-learning systems use, respectively. The current study also includes consumer experience with e-learning content purchase because the previous experience is believed to affect purchasing intention when consumers buy experience goods or services. Previous studies on e-learning did not consider the characteristics of e-learning contents market and the differential impact of consumer experience on the relationship between the antecedents and behavioral intention, which is the target of this study. This study employs a survey method to empirically test the proposed research model. A survey questionnaire was developed and distributed to 629 informants. 528 responses were collected, which consist of potential customer group (n = 133) and experienced customer group (n = 395). The data were analyzed using PLS method, a structural equation modeling method. Overall, both herding behavior and perceived usefulness influence consumer intention to purchase e-learning contents. In detail, in the case of potential customer group, herding behavior has stronger effect on purchase intention than does perceived usefulness. However, in the case of shopping-experienced customer group, perceived usefulness has stronger effect than does herding behavior. In sum, the results of the analysis show that with regard to purchasing experience, perceived usefulness and herding behavior had differential effects upon the purchase of e-learning contents. As a follow-up analysis, the interaction effects of the number of purchase transaction and herding behavior/perceived usefulness on purchase intention were investigated. The results show that there are no interaction effects. This study contributes to the literature in a couple of ways. From a theoretical perspective, this study examined and showed evidence that the characteristics of e-learning market such as continuous renewal of consumers and thus high uncertainty and individual experiences are important factors to be considered when the purchase intention of e-learning content is studied. This study can be used as a basis for future studies on e-learning success. From a practical perspective, this study provides several important implications on what types of marketing strategies e-learning companies need to build. The bottom lines of these strategies include target group attraction, word-of-mouth management, enhancement of web site usability quality, etc. The limitations of this study are also discussed for future studies.

일개 시지역의 가정간호 수혜자들의 만족도 조사 (A Survey on Clients' Home Care Satisfaction in Taejon City in Korea)

  • 김선숙;소희영;이태용
    • 가정∙방문간호학회지
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    • 제5권
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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대학종합병원 수간호사의 업무분석과 모형연구 (Analysis of the Work of the Head Nurse and a Work Model for the Head Nurse in University Hospitals in Korea)

  • 김인숙
    • 대한간호학회지
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    • 제19권2호
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    • pp.212-222
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    • 1989
  • When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6% to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

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

  • 이경혜
    • 대한간호학회지
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    • 제11권2호
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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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