• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.194-204
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• 2016

Purpose: The purpose of this study was to identify physiological functional status and unmet care needs among patients with chronic pulmonary disease, colorectal cancer, and strokes after discharge. Methods: A crosssectional study was conducted with 224 patients diagnosed with aforementioned diseases from January to July in 2014 in two different tertiary hospitals in Seoul and its suburban area. Physiological functional status and unmet care needs were collected using Karnofsky Performance Status (KPS) Scale and Problems After Discharge Questionnaire-English version(PADQ-E) respectively. Data were analyzed using SPSS/WIN 21.0 program. Results: Patients with chronic pulmonary disease and colorectal cancer showed a low level of physiological functional status (mean: 77.20 and 77.60 out of 100 respectively) and a high level of unmet care needs (mean 2.23 and 2.63 out of 4 respectively). Stroke patients showed a high level of unmet care needs in the category of 'counseling', 'physical complaints', and 'instructions'. Physiological functional status was significantly associated with unmet care needs in all three patient groups and it showed a significant effect on unmet care needs in patients with stroke. Conclusion: The results showed that patients after discharge were still having insufficient functional status and various unmet care needs. The results of this study suggest a development of nursing care service for patients with chronic diseases after discharge.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.504-514
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• 2023

Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients' first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intra-class correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. Conclusions: This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.5
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• pp.613-621
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• 2013

Purpose: To identify the extents of nursing professionalism, clinical decision making abilities and job performance of advanced practice nurses and investigate the relationship among the variables Methods: Participants, selected by a convenience sampling method, were 135 advanced practice nurses working in 4 tertiary care general hospitals in 'B' Metropolitan City and in 1 tertiary care general hospital in 'J' city. Data collection was done from January 15 to February 28, 2013 using self-reporting questionnaires. Results: The average score for nursing professionalism of study participants was $81.19{\pm}7.56$. for clinical decision making abilities, $140.42{\pm}9.62$ and for job performance, $102.54{\pm}10.30$. These averages are relatively high. The relationship between the extent of nursing professionalism and the extent of clinical decision making abilities showed an intermediate level positive correlation (r=.45, p<.001). The relationship between the extent of nursing professionalism and the extent of job performance was also an intermediate level positive correlation (r=.42, p<.001). The extent of clinical decision making abilities and the extent of job performance was an intermediate level positive correlation (r=.41, p<.001). Conclusion: Developing a program, which can improve nursing professionalism and clinical decision making abilities of nurse, is required to enhance their job performance.

• Korea Journal of Hospital Management
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• v.12 no.2
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• pp.1-24
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• 2007

The medical fee reimbursement denied by HIRA(Health Insurance Review Agency) amounted to about 1.2% of the total medical fee claim to HIRA for reimbursement. Most of the denials stem from the inappropriate prescriptions of medical staff violating the medical fee review standards issued by HIRA. Considering the significant impacts of the standards observance behavior on the hospitals' financial viability, we attempted to analyze the predisposition factors of medical staffs' review standards observance behavior. The TPB(Theory of Planned Behavior) was adopted as the theoretical framework of the analysis. Data were collected by administrating a survey on the concepts included in TPB model to the 187 medical staff of a tertiary care hospital. Of the 187 questionaries distributed, 150 were responded resulting 80.2% of response rate. The mean differences among the groups classified by age group, years of experience, medical specialty and gender were analysis using ANOVA. The relationships among the TPB concepts were analysed by applying the Structural Equations Modeling method. The TPB model consists of three exogenous concepts (attitude toward the behavior, subjective norm, and perceived behavioral control) and two endogenous concepts (intention and the behavior). The results of ANOVA indicated significant mean differences among the groups classified by the medical staff's age, years of experience, and medical specialty. The older and the more experienced had the higher mean of observance behavior score. The results of Structural Equations analysis showed that the subjective norm and perceived behavioral control had statistically significant influences on intention, but the influence of attitude to intention was not statistically significant. The influences of perceived behavioral control and intention on behavior were significant. Based on these results the theoretical and practical implications were discussed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6095-6098
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• 2014

Background:Cervical cancer is potentially the most preventable and treatable cancer. Despite the known efficacy of cervical screening, a significant number of women do not avail themselves of the procedure due to lack of awareness. Objectives: This study was conducted to elicit information on the knowledge, attitude and practice (KAP) regarding screening (Pap test) and vaccination for carcinoma cervix among female doctors and nurses in a tertiary care hospital in Bangalore and to assess barriers to acceptance of the Pap test. Materials and Methods: A cross-sectional, descriptive study was conducted with semi-structured, self-administered questionnaire among female health professionals. The study subjects were interviewed for KAP regarding risk factors for cancer cervix, Pap test and HPV vaccination for protection against carcinoma cervix. Results: Higher proportion of doctors 45 (78.9%) had very good knowledge as compared to only 13 (13.3%) of the nurses, about risk factors for cancer cervix and Pap test (p=0.001). As many as 138(89.6%) of the study subjects had favorable attitude towards Pap test and vaccination, but 114 (73.6%) of the study subjects never had a Pap test and the most common reason 35 (31%) for not practicing was absence of disease symptoms. Conclusions: In spite of good knowledge and attitudes towards cancer cervix and Pap test being good, practice remained low among the study subjects and most common reasons for not undergoing Pap test was absence of disease symptoms. The independent predictors of ever having a Pap test done was found to be the occupation and duration of married life above 9yrs. Hence there is a strong need to improve uptake of Pap test by health professionals by demystifying the barriers.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.167-174
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• 2020

Background: The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes in patients requiring prolonged acute mechanical ventilation (≥96 hours). Methods: Data from 575 patients (69.4% male; median age, 68 years), hospitalized in the medical intensive care unit (ICU) of a university-affiliated tertiary care hospital March 2008-February 2017, were retrospectively evaluated. Early and late tracheostomy were designated as 2-10 days and >10 days after translaryngeal intubation, respectively. Results: The 90-day cumulative mortality rate was 47.5% (n=273) and 258 patients (44.9%) underwent tracheostomy. In comparison with the late group (n=115), the early group (n=125) had lower 90-day mortality (31.2% vs. 47.8%, p=0.012), shorter stays in hospital and ICU, shorter ventilator length of stay (median, 43 vs. 54; 24 vs. 33; 23 vs. 28 days; all p<0.001), and a higher rate of transfer to secondary care hospitals with post-intensive care settings (67.2% vs. 43.5% p<0.001). Also, the total medical costs of the early group were lower during hospital stays than those of the late group (26,609 vs. 36,973 USD, p<0.001). Conclusion: Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorter lengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

• Korean Journal of Occupational Health Nursing
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• v.31 no.2
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• pp.77-85
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• 2022

Purpose: This study aimed to identify the influence of effort-reward imbalance and job satisfaction on turnover intention among hospital nurses. Methods: Data were collected from January 28 to February 10, 2022, from 237 nurses from five hospitals including clinics, general hospitals, and tertiary care hospitals located in B city. The collected data were analyzed using descriptive statistics, t-test, ANOVA, the Scheffe test, Pearson's correlation coefficients, and multiple linear regression analysis, using SPSS/WIN 26.0. Results: The average of the effort-reward ratio, an indicator of effort-reward imbalance, was 1.67±0.66, and 86.5% of the participants had a value of 1 or more. The mean job satisfaction and turnover intention were 3.32±0.48 and 3.69±0.89 on a 5-point scale, respectively. Multiple regression revealed that factors affecting turnover intention among hospital nurses included effort-reward imbalance (β=.30, p<.001) and job satisfaction (β=-.32, p<.001), and these variables explained 29.0% of turnover intention. Conclusion: These findings indicate that effort-reward imbalance and job satisfaction are associated with turnover intention. Therefore, to decrease the turnover intention of hospital nurses, interventions and policies should be prepared to resolve the nurse's effort-reward imbalance and increase job satisfaction at regional or national level hospitals.

• Journal of Industrial Convergence
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• v.22 no.1
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• pp.185-195
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• 2024

The purpose of this study is to comprehensively interpret the practical adaptation experience of male nurses working shifts and to understand the meaning and essence. The data collection period was from September 2022 to November 2022 and in-depth interviews were conducted with 9 male nurses working at tertiary general hospitals, general hospitals, special hospitals and long-term care hospitals until content saturation. Data analysis was applied according to Colaizzi's phenomenological research method, and as a result of the study, 4 categories, and 11 theme were derived. The 4 categories consisted of 'Changes due to shift work', 'Difficulties arising from gender differences', 'Adaptation for job performance', and 'Growth and direction for the future'. Through this study, it was possible to explore the meaning of the practical adaptation experience of male nurses working in shifts, and it was found that it was necessary to develop and apply work environment improvement plans and male nurses' capacity building programs for nursing work.

• Health Policy and Management
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• v.23 no.1
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• pp.3-18
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• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.

• Journal of Korean Academy of Nursing Administration
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• v.23 no.2
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• pp.151-160
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• 2017

Purpose: The aim of this study was to define the effects of relational bonds and professional authority in organizational commitment of Intensive Care Unit (ICU) nurses. Methods: A questionnaire was distributed to 200 ICU nurses working in 3 tertiary hospitals. The survey content included the Organizational Commitment Questionnaire (OCQ), Relational Bond Questionnaire (RBQ) and Schutzenhofer Professional Nurse Autonomy Scale (SPNA). Results: The score for OCQ was 2.59, for RBQ, 3.23, and for SPNA, 2.93. Organizational commitment was related to relational bonds (${\beta}=0.45$; p<.001; SE=0.08). These factors accounted for 21.6% of the variability in organizational commitment. Conclusion: Results indicate that ICU nurses' organizational commitment could be improved through increasing relational bonds and retaining experienced nurses which suggests a need to develop work systems designed to increase and maintain high relational bonds in ICU nurses.