일본 요양병원 의료서비스 품질이 입원환자 만족도와 재이용의도에 미치는 영향

황선자(Sun-Ja Hwang) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.11

본 연구에서는 요양병원의 의료서비스 품질이 입원환자 만족과 재이용의도에 미치는 영향을 검증하고, 이 과정에서 입원환자 만족의 매개효과를 검증하였다. 본 연구의 대상은 일본 히로시마 소재 요양병원 입원환자 255명으로서, 수집된 자료를 이용하여 공분산구조분석을 통해 얻은 경로계수로 모형과 가설 검정을 실시하였다. 검증 결과, 입원환자인 고객이 지각하는 의료서비스 품질의 의료진 및 의료수준, 응대성, 시설 및 요양비용 품질 요인은 입원환자 만족에 각각 통계학적으로 유의하게 정(+)의 관계를 보였다. 그리고 입원환자 만족과 재이용의도 간의 경로계수는 정(+)의 관계를 보였다. 한편, 입원환자인 고객이 지각하는 의료서비스 품질의 의료진 및 의료서비스 품질, 응대성, 시설 및 요양비용 품질 요인은 입원환자 만족에 각각 통계학적으로 유의한 영향을 미치지는 않았으나, 입원환자 만족을 매개로 하여 유의한 영향을 미치는 것으로 나타났다. 본 연구의 결과는 요양병원산업 차원의 마케팅전략에 있어서, 의료서비스 품질을 반영하여, 요양병원 이용자만족에 미치는 영향을 확인하고, 이 과정에서 요양병원 의료서비스 품질의 역할 및 작용을 검증하였다는데 의의가 있다. The purpose of this study is to examine the effect of the medical service quality of the nursing hospital on the inpatients’ satisfaction, reuse intention and to verify the mediating effect of the inpatients’ satisfaction. The subjects of this study were 255 male and female inpatients in Hiroshima in Japan. The collected data were used as a model of path coefficients obtained through analysis of covariance structure and hypothesis test. As a result of verification, level of medical team and medical service, reception, facility and fee of the medical service quality of the nursing hospital perceived by the inpatients showed a statistically significant positive correlation with the inpatients’ satisfaction. The inpatients’ satisfaction showed a statistically significant positive correlation with their reuse intention. The level of medical team and medical service, reception, facility and fee of the medical service quality of the nursing hospital perceived by the inpatients shows a statistically no significant positive correlation with the reuse intention. But, they show a statistically significant positive correlation with the reuse intention with the mediating effect of the inpatients’ satisfaction. Finally, the result of this study is to confirm the effect of the medical service quality on the inpatients’ satisfaction, reuse intention of the nursing hospital. In this process, it is meaningful to verify the role and function of medical service quality of the nursing hospital.

정신건강의학과 입원 중 피부과로 의뢰된 환자에 대한 분석

이동엽 ( Dong Yeup Lee ),김명신 ( Myoung Shin Kim ),이운하 ( Un Ha Lee ),함정희 ( Jeong Hee Hahm ) 대한피부과학회 2015 大韓皮膚科學會誌 Vol.53 No.8

Background: The need for dermatological consultations for hospitalized patients has gradually increased and there are a number of dermatoses caused by underlying psychological conditions. However, the data regarding the analyses of these consultations for psychiatric inpatients are limited. Objective: To analyze the demographics and the type of dermatoses among inpatients with primary psychiatric diseases. Methods: We retrospectively reviewed 581 consultation reports for inpatients referred by the Department of Psychiatry between January 1, 2009 and December 31, 2014. Results: The proportion of the consulted patients from the Department of Psychiatry was 25.9% (331 consulted inpatients/1279 psychiatric inpatients). The most common age group was the 40∼49 year-old group (19.3%) and the male to female ratio was 1:1.14. There were no remarkable findings regarding the annual or seasonal distribution. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the most common underlying psychiatric disorders were mood disorders (41.0%), followed by schizophrenia and other psychotic disorders (25.0%), and substance-related disorders (12.1%). The most frequent skin disorders were eczematous dermatoses (34.6%) and infectious dermatoses (32.2%); dermatomycosis (20.8%) was especially common.The most common reasons for consultation were new-onset dermatologic problems (68.5%), followed by persistence or aggravation of pre-existing dermatologic disorders (28.7%). Conclusion: This study reports the dermatologic characteristics of psychiatric inpatients. We conclude that dermatologists and psychiatrists need to be concerned about the education and continuous management of various skin diseases in psychiatric patients. (Korean J Dermatol 2015;53(8):585∼593)

만성 조현병 입원 환자에서 대사증후군의 유병률

강감두(Kam-Doo Kang),시영화(Young-Hwa Sea),윤보현(Bo-Hyun Yoon) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2

Objectives:The purpose of this study was to evaluate the prevalence and characteristics of metabolic syndrome in Korean schizophrenic inpatients in a national mental hospital. Methods:Schizophrenic inpatients who met the diagnosis of DSM-IV-TR were included. Body weight, height, waist circumference and blood pressure were directly checked by the authors. Data on blood glucose, triglyceride, HDL-cholesterol were gathered from the fasting state blood samples before breakfast. Metabolic syndrome was defined by revised National Cholesterol Education Program-Adult Treatment Panel III(revised NCEP-ATP-III) and criteria of International Diabetes Federation(IDF). Results:A total of 213 inpatients were included. 104(48.8%) and 95(44.6%) of them were diagnosed as metabolic syndrome by criteria of revised NCEP-ATP III and IDF, respectively. Of the 5 cardiometabolic risks, abdominal obesity and impaired glucose level were significantly more common in women. The frequencies of the cardiometabolic risks were as follows; abdominal obesity(67.1%), low HDL-cholesterol(50.7%), triglyceridemia(47.9%), impaired blood glucose level(44.1%) and hypertension(27.2%). Although the correlation of metabolic syndrome with sex was significant, current age, age at onset, duration of illnesses, and numbers of prescribed antipsychotic were not significantly correlated. Logistic regression revealed that female sex(OR=2.27) and low economic status(OR=1.99) were significant predictors of metabolic syndrome in schizophrenic inpatients by IDF criteria. Conclusions:Our results suggest that the prevalence of metabolic syndrome in schizophrenic inpatients may be twice than that of general population in Korea. Female sex and low economic status were significant predictors of metabolic syndrome in schizophrenic inpatients.

경기 서북부지역 옴 감염의 역학 및 임상적 연구: 입원환자와 외래환자의 비교 및 치료 효과 중심으로

김수진 ( Soo Jin Kim ),허식 ( Sik Haw ),박혜진 ( Hai Jin Park ),김성현 ( Seong Hyun Kim ) 대한피부과학회 2014 대한피부과학회지 Vol.52 No.11

Background: Scabies is a common parasitic infestation that is an important public-health problem in many resource-poor regions. The incidence of scabies decreased during the past 20 years, but it has been increasing with the increase in the number of elderly people and nursing hospitals in Korea. Objective: This study was performed to evaluate and compare the clinical aspects and etiologic factors between outpatients and inpatients diagnosed with scabies. Also, we tried to investigate the clinical efficacy of topical therapies for the treatment of scabies.Methods: We conducted a retrospective analysis of the medical records of 200 patients who were diagnosed with scabies with a mineral oil test or skin biopsy between September 2009 and August 2013. Results: Of 200 patients, 91 (45.5%) were men and 109 (54.5%) were women. The mean age of the patients was59.2±26.6 years (men: 54.9±27.6 years/women: 62.8±25.2 years), and 61% of patients were aged >60 years. There was no seasonal variation in occurrence. Common primary lesions were papules and burrows in both inpatients and outpatients. Also, hyperkeratotic lesions were more commonly observed in inpatients (60%) than in outpatients (16.4%). The majority of the suspected routes of infection were transmissions through the nursing homes or hospitals (outpatients: 37.6%, inpatients: 71.4%). The mean time to diagnosis was 59±85.1 days (outpatients: 62.97±92.11 days, inpatients: 40.6±32.2 days) and to complete treatment was 31.87±49.2 days (outpatients: 35.3±53.14 days, inpatients: 14.8±13.87 days). Conclusion: We confirmed that nursing homes or hospitals are sources of herd infection. Therefore, dermatologists should educate the medical team and caregivers who work in nursing homes and hospitals about the clinical aspects and treatments of scabies. (Korean J Dermatol 2014;52(11):783∼789)

퇴원손상심층조사자료를 이용한 노인 입원 환자의 운수사고 유형과 사망 사이의 연관성

류한준,강선희,부유경 한국산학기술학회 2020 한국산학기술학회논문지 Vol.21 No.7

This study analyzed the association between the type of transport accident and the associated mortality of elderly inpatients. The findings will contribute to the development and establishment of a systematic and effective policy according to the type of transport accident to reduce the mortality of inpatients. The data on elderly inpatients with transport accidents was extracted from the 2013-2017 Korean National Hospital Discharge In-depth Survey dataset. The data was analyzed by descriptive statistics analysis, chi-square tests and multiple logistic regression analysis. After adjustment for sociodemographic, disease, injury and policy factors, the elderly inpatient deaths due to transport accidents were significantly higher for pedestrian accidents (OR: 2.522 95%, CI: 1.291-4.972), bicycle/cart accidents (OR: 2.809, 95% CI: 1.328-5.942) and motorcycle accidents (OR: 2.330, 95% CI: 1.226-4.819) rather than that for car accidents. Likewise, elderly inpatients have a higher risk of death from other types of transport accidents than those caused by car accidents. However, Korean policies related to transport accidents of elderly inpatients are concentrated on car accidents. Effective policy is needed according to the characteristics of each type of transport accident to reduce the transport accident mortality of elderly inpatients. 본 연구의 목적은 노인 운수사고 입원 환자의 운수사고 유형과 사망 사이의 연관성을 분석하여, 노인 운수사고 입원 및 사망 환자를 줄이기 위한 운수사고 유형에 따른 체계적이고 효과적인 정책 개발 및 수립에 기여하기 위함이다. 본 연구의 방법은 2013-2017년의 질병관리본부 퇴원손상심층조사 데이터세트 중 운수사고를 입은 노인 입원환자를 추출하여 기술통계분석, 카이제곱검정과 다중 로지스틱 회귀분석을 실시하였다. 인구사회학적, 의료기관, 의료이용 특성을 보정한 상태에서 분석한 결과 운수사고로 인한 노인의 입원 사망은 승용차 사고에 비하여 보행자 사고(OR : 2.522 95% CI 1.291-4.927), 자전거/카트 사고(OR : 2.809 95% CI 1.328-5.942), 오토바이 사고(OR : 2.330 95% CI 1.126-4.819)로 인한 사망이 각각 통계적으로 유의하게 높았다. 이와 같이 노인의 경우 승용차 사고로 인한 사망에 비하여 다른 유형의 운수사고로 인한 사망의 위험이 높지만, 우리나라 노인의 운수사고 관련 정책은 승용차 사고에 집중되어 있다. 따라서 증가하는 노인 집단의 운수사고 사망자를 줄이기 위하여 노인 집단의 운수사고 유형별 특성에 따른 효과적인 정책적 고려가 필요할 것으로 사료된다.

한국화 매체를 이용한 집단미술치료 프로그램이 정신분열병 입원환자의 자아 존중감에 미치는 효과

박완용 한국미술치료학회 2011 美術治療硏究 Vol.18 No.6

The purpose of this study was to explore the effect of group art therapy using Korean painting on the self esteem of schizophrenic inpatients. A total of 20 schizophrenic inpatients participated in this study. The subjects were divided into two groups: an experimental group of 10 and a control group of 10. The experiment period was from January to April, 00, twice a week, and 20 times in all. Each experiment lasted 70 minutes from 14:00 to 15: 10. The Kinetic-House, Tree, Person (K-HTP) picture tests and self-esteem tests were administered before and after the program to see if there was any change in the degree of the inpatients' self-esteem. The results of this study are as follows: First, the self-esteem points of the experimental group significantly increased after the therapy. Finally, the K-HTP check showed positive changes in the inpatients' self-esteem. This study found that the group art therapy using Korean painting could be a useful treatment tool for schizophrenic inpatients since the therapy in this study helped improve the inpatients' self esteem. The results of this study also indicate that this therapy could be applied to patients with other symptoms. 본 연구는 한국화 매체에 대한 활용방안을 모색하고 한국화 매체를 이용한 집단미술치료 프로그램이 정신 분열병 입원환자의 자아 존중감에 미치는 영향을 알아보고자 하였다. 연구대상은 N시 00병원의 폐쇄병동에 입원하고 있는 정신분열병 환자 중 집단미술치료 프로그램 연구에 동의하는 20명의 지원자들로서 실험집단 10명 통제집단 10명으로 구분하여 실시하였다. 기간은 00년 1월부터 4월까지, 실험집단에게는 주 2회씩 20회기의 프로그램을 매회 70분씩 실시하였으며 자아 존중감 검사와 K-HTP그림 검사를 프로그램 실시 전, 후에 실험집단과 통제집단에게 실시하였다. 집단미술치료 프로그램이 정신분열병 입원환자들의 자아 존중감에 어떠한 효과를 주는지 알아보기 위한 검사자료는 SPSS15.0을 이용하여 chi-square검정, Kolmogorov - Smirnov - Test, 반복 측정식 분산분석(repeated measures ANOVA), 추세검정을 실시하였다. 결과는 첫째, 자아 존중감 점수는 실험집단이 통제집단에 비하여 유의하게 증가하였으며 두 번째는 K-HTP 검사에서 실험집단이 통제집단에 비하여 자아 존중감에 대한 긍정적인 변화가 일어났다. 이상의 결과로 한국화 매체를 이용한 집단 미술치료 프로그램은 정신분열병 입원환자의 자아 존중감을 향상시키고 미술치료 현장에서 유용한 도구로 제공될 수 있으며 다른 환자들에게도 적용해 볼 수 있다.

정신과 입원 환자의 자살 위험성 사정도구의 신뢰도, 타당도 검증

신희연 ( Hee Yeon Shin ),신이수 ( Yi Soo Shin ),주정혜 ( Jung Hye Ju ),장향순 ( Hyang Sun Jang ),홍진영 ( Jin Young Hong ),전홍진 ( Hong Jin Jeon ),유범희 ( Bum Hee Yu ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2012 정신간호학회지 Vol.21 No.1

Purpose: Assessment of suicide risk is a critical task for nurses, especially for nurses working with psychiatric inpatients. The purpose of this study was to verify the reliability and validity of the Nurses` Global Assessment of Suicide Risk (NGASR) for psychiatric inpatients. Methods: This study was methodological study. A scale composed of 15 items was used with 106 psychiatric inpatients in open and closed psychiatric units of a tertiary hospital. Cohen`s kappa coefficient, Intraclass correlation, factor analysis and Jonckheere-Terpstra Test for Ordered Alternatives were used for statistic analysis. Results: Main results were as follows; Reliability of the scale was supported with a total intraclass correlation coefficient of .890 (range from .722 to 1.000). In investigating construct validity, 15 items loaded on six factors which explained 63.4% of total variance. Also the Jonckheere- Terpstra test revealed a significant trend in the order of median scores of NGASR across the three groups of Evaluation of Suicide Risk (ESR). These results supported the criterion-related validity of the scale. Conclusion: The findings in this study indicate that this scale is reliable and valid in assessing suicide risk of psychiatric inpatients. Therefore it is an appropriate scale to assess suicide risk for psychiatric inpatients.

Determinants of Inpatients Satisfaction and Intent to Revisit Oriental Medical Hospitals

박현숙,서영준 대한한의학회 2014 대한한의학회지 Vol.35 No.4

Objectives: This study aimed to investigate the determinants of inpatients satisfaction and intent to revisit oriental medical hospitals. Methods: The independent variables of the study contain the level of satisfaction with doctors, nurses, staffs, medical fee, environment, facilities and hospital life. Each variable was measured by three to eight items about the level of satisfaction with various aspects of hospital ward life. The level of overall patient satisfaction was used as an intervening variable and the level of intent to revisit was used as a dependent variable. The sample used in this study consisted of 268 inpatients from 3 oriental medical hospitals located in Chungnam Province. Data were collected with a structured and self-administrated questionnaire and analysed using path analysis. Results: The major findings of the study were as follows : First, it was found that the 3 variables of hospital life satisfaction, ancillary staffs satisfaction, and metropolitan residents has significant positive effect on the level of overall patient satisfaction. Second, the overall satisfaction and the satisfactory level of facilities, medical fee, and quality of ward life were found to have significant effects on the level of intent to revisit of respondents. Conclusions: The results of the study indicate that oriental medical hospitals should make an effort to improve the overall satisfaction of inpatients, especially focusing on the facilities convenience, medical price, and hospital ward life which will lead to high level of intent to revisit of inpatients.

Determinants of Inpatients Satisfaction and Intent to Revisit Oriental Medical Hospitals

Park, Hyun-Suk,Seo, Young-Joon The Society of Korean Medicine 2014 대한한의학회지 Vol.35 No.4

Objectives: This study aimed to investigate the determinants of inpatients satisfaction and intent to revisit oriental medical hospitals. Methods: The independent variables of the study contain the level of satisfaction with doctors, nurses, staffs, medical fee, environment, facilities and hospital life. Each variable was measured by three to eight items about the level of satisfaction with various aspects of hospital ward life. The level of overall patient satisfaction was used as an intervening variable and the level of intent to revisit was used as a dependent variable. The sample used in this study consisted of 268 inpatients from 3 oriental medical hospitals located in Chungnam Province. Data were collected with a structured and self-administrated questionnaire and analysed using path analysis. Results: The major findings of the study were as follows : First, it was found that the 3 variables of hospital life satisfaction, ancillary staffs satisfaction, and metropolitan residents has significant positive effect on the level of overall patient satisfaction. Second, the overall satisfaction and the satisfactory level of facilities, medical fee, and quality of ward life were found to have significant effects on the level of intent to revisit of respondents. Conclusions: The results of the study indicate that oriental medical hospitals should make an effort to improve the overall satisfaction of inpatients, especially focusing on the facilities convenience, medical price, and hospital ward life which will lead to high level of intent to revisit of inpatients.

Determinants of Inpatients Satisfaction and Intent to Revisit Oriental Medical Hospitals

Hyun-Suk Park,Young-Joon Seo 대한한의학회 2014 대한한의학회지 Vol.35 No.4