병원관리자의 리더쉽 유형과 직무공헌도와의 상관관계에 관한 연구

박창식,손용만 고신대학교 보건과학연구소 2000 보건과학연구소보 Vol.10 No.-

As an intentive organization of labor and technical, a hospital aims to provide quality medical service for the patients by focusing on human life and health. It is also a public organization with the purposes of making its own profits and achieving the self-realization of its members. Henceforth, personnel management counts more than any other commercial or public organization. As the progress of the hospital depends on the quality of medical treatment and service by its members, each individual's job performance is vitally important. In other words, the members' job satisfaction is reflected on their job performance, which determines the prospects of the hospital. At present, the main type of managerial leadership in hospitals tends to be somewhat premodern and conservative. It is inappropriate to deal with various crises happening in hospital organizations and insufficient to improve the workers' job satisfaction and job performance for the development of each hospital. The leader's role to help the members do their best in their jobs is required. The cooperative type of leadership, anticipating the future and making autonomous directions, is a must. Se far, the leadership styles related with job satisfaction and job performance have been studied a lot, but very little in hospital situations. In this respect, the present research aims at analyzing the hospital members' job satisfaction and job performance in relation with the leadership patterns of hospital managers, while examining the present situations of the hospital structure and suggesting sorne directions for efficient workforce management. This research is to empirically analyze the effects of leadership styles on job satisfaction and job performance and to provide some basic data for organizational and personnel management in hospitals. For this analysis, five general hospitals with more than 400sickbeds in Pusan were chosen as the subjects. The questionnaire materials were statistically processed by way of the program called SPSS and empirically analyzed by the χ2 -test. The analytic results of this research are as follows: 1.The recognition of leadership styles has nothing to do with sex, age, educational background, post, job type, and career. 2.Job satisfaction has nothing to do with sex and educational background, but jpb satisfaction has something to do with age, post, job type, and career. 3.Job performance has nothing to do with sex, age, job type, and career, but job performance has something to do with educational background and post. 4.The recognition of leadership styles has nothing to do with the recognition of situations. 5.Job satisfaction and job performance has something to do with leadership styles. In consequence, While the most effective style is one of a patriarchal warmhearted type, most hospital managers show either democratic or dictatorial leadership style. The case of medical technologists and assistants, holding the lowest job satisfaction and regarding the leadership style as a dictatorial one, is an evident example. Therefore, the hospital managers are required to adopt a leadership style which is like an affectionate patriarch. These analytical results, I hope, will lead to even more research for the efficient management and progress of hospital organizations.

종모돈의 정액성상, 동결-융해 후 정자의 생존성, 혈청 중 FSH, LH, Estradiol-17β 및 Testosterone 농도에 미치는 품종과 계절의 영향

박창식,성낙도,김철호,진동일,최양석,이영주 충남대학교 형질전환복제돼지연구센터 2007 논문집 Vol. No.10

본 연구는 종모돈의 정액성상,동결-융해 후 정자의 생존성 그리고 혈청 중 FSH,LH,estradiol-17β 및 testosterone 농도에 미치는 품종과 계절의 영향을 조사하여 우수한 종모돈의 손발을 위한 기초자료를 얻고자 실시하였다. 요크셔 종이 듀록종보다 봄,여름,가을,겨울에서 정액량이 많았으며,정액농도에서는 차이가 없었다. 계절별 정액량은 듀록 및 요크셔종에서 봄철이 여름,가을 및 겨울철에 비하여 많았고,정자농도는 차이가 없었다. 듀록종과 요크셔종에서 각각 봄철에 생산한 정자가 여름,가을 및 겨울철에 생산한 정자보다 동결-융해 후 정자운동성 및 정상첨체 비율이 높았다. 한편 듀록종과 요크셔종에세 동결-융해 후 정자운동성은 모든 계절에서 요크셔종이 높게 냐타났으나,정상첨체에서는 차이가 없었다. 혈청 중 FSH의 농도를 비교한 결과 요크셔종이 듀록종보다 모든 계절에서 낮은 농도를 나타내었다. 그러나 두 품종 모두에서 각각 계절 간애 차이가 없었다. 혈청 중 LH와 estradiol-17β의 농도를 비교한 결과 요크셔종과 듀록종 간에 차이가 없었다. 또한 두 품종 모두에서 계절 간에 차이가 없었다. 종모돈의 품종별,계절별 혈청 중 testosterone의 농도를 비교한 결과 요크셔종이 듀록종보다 모든 계절에서 높게 나타났다. 또한 두 품종 모두에서 각각 봄철이 여름,가을 및 겨울철에 벼하여 혈청 중 testosterone의 농도가 높은 것으로 나타났다. 이상의 결과를 종합하여 보면,FSH의 농도가 낮을수록 정액생산량이 높은 것으로 나타났으며,혈청 중 testosterone의 농도가 높을수록 동결-융해 정자의 운동성 및 정상첨체의 비율이 높은 것으로 나타났다. This study was carried out to investigate. the effects of semen characteristics, frozen-thawed sperm viability and serum FSH, LH, estradiol-l7β and testosterone concentrations between breeds and among seasons in boars. In all seasons, Yorkshire boars produced higher semen volume compared with Duroc boars, whereas sperm concentration did not differ significantly between Duroc and Yorkshire boars. Semen volume in spring was higher compared with summer, autumn and winter in both Duroc, and Yorkshire boars, but sperm concentration did not differ significantly among seasons. Sperm motility and normal acrosome rate of frozen-thawed sperm produced in spring were higher than those in summer, autumn and winter in both Duroc and Yorkshire boars. Sperm motility of frozen-thawed sperm in Yorkshire boars was higher than that in Duroc boars regardless of seasons. However, normal acrosome rate did not differ significantly between Duroc and Yorkshire boars. Serum FSH concentration in Yorkshire boars was lower than that in Duroc boars in all seasons. However, there were no significant differences on serum FSH concentration of Duroc and Yorkshire boars among seasons. Serum LH and estradiol-l7β concentrations did not differ significantly between Duroc and Yorlcshire boars. Also, there were no significant differences in serum LH and estradiol-l7β concentrations of Duroc and Yorkshire boars among seasons. Serum testosterone concentration in Yorkshire boars was higher than that in Duroc boars in all seasons. In both breeds, serum testosterone concentrations were higher in spring than in summer, autumn and winter. In conclusion, when serum FSH concentrations were low, semen volumes were high, and when serum testosterone concentrations were high, sperm motility and normal acrosome rate of frozen-thawed sperm were high.

효율적인 의료 서비스 경영전략을 위한 의료의 질 경영 고찰

박창식 고신대학교 고신보건과학연구소 2009 보건과학연구소보 Vol.19 No.-

의료기관을 둘러싼 환경이 급격하게 변하고 있다. 의약분업의 실시를 비롯하여 대외시장 개방의 촉진/경쟁강도의 심화/ 사회 감시체계의 활성화 등이 그 예이다. 이러한 상황속에서 의료기관이 살아남기 위해서는 변화하는 환경을 이해하고 예측할 수 있어야하며 의료기관의 주요 교환 대상인 고객들의 다양 한 욕구를 능동적으로 파악하여야 한다. 이제 의료인들은 경쟁이 치열하지 않았던 과거로부터 습성화되어온 기존의 안이한 사고방식 을 바꿀 필요가 있다. 그리고 이러한 변화에 적극적으로 대응할 수 있는 방법을 찾는 것이 의료 서비스 경영전략의 근본이라 할수 있다. 이 를 현실적으로 설현하기 위해서 병원에 있어서 병원이 의료의 질 경영을 과학적으로 관리할 수 있는 방안을 모색하고 의료서비스를 새로운 환경변화 에 부응하도록 실천하기 위해서 경영전략을 계획하여야 할 것이다. 따라서 본 연구에서 는 이의 전략과 여기에 맞는 의료의 잘 경영을 구사하기 위하여 K병원의 사례를 연구 대상으로 하여 질 경영의 관리를 점검하고 분석하여 새로운 전략적 경영 을 도모하는 것이 본 연구의 목적이다. 병원의 내부환경 인 의료의질 경영 을 과학적으로 구사하기 위해서 새로운 질 경영의 표준을 제시하고 문헌연구를 병행한다. 이 를 위해서 국내 병원들의 의료 환경 변화에 대한 의 료 서비 스 경영전략과 칠 향상 활동은 짧은 기간 내애 양적 성장을 한 것과는 상반되게 전통 적인 관료주의적 관리에 지우친 감이 없지 않았다. 그러나 이러한 외형적 성장과 달리 설제 서바스 평가활동 등 질 향상 사업의 인프라가 체계적으로 구축되어 있지 않고 활동의 과학생도 아직 미흡한 수준이라고 할 수 있다. 최고 경영자와 조직구성원의 인식 또한 풍부하지 않은 설정이며 전체 조직 구성원의 일상적 활동으로 정착시켜 가기엔 아직까지 많은 문제들이 산적해 있음을 알 수 있다. 따라서 본 연구 를 통하여 이러한 문제들을 단계 적으로 해결하는 데에 일단의 도움을 줄 것으로 사료된다. Today, medical institutions are facing rapidly environmental changes such as separation of dispensary from medical practice, promotion of the opening of healthcare markets, keener competition in the healthcare industry and strengthened social supervision of the industry. Under this circumstance, the survival of medical institutions depends on how much they can predict and understand such changing environments. In addition, the institutions need to actively catch various demands of clients with whom they most exchange the views of medical institutions. Now, medical professionals need to change their conventional, easygoing way of thinking that has been unchangedly followed from the past when there was little or no competition in the medical industry. And they should find how to cope actively with changing medical environments, which is the key of medical service management strategy. Substantially, hospitals should try to find how to manage TQM(QI, QA) in a scientific way and plan an effective management strategy that can lead their healthcare service to comply with such environmental changes as above. Thus, the purpose of this study is to provide a new healthcare service management strategy that ensures TQM(QI, QA) which keeps pace with the above mentioned changes. For the purpose, this researcher examined a related case of K hospital located in Busan. In addition to the examination, the researcher conducted a literature survey in order to provide new standards for TQM(QI, QA). Domestic hospitals have developed their healthcarc service management strategy and QI activities in a relatively short time. But the development has been just quantitative, not escaping from the existing conventional, bureaucratic management of medicine. Also the hospitals have few organized infrastructures for QI, for example, feedback system that evaluates services they actually provide. Their activities of the improvement, if any, are still less scientific. Both the top management and other members of local medical institutions are little aware of the need to enhance the quality of medicine. Like these, there are lots of obstacles to making all members of the institutions usually practice activities for medical quality improvement. The researcher hopes that this study help remove such obstacles on step by step basis.

병원조직의 활성화에 의한 의료서비스 마케팅 전략

박창식 고신대학교 고신보건과학연구소 2010 보건과학연구소보 Vol.20 No.-

Today, the medical circles are never exceptional from the fact that if we do not cope with internal and external environmental changes in a prompt way, we would necessarily meet a disastrous consequence, or in other words, we would be necessarily frustrated and failed. Under this circumstance, local hospitals(hereinafter referred to as 'medical institutions) should build up extremely sophisticated management strategies through which they redefine their duties and roles in order to keep pace with and survive social changes. They also need to establish an effective management control system under which they cope with rapidly changing business environments properly and better. The purpose of this study is to provide management strategies that can be best appropriate for medical institutions. For the purpose, this researcher investigated the current problems and internal management resources of medical institutions in order to find how to develop the leadership and strategical mind of organizational members of those institutions and ultimately more vitalize the entire organization of the medical establishments.

뇌졸중 환자의 단순화된 뇌졸중 자세 평가 척도와 버그 균형 척도의 비교 연구

박창식,최유임,안승헌 대한작업치료학회 2010 대한작업치료학회지 Vol.18 No.1

목적 : 뇌졸중 환자를 대상으로 4점 척도인 뇌졸중 자세 평가 척도(Postural Assessment Scale for Stroke: PASS) 와 5점 척도인 버그 균형 척도(Berg Balance Scale, BBS)를 3점 척도로 단순화시켜 원본 PASS, BBS와 특성을 비교하고 신뢰도 및 타당도를 알아보고자 하였다. 연구방법 : 만성뇌졸중 환자 62명을 대상으로 PASS(0-1-2-3)는 PASS-3Level(0-1.5-3)로 BBS( 0-1-2- 3-4)는 BBS-3Level(0-2-4)로 기록하여 비교하였다. PASS-3L과 BBS-3L 평가의 측정자내·측정자간 신 뢰도는 급간내 상관계수를(ICC3,1), 절대적 신뢰도는 표준 오차 측정(Standard Error Measurement: SEM)과 최 저 실제 차이(Small Reference Differences: SRD)를 이용하였고, 내적 일치도를 알아보기 위하여 Cronbach' s α 계수를 구하였다. PASS(PASS-3L), BBS(BBS-3L)의 동시 타당도와 수정된 바델 지수(Modified Barthel Index, MBI)와 퓨글 마이어 운동(Fugl Meyer-Motor: FM-M)과의 수렴 타당도를 알아보기 위하여 피어슨 상관 분석을 하였다. 결과 : PASS-3L과 BBS-3L의 검사 재검사 신뢰도는 각각 ICC = .96, .96, 측정자간 신뢰도는 각각 ICC = .95, .94이었다. PASS-3L과 BBS-3L의 SEM은 각각 .99, 1.55, SRD는 1.74, 4.30, Cronbach's α계수는 .77, .85로 신뢰도가 높게 나타났다. PASS-3L의 동시 타당도는 PASS(r=.93), BBS(r=.75), BBS-3L(r=.80)과 유의한 관 련이 있었고, BBS-3L은 PASS(r=.80)와 BBS(r=.93)와 유의한 상관관계가 있었다(p<.01). PASS-3L의 수렴 타당도는 MBI(r=.60), FM-M(r=.42)과 유의한 관련이 있었고, BBS-3L은 MBI(r=.79), FM-M(r=.48)와 유 의한 상관관계가 있었다(p<.01). 결론 : 2개의 단순화된 PASS-3L과 BBS-3L은 PASS, BBS와 비교하여 매우 높은 신뢰도와 타당도를 보여 뇌졸 중 환자의 균형을 평가하는데 적합하다고 할 수 있다.

國防體育의 背景과 國家體制에 對해서 論함

朴昌植 경희대학교 체육대학 한국체육과학연구소 1975 體育學論文集 Vol.3 No.-

한글판 Wolf Motor Function Test의 타당도와 신뢰도에 대한 연구

박창식,박시운,김경미,손미옥,유정헌,장순자,박병규 대한작업치료학회 2004 대한작업치료학회지 Vol.12 No.2

목적 : Wolf Motor Function Test는 상지와 손기능 검사를 위해서 개발된 도구이며 국외에서는 이미 타당도와 신뢰도 연구가 이루어져 널리 쓰이고 있고 이러한 WMFT를 한글화하여 그 타당도와 신뢰도를 검증함으로써 상지 및 손기능 장애의 평가와 재활의 기초선을 마련코자 하였다. 연구방법 : 본 연구의 대상은 뇌졸중 발병 6개월 이상된 성인 편마비 환자로 평균 연령 54.45세의 남자 12명, 여자8명을 대상으로 검사를 실시했으며 이들은 기능성 정신질환이나 기질성 정신질환이 없는 환자이며 오른쪽 마비12명, 왼쪽 마비 8명으로 모든 환자의 우세손은 우측이었다. 본 검사를 위해 1명의 작업치료사와 1명의 재활의학과 전문의에 의해 번역 작업이 완성 되었으며 3년 이상의 임상 경험을 가진 1명의 작업치료사에 의해 밝고 조용한 평가실에서 20명의 뇌졸중 환자를 대상으로 검사를 실시하였다. 타당도 검증을 위해 이미 신뢰성 및 타당도가 입증된 Fugl-Meyer Assessment(FMA)를 이용하였으며 WMFT를 이용해 수행시간과 기능 점수를 평가하였다. 결과 : 한글판 WMFT의 타당도를 평가하기 위하여 FMA와 비교한 결과 수행시간의 Pearson 상관계수는 -0.80, 기능적 점수와의 상관계수는 0.94로 둘 다 유의한 상관관계를 보였다(p<0.001). 한글판 WMFT의 Cronbach’s alpha 계수는 수행시간에서 0.92, 기능적 점수에서 0.96으로 높은 내적 일치도를 보였다. 결론 : 본 연구를 통해 한글판 WMFT의 타당도와 신뢰도가 검증되어 국내 뇌졸중 환자의 재활치료의 효과를 알아 볼 수 있을 뿐만 아니라 재활치료의 효과 측정과 더불어 상지와 손기능 장애의 평가에 유용하게 사용될 수 있을 거라고 생각된다. Objective : To verify the reliability and validity of Korean Wolf Motor Function Test(K-WMFT) for the evaluation of the function of upper extremity. Methods : WMFT was translated into Korean by occupational therapist and physiatrists. Twenty patients with stroke were evaluated through K-WMFT by the occupational therapist. The reevaluation was assessed for the intrapersonal reliability by the same occupational therapist through the recorded videotape. Fugl-Meyer Assessment(FMA) was used to verify the validity of K-WMFT. Results : 1) Pearson’s correlation coefficiency between the performance time of K-WMFT and FMA was -0.80 and coefficiency between the functional ability scale of K-WMFT and FMA was 0.94(p<0.001). 2) Cronbach’s alpha coefficiency of the performance time of K-WMFT was 0.92 and that of the functional ability scale of K-WMFT was 0.96. Conclusion : The reliability and validity of K-WMFT were verified. K-WMFT can be used to evaluate the function of upper extremity for the patients with stroke in Korea.

욕창의 치료와 예방

박창식,허찬영 대한의사협회 2015 대한의사협회지 Vol.58 No.9

Repeated or chronic pressure on the eminent part of the body will cause circulation disorder to the affected part of the body. The lack of circulation will result in damage and necrosis of the tissue. This phenomenon is defined as pressure sore. Due to growth of aging population and chronic disease, incidence and prevalence rate is in-creasing rapidly. This leads to increased duration of hospital stay, and medical expenditure. Hence, prevention of pressure sore and appropriate treatment is essential in order to diminish distress of the patient and health care provider. Prevention of pressure sore can be accomplished by frequent position change of the patient, skin care, and appropriate nutrition care. Frequent position change is known to be the most important and effective method to prevent pressure sore. Skin care can be achieved by choosing proper dressing material, management of exu-date, and protection of the tissue around the wound. In addition, appropriate nutrition care in order to correct protein-calorie imbalance should also be performed. Necrotic tissue can cause inflammation, and it can also be a good source of bacterial growth. Therefore, debridement of necrotic tissue is most fundamental and essential part in the treatment of pressure sore. Meanwhile, when the patient is not a candidate for surgical treatment due to poor general condition, many methods of dressing can be performed. Recently, dressing material with silver component, and vacuum assisted closure dressing is being performed frequently. In case of surgical treatment, after debridement of necrotic tissue, reconstruction can be performed by split-thickness skin grafting, full-thickness skin grafting, or primary closure. However, majority of reconstruction is performed by flap surgery. Rotation or advancement flap is usually performed.

한글판 Wolf 운동 기능 검사의 검사자간 및 검사자 내 신뢰도

박창식,박시운,김경미,손미옥,유정헌,장순자,박병규 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.3

Objective: To verify the interrater and intrarater reliability of Korean Wolf Motor Function Test (K-WMFT) for assessing upper extremity function after stroke. Method: Twenty patients with chronic hemiparesis after stroke participated in the study. The Wolf Motor Function Test consists of 15 functional tasks. Performances were timed and rated by functional ability scale. The K-WMFT were administered to the subjects by an occupational therapist. All test sessions were videotaped and scored by 2 physiatrists and another occupational therapist to examine interrater reliability. They were reevaluated at a later time by thesame occupational therapist to examine intrarater reliability. Results: Intraclass correlation coefficient of the performance time of K-WMFT was 0.94 and that of the functional ability scale of K-WMFT was 0.99. Intrarater correlation coefficient of the performance time of K-WMFT was 1.00 and that of the functional ability scale of K-WMFT was 0.97. Conclusion: The interrater and intrarater reliability of K- WMFT were verified. K-WMFT can be used as a reliable tool to measure upper extremity function of the stroke patients in Korea.

정약용의 인성론과 인성교육적 의의

박창식,강정훈 한국윤리교육학회 2018 한국윤리교육학회 학술대회 Vol.2018 No.11