Earticle

Objectives : This study aimed to investigate the mediating effect of psychological empowerment on the relationship of middle managers’ authentic leadership with the staff’s organizational commitment and job satisfaction at the Local Medical Center. Methods : The data were collected from 273 staff from the four Local Medical Centers in Chungnam Province using self-administered questionnaires. The data were analyzed using t-test, ANOVA, and hierarchical multiple regression with the SPSS 23.0 program. Mediation analysis was performed according to the Sobel test. Results : Middle managers’ authentic leadership had a significant positive effect on the job satisfaction and psychological empowerment of staff. Additionally, psychological empowerment showed mediating effects in the relationships among authentic leadership and organizational commitment and job satisfaction. Conclusions : To promote staff's organizational commitment and job satisfaction, it is necessary to build effective strategies to develop middle managers’ authentic leadership and to promote empowering programs for the staff.

Objectives : This study analyzed job performance in local area general hospitals to look for measurable effects from educational training and/or organizational communication. Methods : For the purposes of this study, a survey was conducted of general hospital employees from 29 hospitals in Gwangju and Jeonnam. The survey period was August 22 - September 30, 2016, and 1,004 responses were used in the final analysis. Results : This study revealed that certain aspects of communication (upward,downward,vertical,orinformal) had significant effects on job satisfaction, learning transfer, and general performance. Conclusions : To improve job performance in general hospitals, employers must improve overall satisfaction by improving upon job training and internal communication. Specifically, training should be better connected to learning transfer and organizational design must encourage active communication between employees.

Objectives : The purpose of this study was to identify the effects of emotional competence, learning organization and nursing organizational culture on performance among clinical nurses. Methods : This study was conducted over a six–month period, with 170 nurses from general hospitals with 400 beds in three regions of Korea. Data were gathered from August 25th to September 10th, 2016, using a self-report questionnaire, and analyzed using the IBM SPSS 19.0 program. Results : The significant predictors of nursing performance were self-awareness (β=.32), a master’s degree or higher (β=.20), relationship management (β=.26), personal mastery(β=.23), and 5～10 years in a clinical career (β=.16). These variables explained 47.3% of the variance in nursing performance. Conclusions : To improve nursing performance, interventions that can enhance nurses’ emotional competence and the need for program development to enhance their learning organization, as well as related variables, including academic credentials and clinical career, should be considered.

Objectives : This study investigates the association between weather conditions and the rate of no-shows at an academic medical center. Methods : Electronic data regarding medical appointments atover the course ofone academic year (2016.03~2017.02) were used for analysis. Characteristics of weather conditions and the daily number of no-shows were compared by Chi-square test. A logistic regression was run to determine if certain aspects of weather affected the rate of no-shows. Results : The results reveal an overall no-show rate of 6.8% that appears to vary in accordance with specific weather conditions. Lower average temperatures, in particular, corresponded with a ㅌigher rate of no-show patients. This may indicate that o-show rates in autumn and winter can be expected to exceed those during spring. Conclusions : This study investigates the association between no-show patients and weather conditions, and offers suggestions for augmenting this loss. One recommendation is to begin conducting investigations nationwide in order to provide more useful information.

Objectives : The purpose of this study was to explore and describe the factors related to clinical nurses’ organizational socialization, process and to find out the strategic information for successful organizational socialization. Methods : Data were collected with a structured questionnaires from 300 clinical nurses. The data were analyzed with SPSS/WIN 21.0. Results : First, the average score for the organizational socialization(2.95±0.37), organization climate(3.28±0.43), autonomy(3.23±0.43), role stress(3.21±0.56), professional self-concept(3.19±0.46), organization value internalization(3.11±0.59), and perceptional justice(2.91±0.50). Second, influencing factor of organizational socialization of the participant were organizational climate, role stress, professional self-concept, Job esteem, Living arrangement type, collaboration between medical professionals in hospital, the other hospital work experience, role model or Mentor, total hospital career, perceived health status, spouse, perceptional justice, Adjusted R²=.702. Conclusions : These results suggest that organizational socialization of clinical nurses could be enhanced by organizational climate. Thus creating a positive organizational climate are mandated for clinical nurses to have constructive organizational socialization.

Objectives : This study compared Value added to personnel expenses between 12 private general hospitals and 12 regional public hospitals, based on location and size, to examine industry competitiveness in terms of management. Methods : From 2011 to 2015, the value added and value added to personnel expenses were calculated by year. and a SPSS statistical program was used to determine and influential factors between private general hospitals and regional public hospitals. Results : The total value added to personnel expenses was 26.85 percent lower than general hospitals compared to regional public hospitals. The product category most influenced by the value added to personnel expenses was Stationeries & expendables at general hospitals and Outsourcing at regional public hospitals. Conclusions : Regional public hospitals have relatively low value added to personnel expenses compared to the general hospitals. Therefore, it is necessary for hospital management to reexamine gross revenue relative to total manpower.

Objectives : To examine the factors associated with the use of the prenatal care services provided by the Ministry of Gender Equality and Family by married migrant women in Korea. Methods : We employed data from the 2015 Nationwide Multiculturale Family Survey. We selected 19- to 39-year-old married immigrant women with children aged 5 years or less for the study (N=1,579). We included four predisposing factors, six enabling factors, and two need factors based on the Andersen's Health-care Utilization Model. Results : Only one third of married immigrant women(31.6%) used prenatal care service and 45.9% of them reported prenatal care service needs. Area of residence, country of birth, and Korean language proficiency were significantly associated with prenatal care service use. Further, age, country of birth, length of time in Korea, household income, and discrimination experience were significantly associated. Conclusions : Findings suggest the need to develop strategies to improve accessibility to prenatal care service use especially for married immigrant women from developing countries, low-income families, having poor Korean language proficiency or having discrimination experience.

Objectives : The purpose of this study was to find the determinants for non-participation in health screenings among the disabled. Methods : We used 2014-15 Korea Health Panel data and analyzed 1,073 people with disabilities older than 19 years to investigate the two-year health screening participation rates. Multiple logistic regression analyses were conducted to analyze the factors affecting non-participation in health screenings. Results : Of the 1,073 people with disabilities who were analyzed, 29.8% and 27.1% participated in NHI mass screenings and cancer screenings, respectively. In both screenings, non-participation rates were higher in people aged 19–49 and lower in people aged 50–69 than those aged 70 or older; higher in people with lower education, higher in people with private health insurance; higher in people with fewer chronic diseases; and higher in people with severe disability ratings. Conclusions : People with disabilities should be provided with more appropriate preventive care services according to their disability types and severity compared to people without disabilities.

Objectives : The purpose of this study was to investigate the relationship between dietary pattern and the Community Periodontal Index in elderly people who live alone in rural areas and to provide necessary data to strengthen nutrition education about the oral health of elderly people who live alone. Methods : Dental examinations and questionnaires were conducted with 380 elderly people who live alone in rural areas of Gyeonggi-do. Results : The Community Periodontal Index was higher when the elderly people who live alone had a low intake of vegetables and fruits, a high intake of sugars, a low number of breakfasts, a high frequency of overeating and a high frequency of instant ingestion. Conclusions : It is necessary to provide nutritional management services for the elderly people who live alone in rural areas and to provide preventive centered comprehensive oral care.

Objectives : The purpose of this study was to investigate the depressive change and predictors of chronic illnesses and to examine whether depressive change predictors are different according to chronic disease types. Methods : Data from the 1st to the 10th year of the Korean Welfare Panel of 5,023 adults over 20 years of age who were treated for chronic diseases for more than three months were examined. We assessed demographic, sociological, and socioeconomic factors including depression predictors of chronically ill patients, and analyzed the data using latent growth modeling and multiple group analysis. Results : Depression symptoms of chronically ill patients gradually decreased, showing a linear relationship across time. In addition, multiple group analysis was performed for each type of chronic disease. Conclusions : We described the phenomenon of depression in chronically ill patients, and discussed the practical and policy interventions required to improve depression in chronically ill patients.

Objectives : The purpose of this study was to identify factors affecting the subjective happiness of adolescents in Busan using data from the "12th Online Survey on Youth Health Behaviors, 2016." It intended to provide basic information for the development of intervention programs that can improve the subjective happiness of the youth. Methods : Data on 3,979 adolescents residing in Busan were drawn and statistically examined using frequency analysis, a t-test, an ANOVA, and a multiple regression analysis. SPSS 24.0 was used for all analyses. Results : Subjective happiness showed statistically significant differences depending on the factors of health equity like emotional support, gender, school level, financial state, academic performance, type of residence, and parents’ educational level, and on the factors of health status, like subjective health state, depression, sleep and stress. Conclusions : The results of this study suggest that a variety of intervention programs on health status factors need to be developed, and implemented to improve the subjective happiness of adolescents in Busan.

Objectives : To investigate the factors affecting bone mineral density in across stratified postmenopausal ages. Methods : Data from 1,698 subjects who completed the 2010-2011 National Health and Nutrition Survey were analyzed using SPSS Statistics 21.0 The χ² test and one way (ANOVA) were used to verify the relationship between general characteristics and health behaviors and the prevalence of osteoporosis. Logistic regression analysis was used to verify the factors Influencing bone mineral density. Results : The bone mineral density distribution was the highest among those with osteopenia, with proportions of 21.8% in healthy subjects, 58.1% in osteopenia, and 20.0% in those with osteoporosis. The distribution of osteoporosis by age group was 5.2% among subjects in their 50s, 15.4% among those in their 60s, and 42.4% among those in their 70s. In multivariate logistic regression analysis, the prevalence of osteoporosis according to ages was significantly correlated with age, educational level, body mass index(BMI), and parity 4 of more than 1-2 babies. Conclusions : Although age is an uncontrollable factor in the prevention of osteoporosis, educational level and BMI are correctable factors to maintain bone mineral density. There is a need to maintain healthy BMI and expand osteoporosis prevention education

Objectives : The purpose of the study was to provide basic data for the improvement of their happiness through the use of effective denture-related services and restoration of healthy oral function. Methods : The subjects of the study were 452 denture wearers using the elderly welfare facilities in Seoul. Results : The main variables influencing the happiness of the denture wearers were living with the family, subjective health, oral health status, duration of denture use, and regular oral examinations. Living with one’s family had the greatest influence on the happiness of the denture wearers. Conclusions : This study discusses the effect of satisfaction and behavior factors on effective denture use with reference to the happiness of denture wearers. This information will help improve denture management programs.

Objectives : In this study, we investigated the correlation of mental-and oral-health status with periodontal disease. Ultimately, we sought to make a positive contribution to the promotion of periodontal health and the prevention of periodontal disease. Methods : This study was analyzed using the data of KNHANES 2013–2015. The participants of this study were between 20 and 64 years old. The final selection was 1,512 adults. Results : Participants with a sleeping time of less than 6 hours and those who recognized stress showed higher periodontal disease. Number of decaying teeth, oral-health status, toothaches, and chewing problems were associated significantly with periodontal disease. To investigate the effects of general characteristics and mental and oral-health status on periodontal disease, a logistic regression analysis was conducted. Sex, age, education level, smoking status, oral-health status, and chewing problems were variables that affected periodontal disease. Conclusions : This study showed that mental-and oral-health status is closely related to periodontal disease. Therefore, it is expected that this will be used as basic data to effectively improve periodontal disease in adults.

Objectives : This study tried to examine whether there is any difference between the middle-aged men and women in terms of the effect of health-related and oral health-related characteristics on their depressive symptoms (PHQ-9). Methods : We used the 2nd year data of the 6th session of the National Health and Nutrition Survey of 2,008 adults(aged40～64 years) for fulfilling the research objectives. Results : The analysis showed that among middle-aged male and female respondents, household income, subjective health conditions, and stress perception among health-related characteristics had common elements affecting their depressive symptoms. The self-reported oral health conditions affected depressive symptoms for male respondents. On the other hand, chewing problems and contraction of periodontal disease affected depressive symptoms of female respondents. Conclusions : Thus, it is necessary to consider the effect of sex in the relationship between health-related and oral health-related characteristics, and to make efforts to develop differential programs to manage and prevent depressive symptoms among men and women.

Objectives : This study aims to present a new classification system using evaluation standards to ensure the safety of transport ventilators used in Korea. Due to the rapid advancement of technology, various types of ventilators have been developed and as the range of application increases, so does demand. With quick access to information and a growing economy, the technology used in Korean hospitals is equivalent to that of other countries; however, regulatory and safety consciousness are still lagging in Korea. Methods : Based on researching overseas cases, reference data and standards for improving the current system in Korea are proposed. Results : According to the review of transport ventilator use in Korea, it was found that concerns about safety is due to the absence of a standardized classification system for evaluating the safety and effectiveness of transport ventilators. Conclusions : In order to improve the safety of patients and the quality of medical care, it is essential to establish guidelines and assessment standards guaranteeing the safety of transport ventilators in Korea. Clear definitions and classifications for devices must precede the application of such standards. In addition, effective evaluation standards should be developed in order to resolve problems and improve upon the current system through continuous validation.

Objectives : This study aims to design a method for drying forceps jars. As part of the process, holes were made in the forceps jars. Drying time, rate of wet pack, and cost of rewashing linen were then determined. Moreover, the study looked into the bacteria incidence rate in the forceps jars. This study suggests a practical way for preventing infection in a hospital through a surgical device. Methods : This study investigated the effect of forceps jars with holes on reducing drying time, rate of wet pack, and cost of rewashing linen. It also looked into the bacteria incidence rate in the forceps jars through a parallel design. Data was collected and analyzed using SPSS version 21. Results : The drying time of a forceps jars was remarkably reduced from 18.44±0.22 minutes(non-hole forceps jars) to 0.58±0.02 minutes(4-hole forceps jars). The rate of wet pack of non-hole forceps jars was 51.4%. However, the rate of 4-hole forceps jars reached 4.6%. The cost of rewashing linen saw a decline from 38,073 won to 3,381 won. In addition, no bacteria and virus were detected from the 24-hours usage of forceps jars even though the jars had holes. Conclusions : The 4-hole forceps jars greatly increased work efficiency as a result of the reduced drying time, rate of wet-pack and cost of rewashing linen. The 4-hole forceps jars did not influence their sterilizing effect.

Objectives : The purpose of this study was to analyze representative topics and topic trends of papers in Korean Society and Health Service Management(KSHSM) Journal. Methods : We collected English abstracts and key words of 516 papers in KSHSM Journal from 2007 to 2017. We utilized Python web scraping programs for collecting the papers from Korea Citation Index web site, and RStudio software for topic analysis based on latent Dirichlet allocation algorithm. Results : 9 topics were decided as the best number of topics by perplexity analysis and the resultant 9 topics for all the papers were extracted using Gibbs sampling method. We could refine 9 topics to 5 topics by deep consideration of meanings of each topics and analysis of intertopic distance map. In topic trends analysis from 2007 to 2017, we could verify ‘Health Management’ and ‘Hospital Service’ were two representative topics, and ‘Hospital Service’ was prevalent topic by 2011, but the ratio of the two topics became to be similar from 2012. Conclusions : We discovered 5 topics were the best number of topics and the topic trends reflected the main issues of KSHSM Journal, such as name revision of the society in 2012.

Objectives : This study reviews the feasibility of Reciprocal Health Care Agreements (RHCA) between South Korea and Australia. Methods : A literature review was conducted using government reports and media articles. Results : In Australia, the Health Insurance Act enables health care agreements with other nations, but Korea has no similar legislation in place. Therefore, Korea must build a broader consensus on the need for RHCA, based on the precedent of Australia’s RHCA with 11 nations, as well as on the Korean Pension Act, which has made reciprocal pension agreements with 28 nations through an exceptive clause. The active government involvement of the Ministry of Health and the Department of Foreign Affairs and Trade in Australia, and the Ministry of Health & Welfare and Ministry of Foreign Affairs in Korea, are essential for a successful RHCA process. Conclusions : RHCA between Australia and Korea would constitute a significant step forward in strengthening people-to-people links between these two trading partners in the spirit of health diplomacy.

Objectives : The purpose of this study was to analyze the types of hospitals participating and the factors influencing comprehensive nursing service. Methods : Data were gathered from 231 hospitals offering the comprehensive nursing service in 2016. Collected data were analyzed using the multinomial logistic regression with the SPSS 24 version program. Results : First, factors influencing the types participating comprehensive nursing services were identified as hospital type, number of beds, medical doctor and, nurses per bed. Second, if all tertiary hospitals, general hospitals and hospitals participated in the service, approximately 122,022 ~ 166,274 nurses would be needed for the service. Conclusions : Hospitals providing the comprehensive nursing service will be expanded gradually. As such, thoughtful policy considerations are required to successfully establish services, such as improvement in hospitals, required nurse staffing level and demand and supply of nurses. Therefore, it is necessary to control the participation ratio of hospitals in consideration of the various circumstances.