The purpose of this study is to develop a ratio scale measuring organizational charateristics in nursing. 599 staff nurses working at 10 educational hospitals in Seoul were participated during the period from July 1 to July 31, 1985. Subjects were instructed to rate at one to five points likert type scale according to the level of positive characteristics affecting the nursing organizational effectiveness. As a result of factor analysis given to 50 items with varimax rotation and rearrangement on the asis of factor loading 0.3, there are 4 factors consisted of 33 items presented; factor 1: leadership of head nurses and interac-tion(11 items) factor 2 : leadership of supervisors and top man-agers(Il items) factor 3 : interaction with supervisors(5 items) factor 4 : organizational climate(6 items) Reliability of the factors were tested by Cronb-ach's Alpha, and the result was alpha=0.67~0.84 Further studies are needed to identify the relationship between this tool and the effectiveness of various organization in nursing.

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June, 1979 to December, 1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from docters or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the outpatient chinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, skin care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results explain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted to have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1,352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below; 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and/or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the contol and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1% of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal ?neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior (8.89%), with health-related educational needs (8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources (3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by community based home care nurses.

This study identified the relationships between the hospital's organizational pattern for nursing, the organizational characteristics perceived by nurses and their job satisfaction. The study subjects were a convenience sample of 383 staff nurses working at 10 general hospitals with more than 300 beds in Seoul. Hospitals included in the study were. classified into five organizational patterns, where nursing was organized as an independent but lower level, attached to the medical de pattment, attached to a department supporting medicine, and various other organizational pattern. The data were collected from July 10 to August 15, 1992. The organizational characteristics as perceived by the staff nurses were measured by Park and Yoon's Scale (1986) and job satisfaction was measured by Slavitt 's Scale (1978). The data were analyzed by percentage distribution, Pearson's correlation. x2-test, t-test, ANOVA, and ANCOVA. The summarized results are as follows: 1. The proportion of independent and attached nursing organizational patterns was 35. \% and 54.9% re spectively. 2. There were differences between four general characteristics of the nurses, age, experience, pos ition and education level, and the five structural types of nursing organization(p<.05). 3. 1) There were no relationship between the perceived organizational characteristics and general characteristics of the nurses but there was a difference in job satisfaction according to education level of nurses in hopitals where nursing was an indepen dent department (T=-2.24. p<.05). 2) There were differences in the perceived organizational characteristics according to age group and experience of nurses (F=3.26, 5.41, p<.05)and in job satisfaction according to the pos ition of nurses in the independent but lower level organizational pattern (T=2.26, p<.05). 3) There was a difference in the perceived organizational characteristics according to age group (F=3.19. p<.05) and in job satisfaction according to the experience of nurses where nursing was attached to the medical department (F=3.49, p<.05). 1) There was a difference in the perceived organizatinal characteristics according to nursing unit (F=3.19. p<.05), but none between job satisfaction and general characteristics of nurses where nursing was attached to a departiment supporting medicine. 5) There were no relationships between the perceived organizational characteristics and job satisfaction and general characteristics of nurses in the various other organizational patterns. 4. Nurses in hospitals: where nursing is organizationed as an independent department perceived their organizatianal pattern more positively and had higher job satisfaction than nurses working in hospitals where nursing is part of another department. 5. There were differences between perceived organizational characteristics and job satisfaction according to the organizational patterns for nursing (F=13.52, 8.76, p=.0000). 6. There were correlations between the perceived organizational characteristics and job satisfaction of nurses working in two independent nursing departments (r=0.2180. 2351. p<.05). In conclusion, the relationship between perceived organizational characteristics and job satisfaction was significantly correlated in the hospitals where the nursing department is independent. Perceived organizational characteristics and job satisfaction depended on whether the nursing department is independent from or attached to other departements in the hospital. For nurses job satisfaction the nursing department should be independent from other departments and at the highest level of organization in the hospital.

The purpose of this study was to develop a ratio scale to measure job satisfaction of nurses and health workers in health centers. Of the 224 health centers in Korea, 105 were drawn as the sample using disproportional stratified random sampling. The data collection period was from May 1 to June 30, 1990 and 771 nurses and health workers working at 75 health centers participated. Subjects were instructed to rate, according to the level of satisfaction, from one to four points, 42 items revised from the tool made by Stamps et. al. (1978). The internal consistency reliability of the tool was measured by Cronbach alpha and the corrected item-total correlation coefficient. As a result of the item analysis, one item was excluded since the item had negative correlation with total items. As a result of factor analysis on the 41 items with varimax or above. Labeling and numbering of 6 factors were as follows ; factor 1 (8 items) ; professional status of job factor 2 (6 items) ; Interaction factor 3 (8 items) ; Autonomy factor 4 (8 items) ; Administration factor 5 (7 items) ; Pay factor 6 (4 items) ; Job(Task) Further studies are needed to identify the relationship between this tool and the effectiveness of the health center and more research is needed for generalization.

This study was done to identify the relationship between the organizational characteristics of hospital nursing and job satisfaction. The factors used for the organization characteristics of hospital nursing were leadership of the head nurse, leadership of supervisor and others in higher authority positions with supervisors and organizational climate. The subjects consisted of 243 staff nurses from seven general hospitals in Seoul. The data was collected from August 1. to August 31. 1991. The tools used for measurement in this study were Park and Yoon's scale of the Perception of Organizational Characteristics and Stamp' Scale of the Job Satisfaction. The results are summarized as follows ; 1. There were significant differences between for the three nursing units organizational characteristic factors, leadership of supervisors, other higher authorities, interaction with supervisors and organizational climate and job satisfaction(p<0.05) 2. There was a correlation between organizational characteristics of hospital nursing and job satisfaction(r=0.32, -0.65) 3. There factor explaining the highest proportion of variance was interaction with supervisor. (39.8%) In conclusion, there was significant correlation between of the organizational characteristics hospital nursing and job satisfaction. And there were significant differences in the organizational characteristics of hospital nursing and job satisfaction for differences in the organizational characteristics of hospital nursing and job satisfaction for different nursing units.

The purpose of this study was to identify relationships between the nursing performance of staff nurses and the leadership styles of head as perceived by the head nurses and the staff nurses. The subject consisted of 33 head nurses and 200 staff nurses who were working at SNUH between July 1, and July 31, 1991. Leadership styles as perceived by head nurses and staff nurses were measured using an instrument adapted by Park(1988). Evaluations of the nursing performance of staff nurses were done by head nurses utilizing a questionnaire adopted by Park(1988). Data were analyzed using percentage distribution, ANOVA, Scheffe test and Pearson Correlation Coefficient. The results are summarized as follows : 1. The majority of the head nurses and staff nurses perceived the head nurse as having a tendency to exercise high level authority and benevolence oriented leadership. 2. The majority of the staff nurses carried out their nursing performance in a highly skilled manner. 3. There were significant differences in perceptions of leadership style between head nurses and staff nurses. 4. "Authority" and "Benevolence" in leadership style as perceived by the head nurses were related very weakly to the nursing performance of the staff nurse. 5. "Benevolence" of leadership style as perceived by the staff nurses was related very weakly to the nursing performance of the staff nurse. 6. Group comparisons of nursing performance and leadership style found that high nursing performance by the staff nurse was related in the group with high "Authority" as perceived by the head nurse and low "Authority" as perceived by the staff nurse. From the above findings this study suggests the following : 1) Further studies are needed to control extraneous variables. 2) Efforts in leadership development are needed to enhance nursing performance. 3) Factor exploration study are needed to seek factors that contribute to the perception gap between the head nurse and the staff nurse.

The purpose of this study is to identify the leadership and subordination of hospital nurses; to determine the leadership and subordination by nurses' characteristics, which are age, educational background, carter, and position of nurses. 279 staff nurses, 13 charge nurses, 32 head nurses and 16 nurse supervisors were participated in this study during the period from Dec. 5 to Dec. 20, 1986. Subjects were instructed to rate at one of five points likert type scale on the 26 items of leadership and subordination. The reliability of the items (Cronbach's a) were 0.63~0.84. Among the total 26 items, 8 items on authority, 4 items on human relation, 9 items on committment of position and 5items on committment of job were summed to cummulative scores in each category. As a result of data analysis nurses who perceive positive on authority are 68.6% and positive on human relation are 67.9%. The perception of authority is different by age, Career and position of nurses. (P<0.05). And nurses who perceive positive on committment of position are 84.7% and positive on committment of job are 62.1%. The perception of committment for position is different by age, career and position of nurses (P <0.05), and committment of job is different by age and position. (P<0.05)

The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven community health practitioners in Yon-Cheon county, Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children: 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satisfaction toward child rearing and parental support, but no significant difference in education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this research, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.