PURPOSE: This study was done to identify prevalence of, and factors influencing metabolic syndrome among long-term care facility patients with schizophrenia. METHODS: A cross-sectional survey was conducted using a 20-item questionnaire. Clinical data for blood triglyceride, HDL-cholesterol, and fasting blood sugar were collected from medical records. Body weight, body fat, body mass index, blood pressure, height, and abdominal circumference were measured. Data for 198 participants were analyzed using t-test, x2 test and logistic regression. RESULTS: Prevalence of metabolic syndrome was 56.1%. The number of persons who overate was significantly higher in the metabolic syndrome group than in the normal group (p<.001). Factors influencing metabolic syndrome were hyperphagia (p<.001), abdominal circumference (p<.001), systolic blood pressure (p=.040), blood triglyceride (p<.001), fasting blood sugar (p=.015), and HDL-cholesterol (p<.001). CONCLUSION: The results indicate that nurses working with patients who have chronic schizophrenic should make an effort to help patients achieve control of overeating behavior and reduce abdominal circumference to prevent metabolic syndrome.
Adipose Tissue ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; Cross-Sectional Studies ; Fasting ; Humans ; Hyperphagia ; Logistic Models ; Long-Term Care ; Medical Records ; Mental Health* ; Metabolic Syndrome X ; Obesity ; Prevalence ; Schizophrenia* ; Triglycerides

PURPOSE: The purpose of this study was to explore and describe life-stories and meanings of life in wives of alcoholics by analyzing their autobiographies. METHODS: Autobiographies were collected from 20 participants who produced their own autobiographies in the logotherapeutic autobiography program at community alcohol counseling centers in Korea. The data were coded to identify themes of agency and communion using the manual coding system developed by McAdams, and analyzed by the existential approach. RESULTS: There were 214 coded episodes in twenty autobiographies. There were 128 agency themes and 86 communion themes. The most common themes were Love/Friendship. Five themes emerged from the autobiographical episodes on the existential perspective: 1) overcoming the suffering, 2) meaningful people and relationships, 3) spiritual maturation, 4) caring and helping, and 5) finding a meaning of life. CONCLUSION: These results showed that the wives of alcoholics who participated in the logotherapeutic autobiography program found the meaning of life through their suffering. Furthermore, a study on existential nursing interventions for people who have meaninglessness in life needs to be done.
Adaptation, Psychological ; Adult ; Alcoholism/etiology/*psychology ; Autobiography ; Female ; Friends ; Humans ; Interpersonal Relations ; Middle Aged ; *Quality of Life ; Spirituality ; Spouses/*psychology ; Stress, Psychological

PURPOSE: This study was done to identify the causes of burnout among South Korean counselors for North Korean refugees. METHODS: Data were collected using open-ended questions in a survey from 85 South Korean counselors for North Korean refugees, and a content analysis of the textual data from the questions was conducted. RESULTS: A total of 192 statements were selected from the data and those were categorized into 3 domains, 8 categories, and 24 sub-categories. Institutional, client, and social recognition domains emerged. Findings indicate that the causes of burnout were derived from the following categories: 1) the categories for the Institutional domain were physical environment, work conflict, and work overload, 2) for the client domain, lack of cooperation, selfish attitude, and limits to interventions, and 3) for the social recognition domain, lack of rewards and identity confusion. CONCLUSION: The results indicate that community mental health professionals need to understand these causes of burnout among the counselors working with North Korean refugees. It is also necessary to do further research to develop strategies to prevent burnout and potential mental health problems for these counselors.
Counseling ; Humans ; Mental Health ; Refugees ; Reward

OBJECTIVES: To investigate the information searching behavior of health care consumers according to sociodemographic characteristics. METHODS: A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling of the Republic of Korea, excluding the province of Jeju-do. Personal were conducted through a door-to-door survey between 27 July and 10 August 1999. RESULTS: 80.5% of respondents used more than one source of information and those 40~59 years of age, female, a housewife or student and those who claimed a religion demonstrated more active information searching behavior. A personal informer was used significantly more in those 20~39 years old, female, and those who claimed a religion. Clerical workers, those with post-secondary education and a monthly income greater than 2,000,000 won ($1500) were more actively used a public informer. Low socioeconomic status and older persons used an experimental informer when they chose a health care institution. CONCLUSION: Regardless of the sociodemographic characteristics, personal and experimental informers were the most useful source of information. Because appropriate information was not easy to obtain, the health care consumer was dependent upon word-of-mouth communication(personal informer) when using health care services.
Appetitive Behavior* ; Data Collection ; Delivery of Health Care* ; Education ; Female ; Humans ; Jeju-do ; Questionnaires ; Republic of Korea ; Social Class

OBJECTIVES: The Study of Small Area Variation(SAV) is most interesting issue in the health care researches. Most studies of SAV have been concluded the existences of variation on the basis of the magnitude of variation without statistical testing. But it is difficult to explain the existence of variation with this way because variation indicies are easily influenced by several parameters and also their distribution are skewed. So, it needs for the study to investigate the distribution of these indices and develop the statistical testing model. METHODS: This study was planned to analyze on the distribution of variation indices such as Extremal Quotient(EQ), Coefficient of Variation(CV), Systematic Component of Variation(SCV) and compare the statistical power among indicies. The simulations was performed on the basis of several assumptions and compared to the empirical data. RESULTS: Main findings can be summarized as follows. 1. If other conditions are constant, the more number of regions, the larger 95 percentile of EQ. But under same situation, 95 percentile of CV and SCV were slightly decreased. 2. If the size of regional population or utilization rate were increased, 95 percentile of all statistics were decreased. Also in the cases of small population size and low utilization rate, 95 percentiles of EQ showed various change contrast to the little change of CV. 3. If the difference at the size of regional population were increased, 95 percentiles of EQ and SCV were increased contrast to the little difference of CV 4. If the utilization rate were increased, 95 percentiles of all indicies were increased. But under the same difference of utilization rate, the power of CV and SCV were increased comparing to no change of the power of EQ. 5. Usually the power of EQ were lower than that of CV or SCV and it is similar between CV and SCV. CONCLUSIONS: Therefore, we suggest that in selecting the variation indicies at the SAV, CV or SCV are superior than EQ in terms of significance level and power.
Health Services Research ; Population Density ; Small-Area Analysis* ; Statistical Distributions*

PURPOSE: This study aimed to evaluate the effects of meaning-centered therapy (MCT) on depressive symptoms in adults and older adults, excluding cancer patients.METHODS: Ten databases were systematically to extract peer-reviewed journal articles and dissertations in Korean or English. Two independent researchers assessed the risk of bias and the quality of the report using Scottish Intercollegiate Guidelines Network criteria.RESULTS: A total of 12 (five Korean and seven non-Korean) studies were finally selected after removing 66 of the 78 studies assessed for eligibility due to inappropriate subject inclusion and research design. Eleven studies reported that MCT was effective in reducing depressive symptoms, except for one study using web-based MCT for cancer caregivers. Those studies also showed that the effects remained at the patient follow-up sessions.CONCLUSION: The reviewed studies provide evidence suggesting that MCT may be effective in reducing depressive symptoms in adults and older adults. However, it is necessary to investigate the effectiveness of on-line MCT on the depressive symptom reduction in the future.
Adult ; Bias (Epidemiology) ; Caregivers ; Depression ; Existentialism ; Follow-Up Studies ; Humans ; Psychotherapy ; Research Design

OBJECTIVES: Organizational culture has been important in field of organizational behavior research for the past decade. Although there has been a growing interest in the organizational culture and organizational effectiveness, there is few research in health care field. This study was carried out to investigate the relationship of organizational culture and organizational effectiveness at general hospital. METHODS: Data was collected by self-administrated questionares. Organizational cultures were measured by using Likert scale. A general hospital in Kyunggi-Do was selected and survey was conducted to 675 workers. Data was analyzed with computer package, PC- SPSS. RESULTS: There were four types of organizational culture in this hospital : consensual culture, developmental culture, hierarchical culture, rational culture. Many workers recognized their culture as rational culture and developmental culture. This finding showed that the hospital had both human related and task related climate. There were some differences in recognition of sub-organizational culture by occupational group, but perceived organizational culture was in accordance with sub-organizational culture in general. Multiple regression analysis and multiple logistic regression analysis were conducted to find the relationship of organizational culture and organizational effectiveness. As a result, developmental culture showed a strong relationship with organizational commitment and job-satisfaction. CONCLUSIONS: These results showed that types of organizational culture were significantly related to organizational effectiveness and understanding the existing culture is essential to develope their organizational effectiveness.
Climate ; Delivery of Health Care ; Gyeonggi-do ; Hospitals, General* ; Humans ; Logistic Models ; Occupational Groups ; Organizational Culture*

OBJECTIVES: To determine the relationships among quality, satisfaction, value and purchase intention in health care service. METHODS: The data were gathered from out-patients who had used hospital services. They were asked to assess service quality, satisfaction, service value, and purchase intention. A total of 557 usable questionnaires were gathered. The data were analyzed using SAS version 6.12. The analytic methods employed in the study were confirmatory analysis and covariance structural analysis. RESULTS: Service quality exhibited a significant and positive relationship with satisfaction, service value, and purchase intention. Furthermore, satisfaction had a significant and positive relationship with purchase intention. And finally, service value had a significant and positive relationship with both satisfaction and purchase intention. Based on these findings, it is evident that satisfaction was a mediator between service quality and purchase intention. Also service value played a mediating role between service quality and satisfaction. CONCLUSIONS: These results suggest that service quality is an antecedent of satisfaction and service value, and exerts a stronger influence on purchase intentions than satisfaction and service value do. Thus, managers may need to emphasize service quality in health care.
Delivery of Health Care* ; Humans ; Intention* ; Models, Structural* ; Negotiating ; Outpatients ; Surveys and Questionnaires

OBJECTIVES: The SERVQUAL scale is based on gap theory, which suggests the difference between consumers' expectations and the quality of the medical service actually received. However, problems in the implementation of the SERVQUAL scale have been identified by several researchers. Some researchers have proposed a simple performance-based measure (SERVPERF) or an expectation-controlled performance-based measure(Non-Diff) as alternatives to the SERVQUAL scale. On the basis of the theoretical concerns discussed, we examined the capability of each of the three scales(SERVQUAL, Non-Diff, SERVPERF) to explain variations in consumer satisfaction. METHODS: Data was gathered from a self-administered questionnaire in a 430 bed hospital. Questionnaires evaluating medical services were distributed to 180 ambulatory patients. A total of 167 usable questionnaires were gathered. The questionnaire was composed of 10 expectation, performance and expectation-controlled performance items. In addition, overall satisfaction and purchase intention were measured. RESULTS: Compared with the SERVQUAL scale, the Non-Diff and SERVPERF scales better explained the observed variations in consumer satisfaction(SERVQUAL, R2=0.29; Non-Diff, R2=0.51; SERVPERF, R2=0.48) and purchase intention(SERVQUAL, R2=0.22; Non-Diff, R2=0.33; SERVPERF, R2=0.34). CONCLUSION: The major conclusion from our study is that the Non-Diff and SERVPERF scales are more efficient in assessing consumer satisfaction than the SERVQUAL scale. Therefore we suggest that consumer satisfaction be measured by the Non-Diff or SEVPERF scales.
Consumer Satisfaction* ; Delivery of Health Care* ; Humans ; Intention ; Questionnaires ; Weights and Measures

Binding of clathrin assembly protein to clathrin triskelia induces their assembly into clathrin-coated vesicle (CCV) in neurons. The clathrin assembly protein gene (rCALM) was cloned from rat brain cDNA library. rCALM deduced 69 kD molecule has overall 73% amino acid homology compared with that of AP180 protein. The N-terminal domain, where amino acid sequences are very similar with AP180, harbours binding sites for clathrin and inositides, as well as possible phosphorylation sites, but the proline rich C-terminal domain is different from that of AP180. The mRNA expression of rCALM and AP180 by in situ hybridization histochemistry revealed that the rCALM mRNA was more intensely expressed than that of AP180, and the distribution patterns were different from each other. These results suggest that the rCALM mediates the assembly of clathrin in neural and supporting cells of brain, and regulates the clathrin coated-vesicle formation through phosphorylation and inositide metabolism. Copyright 2000 Academic Press.
Age Factors ; Alternative Splicing ; Amino Acid Sequence ; Animal ; Base Sequence ; Brain/physiology* ; Cloning, Molecular ; Gene Expression Regulation, Developmental ; Molecular Sequence Data ; Nerve Tissue Proteins/metabolism ; Nerve Tissue Proteins/genetics* ; Phosphoproteins/metabolism ; Phosphoproteins/genetics* ; Rats ; Sequence Homology, Amino Acid