Purpose: The purpose of this study is aimed to examine the Free Trade Agreement and its General Agreement on Trade in Services, especially, the healthcare service and the prospect of the system. Methods: This study was based on fourteen literature reviews from 2001 to 2014. Results: Free Trade Agreement and the General Agreement on Trade in Services were examined and Japan, China, and the United States's examples were shown. Healthcare market opening issues are the tendency of this era with the concept of globalization. Conclusion: This study highlights the tendency of healthcare market opening with all the pros and cons. The healthcare system along with the medical and nursing fields need to modify their system based on the globalization.

Purpose: This observational study was aimed to determine the influence of the Hawthorne effect on the adherence to hand hygiene (HH) among healthcare workers (HCWs) in South Korea. Methods: HCWs were monitored in 2 periods regarding adherence to HH when there were indications for HH. In first period, HCWs recognized that their behavior of hand hygiene being observed (overt observation), and did not recognize in second period (covert observation). Results: The overall difference in HH rate between two periods was 45.0% point (77.8% vs 32.8%). There were significant differences between profession but in nurse aids. The differences in HH rate between two periods were 46.1% point in nurses, 29.9% point in physicians, 64.0% in radiologists, 62.5% point in laboratory technicians, 36.4% point in physio-therapist, and 1.0% point in nurse aids. The Hawthorne effect on the adherence to HH lasted more than 3 months. Conclusion: The Hawthorne effect markedly influence on the adherence to HH regardless of profession except nurse aids. Therefore, Hawthorne effect can be useful tool to improve and sustain the adherence to HH among HCWs in South Korea.

Purpose: Forests have positive effects on health due to phytoncide, thus increasing physical activity and stress relief. However, research has not been conducted on the daily health benefits of existing forests. Therefore, this study attempts to compare the health status and behaviors of residents in urban and forested areas. Methods: This cross-sectional study used anthropometric measures, blood tests, heart rate variability, depression, stress, and health behavior self-reports for adults between 35 and 79 years from two regions. Results: Adults living in a forested region had better health consequences-including lower prevalence of osteoarthritis (6.4%) and mean bone mineral density (-0.84) -than those in an urban region (osteoarthritis: 13.7%; bone mineral density: -1.55). The percentage of 'physically active' participants (measured in MET-minutes) differed significantly different between the forested (49.1%) and urban (7.3%) areas. However, health behaviors such as smoking, alcohol consumption, and regular heath check-up rates were worse among residents from the forested, than the urban area. Conclusion: We concluded that more proactive forest therapy programs are needed to prove the health differences.

Purpose: This study attempted to estimate the need for home visiting nurse at public health centers. Methods: A model was generated to estimate a community's home visiting health service needs in 16 regions and a workload analysis was adopted to estimate the number of required Nurses. Data were collected from 16 public health centers using the South Korean government's open-information systems. Subjects were divided into three groups: vulnerable social group, bottom 10% income group, and bottom 20% income group. Results: The analysis revealed that 2,158 and 6,667 nurses were needed to provide home visiting health service for the bottom 10% and 20% income groups, respectively. It was estimated that for the vulnerable social group, 10,336 nurses were needed to provide home visiting health service, implying that the need-based demand for nurses is well over 5 times the number currently employed. Conclusion: The results indicate that the number of currently employed nurses is insufficient for the health management of vulnerable social groups. The government should consider active employment policies to encourage nurses to apply for home visiting health service.

Purpose: This study attempted to describe hospital nurses' pre-diabetes knowledge, performance and expectation of patient. Methods: The total of 204 hospital nurses were administered the questionnaires. The questionnaire comprises general background information (including sex, age, religion, education and career), ten researcher-generated questions regarding knowledge about pre-diabetes, performance of patient education (including how many people encounter in workplace, how often teaching, how many minutes required to teach and course contents) and expectation (including need improvement of teaching, barrier to education and desirable course contents and teaching methods) Results: The average score of hospital nurses' pre-diabetes knowledge was as low as 0.82 (82% correctness). On comparison of the knowledge levels among ten pre-diabetes knowledge dimensions, the highest score was 0.95 for necessary of medical check-up. The lowest score was 0.57 for complication can rarely happen. Significant correlations were observed for education, career and knowledge regarding pre-diabetes. Moreover, 49.5% of the nurses did not instruct patients about pre-diabetes, 24.5% taught prevention skills to a third of the pre-diabetes patients they encountered, and 61.2% nurses disseminated information under 5 minutes. Improvement was necessary for 78 nurses (75.8%). Conclusion: Pre-diabetes awareness among nurses is necessary.

Purpose: The purpose of this study was to investigate nursing students' awareness of career decision-making self-efficacy, career search behavior and commitment to career choice. Methods: Data were collected using a self-report questionnaire from 397 nursing students in D city from October 1 to October 8, 2014. Results: The average score of career decision-making self-efficacy, career search behavior and commitment to career choice was 3.42, 3.08 and 3.27 on a Likert 5 point-scale respectively. Career decision-making self-efficacy and career search behavior were significantly different according to grade of subject. There were positive correlations between career decision-making self-efficacy, career search behavior and commitment to career choice. Conclusion: It is necessary to develop an effective career support program from 1st grade to improve nursing student's career decision-making self-efficacy, career search behavior and commitment to career choice.

Purpose: The purpose of this study was to investigate the influencing factors on the quality of life of elders. Methods: Data were collected from August 25, September 1, 2014, and participants were 300 elders who were using senior welfare centers. Descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. Results: Elders who were more painful, highly perceived health status, self-esteem and social support, and lower depression showed relatively higher quality of life. Also, there were strong correlations between quality of life and depression (r=-.737) /perceived health status (r=.709). Factors predicted quality of life of elders were perceived health status (${\beta}=.349$), depression (${\beta}=-.267$), social support (${\beta}=.172$), self-esteem (${\beta}=.170$), pain (${\beta}=-.130$), income (${\beta}=.113$), and level of education (${\beta}=.064$). These 7 factors explained 78.2% of the variance in quality of life of elders (F=154.49, p<.001). Conclusion: Therefore, in order to improve the quality of life of elders, a systematic approach is necessary through multilateral cooperation among comprehensive sectors.

Purpose: The purpose of this study was to identify the factors influencing medication adherence in hemodialysis patients among primary medical care and secondary medical care. Methods: A cross-sectional survey design was utilized. Data were collected using questionnaires from 280 hemodialysis patients who had taken prescribed medication regularly as a result of chronic renal failure at primary and secondary medical care in Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: There were statistically significant differences in medication adherence according to living area (p=.002), health condition (p<.001), amount of medication (p=.004), inconvenience for taking medication (p<.001), and depression level (p=.001). The mean of medication adherence was 3.72 points. Medication adherence was explained by perceived barrier related to medication taking (${\beta}=.338$), attitude (${\beta}=.250$), and depression (${\beta}=.132$). Conclusion: This study strongly recommended that nursing intervention program to improve medication adherence should be developed and a match control study in improvement of medication adherence for hemodialysis patients needs to be done.