Needs on Management Development Program for Head Nurse (간호 관리 능력 개발을 위한 교육 연구)
-
- Journal of Korean Academic Society of Home Health Care Nursing
- /
- v.5
- /
- pp.84-99
- /
- 1998
The objectives of this study are to identify the actual educational contents of management for head nurse and to propose the educational subjects according to identity the needs of head, charge, and staff nurses. The subjects were investigated the actual Management Development Programs and educational needs of head nurses and prospective nurse manager(charge nurse, staff nurse with a lot of clinical experiences) in general hospitals. The tools were composed of two questionnaires: One was developed from the literature review for making items to measure actual situation. The other was revised Katz's model for measurement of educational needs. The first respondents of actual situation were 27 general hospitals with over 400 beds in Seoul and the second respondents were 89 head nurses, 67 charge nurses and 136 nurses at 3 hospitals by convenient sampling out of 27 general hospitals. Data were collected by telephone interview, mail questionnaire and visiting from 7th of October through 30th of November in 1997. In data analysis, general characteristics of the respondents and actual status of Management Development Programs were analyzed by frequency and percentage. Educational needs according to general characteristics were analyzed by ANOVA The results were as follows: 1. Actual situation of Management Development Program 1) Seven hospitals(26%) had Management Development Program for prospective managers and 14 hospitals (52%) for head nurses. 2) Education Department existed in 14 hospitals (52%). 3) One hospital(4%) had top level managers took part in the Management Development. 4) Two hospitals selected head nurse, who had finished courses of Management Development. Eight hospitals(30%) assessed educational needs. The assessment tools consisted of making a question via questionnaire(75%), determining at department meeting(12%) and interview(13%). 5) Educational programs had 3 types: 10 lecture type, 7 discussion type and 4 role play type programs. 6) One hospital evaluated the change of learner's attitude. 7) Four hospitals scored educational point, but that was measured only by attending. 8) Actual Management Development Programs were as follows. parenthesis indicates the number of hospitals. (1) Management Development Programs for Prospective manager. Role perception of Middle level Manager (1) . Role reconstruction of Nurse Manager (1). Workshop for Charge Nurse (1). Nursing Delivery System and Nursing Process (1). Communication (1). Motivation (1) (2) Management Development Programs for Head nurse.. Head nurse's Role (5). Administrative Work (7). Service Education (4). Prevention and Countermeasure of Nursing Incidence (3). Appraisal (3) 2. The results of needs on Management Development subject 1) The educational needs of all respondents on 3 skill domains showed positive agreement to strongly positive agreement. 2) High priority(more than 4.5) items were 12 of 24 Human skill items(50%), 1 of 6 Technical skill items(16%), and 2 of 13 Conceptual skill items (15%). 3) Out of high priority items, 8 items were instituted. 4) All respondents showed high needs on 3 skill domains regardless of 3 positions (head nurse, charge nurse, and nurse). Educational needs of Human skill domain, according to position were 108. S, 108.7, 106.8 (mean score = 72) , needs of Technical skill domain were 26.5, 26.6, 26.I(mean score=18), and needs of Conceptual skill domains were 56.9,56.7, 55.1(mean score=39). 5) Needs of 3 skill domains according to clinical career showed significant difference. Out of respondents, nurses with career of over 16years showed lowest degree of needs in Human skill domains(F=4.47, P=.004) and Conceptual skill domain(F=2.93, P=.034). 6) Educational needs according to educational background were not significant difference. But out of respondents, nurses educated at 3-year junior college relatively showed lowest needs in all of the 3 skill domains. With the above-mentioned findings, further study is necessary for generalization of this study at hospitals with different bed size and location. Also it is needed to study about management skill of nurse and charge nurse, and effective educational method.
It is significant for developing the future for us to know our present age. In order to preserve our Korean costume as a fola clothes retaining our distinguished independent characterisitics and to help design the tomorrow of our Korean costume playing a role as a racial to develop the world clothing culture, a survey was conducted to investigate modern people's conscious-ness and wearing practumes of Korean costume by questionaire and interviewing methods. The results of the survey were analyzed as follows: (1) At present, Korean costumes were purchased as customtailored(64.0%) and as ready-made(17.8%) and most of them were not made at individual homes. The laundry and ironing of them were carried out at laundry shops(68.8%). Considering our present economic, social and cultural aspects, sowing, laundryand ironing will not be carried out at homes again in the future and ready made costumes seen to be produced in a large scale in the future. Garment makers and laundry shop operators should be trained how to make our Korean costumes retain our traditional beauty in the course of their production and laundry and the makers of ready-made costumes must make research how to efficiently produce ideal ready-made costumes by adopting the synchro system in their wrk odisivion. (2) The age group wearing Korean costumes most frequently was the aged people over 60 (their wearing rate; 45%-50%) and the group wearing them most frequently next io the aged people over 60, was housewives(their wearing rate; 15%-20%). Excludign aged people and housewives, other respondentsdid not wear Korean costumes very frequently. Men's wearing rate was lower their wearing rate was the younger their ages were and the less their monthly incomes were. Korean costumes were used for holiday and festival(60%), wedding and funeral ceremonies (52%), visiting and working(22%), casual wear(12.8%) and home wear(9.2%). The use of Korean costumes as casual and home wears, was lower than the use for holday, festival, visiting and working, Under our present circumstances in which our Korean people use both Western style clothes and Korean costumer, our Korean costume has lostits position as a basic and necessary requiement in Korean people's daily life and become a ceremonical and fancy costume. It is natural that the times and life change everything in our daily life. Our costume has to be made as good ceremonial and fancy clothes satisfying modern sensibility according to its new role. In order for us to get close with our clothes, a keen study must be carried out to cleat the color, material, style, function and harmony of the Korean costume matching the of the times. (3) The 47.8% of the respondents answered that they were proud of our Korean costume as our folk clothes, 47.6% replied that thought them just common and 1.1% responded that they were ashamed of it. Most of them were affirmative in feeling pride with our Korean costume. (4) Considering the functional aspect of Korean costumes, their strong points were symetric beauty, rhythmical beauty, unity feeling, harmonical beauty and detailed decorations. Their common shortcomings were lack of individuality and inadequateness for active life. The shortcomings of woman costumes were suppressing breast, making resperation difficult and in adequnteness in summer time. The main reason not to wear our Korean costumes, was due to the fact that they are incomvenient for active life. As a measure to eliminate such shortcomings, 1) the suspension system of skirt to remove the suppression of breast should be generally adopted. 2) they should be simplified in their structure to make them convenient for active life and adepuate in wearing them in hot weather in an extent to which the traditional beauty of the costume may not be lostand 3) a new technique must be explored for showing individuality by wearing method and new arrangment of colors and decorations. (5) The reasons desiring to wear Korean costumes were classifide as follows: A. Korean costumes are our traditional clothes(43.4%). B. Korean costumes are noble and beautiful(26.8%). C. They are accustomed to wear Korean costumes by habit(19.5%). D. Korean costumes are necessary for attending ceremoneis(9.5%). E. Miscellaneous reasons(0.8%). Classifying these reasons into age groups, the high age group over 40 wore them because they were easy to wear by habit and the low age group of 10-30 never thought that they were east to wear by habit. Considering that even those who were accustomed to wear Korean costumes showed a low wearing rate and that the young generation were accustomed to wear Western style clothes rather than Korean costumes, the wearing rate of Korean costumes will be reduced in the future if such trend continues. It is urgent for us to make our best efforts in order to enhance the interest of young generation in Korean costumes and not to make them lose the strong points of Korean costume in the future. (6) Conicering the plan of the respondents on what kind of clothes they were going to wear in the future, among the age group over 50, those who wanted to wear only Korean costumes were 24.8%(men) and 35.1%(women), those who wanted to wear 49.7%(men) and 47.4(women), those who wanted to wear chiefly Western style clothes were 20.7% (men) and 14.4%(women) and those who wanted to wear only Western style clothes, were 2.4% (men) and 2.1%(women). This shows that the general tendency to wear only or chiefly Korean costumes is more prevalent than that to wear only Western style. Among the age group under 50, the tendency to wear Western style clothes was conspicuous and most of the respondent answered that they would wear chiefly Western style clothes and Korean costumes occasionally. Only 5.4% of the respondent answered that they would wear only Western style clothes and this shows that meny respondents still wonted to wear Korean costumes. Those who wanted their descendants to wear what they desire, were 50.1%(men) and 68.8% (women) and those who wanted their descendants to wear Koran costumes occasionally, were 85.8%(men) and 86.3%(women). This shows that most of respondents wanted their descendants to wear Korean costumes. In order to realize, it is necessory for us to make ourdescendants recognize the preciousness of our traditional culture and modify our Korean costumes according to their taste so that they may like wearing them.
Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.