• 한국보건간호학회지
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• 제35권1호
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• pp.5-18
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• 2021

Purpose: This study aimed to develop a client-centered integrated home nursing care model for rural areas by analyzing public health nursing, hospital-based home care services, and long-term nursing care in Korea. Methods: The literature review performed included data from the National Assembly Library, DBpia, RISS, and KISS, Google Scholar, the Ministry of Government Legislation, Statistics Korea, and the Ministry of Health and Welfare. Results: The client-centered and integrated home nursing care model in a rural area was opened as the Home Nursing Care Center in a public health center operating directly or on consignment. This model provides both a hospital-based home care services as well as long-term care, in accordance with the health status of the client and difficulty of nursing services. Moreover, the nurse who worked in a sub-organization (Centers for Supporting Healthy Living, Public Health Units, and etc.) of the public health center as care coordinator and case manager facilitates to connect home nursing care services and social welfare services. Conclusions: Our data indicates that the client-centered integrated home nursing care model in rural areas effectively combines professional services, regional accessibility, and social welfare services.

• 한국노년학
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• 제30권1호
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• pp.195-220
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• 2010

본 연구의 목적은 전국의 노인 돌봄 서비스관리자를 대상으로 직무만족 현황을 살펴봄과 동시에, 개인적요인, 근무관련요인, 서비스관련요인들이 직무만족에 어떠한 영향을 미치는지 알아보는데 있다. 이를 통해 직무만족 향상을 위한 정책적 대안과 실천적 방안들을 제시해 보고자 한다. 본 연구 목적을 달성하기 위하여 전국에서 현재 수행 중에 있는 노인 돌봄 사업수행기관 244개 가운데 각 기관을 대표한 231명에 대해 수집된 자료 중, 분석 유효한 자료 220개를 활용하여 분석하였다. 분석을 통해 어떠한 요인이 서비스관리자의 직무만족에 영향을 미치며, 어느 정도 영향을 미치는지 파악한 결과 직무만족의 수준은 3.01로 중간을 조금 넘는 수준에 머무르고 있는 것으로 나타났다. 그런데 여성보다는 남성이, 연령이 낮은 미혼이, 계약직보다는 정규직이 그리고 타 업무를 병행하지 않는 서비스 관리자의 만족도가 상대적으로 더 높은 것으로 나타났다. 또한 직무만족에 영향을 미치는 요인을 살펴본 바, 개인관련요인으로는 성별이, 근무관련요인은 타 업무 병행 여부와 기관장의 의지가, 서비스관련 요인은 서비스 태도가 직무만족에 영향을 미치는 것으로 나타났다. 그 가운데도 기관장의 의지가 가장 큰 영향을 미쳤으며, 그 다음은 서비스 태도, 타 업무 병행 여부, 성별 순으로 밝혀졌다. 이러한 결과를 바탕으로 볼 때, 사업수행기관의 기관장 지지와 관심이 높거나, 서비스 태도가 좋고, 타 업무를 병행하지 않으며, 남성일수록 만족도가 높음을 알 수 있었다. 따라서 만족도가 평균 이하로 낮은 수준인 급여 및 각종 혜택과 고용의 안정성 및 업무량이나 근무시간의 적절성, 근무시설 및 복지후생여건의 개선 등에 관한 방안의 개선이 요구되었다. 특별히 급여의 경우 3년 연속 동결된 낮은 급여로 인하여 그 개선이 절실히 필요하며, 업무량 및 근무시간의 적절성 문제 해결을 위해서는 사업수행기관에서 타 업무와의 병행을 하지 않도록 하며, 노인돌보미의 인력을 활용하여 행정지원을 받는 방법도 고려해 볼 수 있을 것 같다. 특히 사업의 성공 및 효과성을 유지하기 위해서는 휴먼서비스의 핵심이 되는 서비스 관리자들의 직무만족 향상을 위한 지속적인 노력이 요구된다.

• 한국직업건강간호학회지
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• 제25권4호
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• pp.340-351
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• 2016

Purpose: The purpose of this study was to identify depression and its influencing factor of nurses among comprehensive nursing care service ward. Methods: The research was cross-sectional descriptive study. The subjects of the study were 173 nurses of comprehensive nursing care service ward in Gyeonggi-do. Data collection was done using self-reported structured questionnaires asking about job stress, emotional labor, job burnout, somatic symptoms, turnover intention, depression and general characteristics from May 16 to June 3, 2016. Data were analyzed with SPSS/WIN 19.0 program. Results: Mean scores of job stress were 159.15(range 43~215), emotional labor 30.90(range: 9~45), job burnout 59.45 (range: 0~132), somatic symptoms 24.03 (range: 12~60), turnover intention 5.61 (range 0~18) and depression 19.25 (range: 0~60) and reported as depression in 63.6%. Somatic symptoms (${\beta}=.26$, p<.001), job burnout (${\beta}=.37$, p<.001) had significant associations with depression and the most important variable was job burnout. Conclusion: It is necessary to apply the developed program to reduce job burnout in hospitals and to prevent and/or control depression. And also, it needs to improve working conditions and increase the nursing staff to reduce somatic symptoms for nurses among comprehensive nursing care service ward.

• 한국직업건강간호학회지
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• 제20권3호
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• pp.299-307
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• 2011

Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

• 한국임상약학회지
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• 제24권4호
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• pp.282-287
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• 2014

Objective: Objective of this study was to investigate community pharmacy-based pharmaceutical care accessibility in Korea. Survey on the current pharmaceutical care service provision was performed by PM2000 XE, a real-time pharmacy manager program, operated by Korea Pharmaceutical Information Center beginning November 4, 2013 until December 6, 2013 towards all community pharmacies throughout the nation which use the program. Method: The survey questionnaire consisted of four sections: pharmacy type, time-based accessibility, item-based accessibility, and spatial accessibility for non-prescription drugs. Results: Number of pharmacy responded to the survey was 331, and size of the responding pharmacy was mostly medium-scale (66.47%) with 30-99 prescription fillings a day. Proportion of pharmacy with opening hour of 12 hours or longer was only 53.77% and it was less than 25% during saturdays and holidays. Item-based accessibility was generally acceptable for prescription and non-prescription drugs, medical devices, and health supplements. However, spatial accessibility for non-prescription drugs was problematic because only one quarter of the drugs was displayed over the counter, and most of the drugs were behind the counter so that customers could not reach out. Conclusion: Based on the survey result, current situation for accessibility of pharmaceutical care service in Korea is concluded inadequate and therefore needs multidimensional efforts to improve accessibility of the service at national level such as Korea Pharmaceutical Association and Ministry of Health and Welfare.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3153-3157
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• 2015

Background: Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. Materials and Methods: This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). Results: A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (p<0.001), poor performance(p<0.001), changes in medical condition (p<0.001), timing of case manager contact (p=.026), the methods by which case manager contact patients (p<0.001) and the frequency that case managers contact patients (${\geq}10times$) (p=0.016). Conclusions: Cancer patients who refuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.

• 부모자녀건강학회지
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• 제3권2호
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• pp.81-93
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• 2000

The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

• 간호행정학회지
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• 제6권3호
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• pp.333-345
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• 2000

The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

• 보건의료산업학회지
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• 제5권3호
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• pp.13-23
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• 2011

This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.

• 대한간호학회지
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• 제29권5호
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• pp.1103-1112
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• 1999

In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabilitation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care activity and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used. Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contacted by phone. the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition. elimination, dressing. leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.