The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.6
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pp.147-156
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2016
The purpose of this study was to identify the factors associated with the improvement of metabolic syndrome, and provide basic data for the health management of clients. The subjects were 280 adults who were diagnosed with metabolic syndrome in 2013, and who were examined from January 2013 to December 2014. The data were analyzed by descriptive statistics, t-test, ${\chi}^2$-test, and logistic regression analysis with SPSS WIN 18. The change rate from 3 to 2 risk factors was 60.6% among those clients whose metabolic syndrome improved. The improvement group showed a decrease in their waist circumference, systolic blood pressure, triglycerides and increase in their HDL cholesterol in 2014 compared to 2013, as well as decreased drinking, increased exercise, proper calorie, protein and carbohydrate uptake, and increased consumption of a lipid lowering agent. Exercise, calorie uptake and maintenance of an oral hypoglycemic drug influenced the improvement of the metabolic syndrome. In conclusion, it is necessary to have an intervention program including exercise enhancement and diet modification and to reinforce the health education for continuing health management.
As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.
Purpose: This study analyzed the perception and importance of country-of-origin labeling at restaurants in 500 college students in Jeju surveyed from April 15 to May 5, 2016 with the aim of providing basic data. A total of 465 questionnaires out of 500 were used as base data for this study. Methods: The data were analyzed using descriptive analysis, ${\chi}^2-test$, and t-test using the SPSS Win program (version 21.0). Results: Regarding food safety-related dietary behaviors, average score was 3.65 points (out of 5), and 'put the food in a refrigerator or freezer immediately (4.07)' showed the highest score, whereas 'cool rapidly hot food prior to putting it in the refrigerator (3.08)' showed the lowest score. Regarding the awareness of country-of-origin labeling at restaurants, 67.5% of subjects were aware of it. With regard to dietary behavior of food safety, the high group showed a higher score than the low group (p < 0.001). Regarding reliability of the system, 4.9% of subjects indicated 'very reliable' and 45.4% 'somewhat reliable'. For perception of subject's country-of-origin labeling, the average score was 3.77 (out of 5). Regarding checking country-of-origin labeling at restaurants, 68.0% of subjects checked country-of-origin labeling, and the high group in the safety-related dietary behavior score ranking showed a higher rate (79.3%) than the low group (57.1%) (p < 0.001). With regard to importance by item, 'honest country-of-origin labeling of restaurants' showed the highest score at 4.27 (out of 5). Conclusion: It is necessary to provide continuing education for college students in order to enhance their perception of country-of-origin labeling at restaurants. Moreover, a systematic and appropriate support and control system by the government and local government needs to be developed in order to improve country-of-origin labeling at restaurants.
The purpose of this paper is to understand the prescription and management of medicines by school-nurses. A survey was mailed to 199 school-nurses in elementary and secondary schools in Pusan from February 10 to March 31, 1997. It was shown that 97.0% of the schools have visiting school-doctors and only 29.6% have visiting school-pharmacists. 36.7% of the respondents don't know the amount of this annual health-related budget. Concerning the annual budget of purchasing medicines, 50.4% of the elementary schools spend 210,000 won to 400,000 won and 45.0% of the secondary schools spend more than 610,000 won. 56.3% of the respondents said the budget was enough, but 5% said it was not. 70.9% of the schools purchase medicines twice a year. The average number of students visiting the nurse in a year are 1,892 in elementary schools, 1.6 times per student and 2,471 in secondary schools, 1.7 times per student, respectively. The annual average number of students who were prescribed medicine a year are 1,804 in elementary schools, 1.5 times per student, 2,372 in secondary schools, 1.7 times per student. The percentage of students who are prescribed internal medicines was 45.5% in elementary, schools and 61.3% in secondary schools, respectively. To the preralence sicknesses, the wound was the most common, accounting for 42.7% in elementary and 22.6% in secondary schools. Next was abdominal pain, indigestion, and headaches in elementary schools; and colds, indigestion, and abdominal pain in secondary schools, respectively. To the dirersity of medicines prescribed: internal medicines 29 for abdominal pain, 25 for indigestion, 8 for physiological pain, 13 for headaches, 30 for colds, and 10 for eye disease; external medicines 2 for skin disease, 10 for toothaches and 31 for other sicknesses. 42.7% of the respondents said the schools have enough medicines, but 7.6% said that schools need more. 50.8% of the respondents said they get information on medicines from TV advertisements or medicine-related books, 16.6% get information from visiting pharmacists. More experienced nurse-teachers are likely to get information from visiting pharmacists, but 37.5% of the respondents who have less then four year experience in school get information through other nurse-teachers before deciding to buy medicines. To the choice of medicines: 83.9% of the respondents said that they choose safe medicines with less side-effects. 40.7% responded that they write down the prescription history daily, but 6.1% said they do this only once in two or three months. To the confidence in prescriptions, 37.7% of the respondents said they are sure of the effectiveness of the medicines they prescribe. To what extent the nurse-teachers prescribe, 50.3% said they prescribe to the level of anagelics, and 21.1% prescribe to anti-histamines and antibiotics. 80.4% said that the details of illnesses and medicines to be prescribed in school should be regulated by a school health-care law. To the problems in prescription, 79.9% of the respondents worry about abuse by students who want prescriptions but have no serious illnesses, 57.8% worrg about the lack of information on medicines and dosage. And 55.8% said they can't tell the difference between medicines whose brands are different, but bare the same ingredients. The conclusion of this study is that a health education program is necessary to prevent the misuse or abuse by students and a continuing education program for school-nurses is needed to solve the problems related to the purchasing and prescription of medicines. The criteria of the prescription of medicines also should be regulated by a school health-care law or management acts.
An important role of community health nurses in health centers is to solve community health problems found through data collection methodology which has been used to identify the health needs of the community, diagnose the health problems and to plan health programs suitable for the health problems. Also community health nurses must be prepared to know the community health needs and to participate in the planning process. Since 1956 when the health center law was established, community health nurses have really implemented only the services which the government has asked them to do. This has kept them busy enough. But these days as society is in rapid change, community health nurses should have the flexibility to deal with the social change and demands that are unique to their community each which has different health needs and demands. So community health nurses need to identify what community health problems exist in their particular communities. The purposes of this study were as follows. 1) To explore the suitability of the health programs which the government has asked the community health nurses to do for their own communities and if these programs are not suitable, to explore the reasons why. 2) To explore the degree to which the community health nurses have the ability to identify health problems in their own communities and activate the community diagnostic process. 3) To identify the degree that the community health nurses have the ability to implement plans related to community diagnosis. 4) To find out how much data related to community health problems, the community health nurses have and how they are utilizing it. 5) To measure the community health nurses self-confidence concerning diagnostic activities for community health. The study subjects were 454 Community Health Nurses working in Health Centers in Seoul, Korea. The period of data collection was 6 days(Nov. 9th 1991-Nov. 15th 1991). A questionnaire used for data collection was composed of three different items; general characteristics, community health diagnostic activities and self-confidence in performing diagnostic activities. The results of the study are as follows. First, over one third of the respondents replied that the government required activities for their communities are not appropriate. Of these activities the most frequent reply $(51.2\%)$ indicated that many of the activities in the community were inappropriate to the actual situation. Further, $25\%$ of the replies indicated that many activities were only administratively oriented and as such not appropriate. Second, $49.8\%$ of the respondents replied that they had done general assessments and had a general idea of the health problems of their community. Effective solutions to health problems could be found with an increase in health personnel and management ability according to $41.5\%$ of the respondents. Third, to the question as to whether they had ever independently implemented a plan towards solving community diagnosed problems, $52\%$ of nurses replied 'never', $40\%$ 'occasionally' but only $7.5\%$ replied that they did it frequently. Actually there was very little done even in the basic work of collecting the necessary data. Fourth, when asked how much of basic information they had collected that might be used in community diagnosis activity, of 26 items in 5 areas, there was hardly one for which complete data had been collected. Fifteen percent did have data on the geographical aspects of their area, housing distribution and types of housing, while $17.8\%$ knew the frequency with which the health center was used. Concerning community resources, even with a list of community resources, only $12.3\%$ had data on any of these resources, and this data was incomplete. Further, information about social work institutions, and facilities was also incomplete, only $14.2\%$ of the respondents had any data and even it was incomplete; that is, in general, the nurses did not have this information. Fifth, concerning the confidence of the community health nurse in their ability to carry out community diagnoses activities, $60\%$ replied that they were very or at least nominally confident, indicating that although they were not doing community diagnostic activities they felt they could do so, as they were carrying out home visits and program planning as part of their official duties. The following recommendations are made based on the results of this study. First; since the community health nurses have a high perception of the need for community diagnostic activities and. high confidence in their ability to carry out this activity and high percentage of respondents replied that with a little training they could do this even better it is recommended that community diagnostic activity training be included in the continuing education program for community health nurses. Second, in order for the Community Health Nurses to successfully solve the health problems of their respective community they reported to a need to increase the number of health personnel, improve the facilities and the system of managing their work. Considering this, it is recommended that ways be sought to remedy these deficits.
Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.13
no.1
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pp.117-128
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2002
Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.
According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.
. In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.
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