The article reviewed the elderly health care management problems in policy development issue of the nation. Policy of Korean government on elderly health care has still not yet developed. The main stream of policy which is effective on elderly welfare policy is 'Elderly care are responsible by their families'. Now only those aged whose family members are not able to take care of their parents are receive custodial care at the non-profit nursing homes. This article examined the main stream policy in pro and cons aspects in relation to social changes such as: demographic changes. family structure changes. attitude changes. health care delivery system. and political settlement view points in connection with medical insurance program. Finally. a model for the elderly health care management was proposed which will provide chronic care services at the community level. such as nursing homes. day care centers. day hospitals, respite care units, and special care institute for dementia.
The purpose of this study was to investigate service support programs for the work-family balance in the community. Service support programs in the community are at beginning stages of development, because it has taken about 10 years to put a self-governing system into practice in Korea. This study concentrates on service support programs developed by various service organizations in the city and does not include any rural districts. First, the developmental process of the work-family balance model and type of the service support program in the community were studied. Next, the situation of care service support was examined based on written articles. Finally, a few suggestions were made f3r work-family balance in the community. The developmental situation of work-flmily balance in Korea is in a stage which is shifting from the company-leading model to a family-company-community model. The most common type of service support program offered in the community until now has been the informal sector through relatives, neighbors or friends. However, service support programs, in the public sector by the government and in the voluntary sector by nonprofit organizations and corporations, has rapidly been growing and the number of services from each sector has also increased. Profit organizations in the private sector, such as medical and care service centers, are also now rapidly increasing. It appears that service support programs contributing to the work-family balance in the community come from a number of sectors, including public, voluntary, private and informal sectors, to suit consumer needs.
Occupational health services in Korea have been operated as dual types: one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative. health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area: 154 places (39.4%) managed by designated. health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation due to the characterstics of each variable and analyzed for impacting factors with relation to the using multiple regression analysis using SPSS PC program, especially using t -test method in order to compare each type of health care management. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. The common sickness management is the most accomplished item in health care area of occupational health care services, while the preventive care and control for the workers who have serious health problems are insufficient in workers health care area. 3. An insufficient accomplishment of overall health education has been shown because it is difficult to perform health education due to almost no chance of the direct introduction at workplaces. Therefore a strong support system for making and supplying the media is necessary in order to activate indirect health education by means of media. 4. Because health care managers and the agencies managers where take the workplaces for this study are almost nurses who have been comparatively high work site rounding rate about an environmental management at the workplaces, that non-profession can also do it, the activities about the professional area not enough. Therefore, an appropriate referral system should be established in order to complement professional area. 5. Two factors which have an effect on the coverage rate of occupational health care services are : one is those from the workplaces such as type of services, the number of workers, the number of harzadous factors and safety & health committee, the other from health care organization about whether there is its own manager or not.
현재 우리나라가 겪고 있는 고령화는 사회복지서비스의 질적, 양적 확대를 요구하고 있다. 특히, 노령인구의 급격한 증가는 노인과 관련된 다양한 복지 및 의료수요를 유발하여 이에 대한 해결대응이 시급한 실정이다. 또한, 우리나라의 IT기술력은 하루가 다르게 발전하고 있고, 특히 유비쿼터스 분야중 하나인 U-Health의 연구가 활발히 진행 중에 있다. 본 논문에서는 U-Health 기술을 활용하여 노인 Care시스템 모델에 대해 연구하였다. 노인전용 주거환경의 Care시스템에 대해 설계하고, 설계한 내용을 중심으로 유비쿼터스 기술을 접목한 노인 Care시스템에 대해 연구하였다. 기존 사회기반모델과 IT기술을 융합한 노인 Care시스템과 모바일기기간의 연동으로 Care서비스 어플리케이션을 제공하여, 기존의 Care 및 의료수요의 문제점을 해결할 수 있을 것이다.
Purpose: This study sought to provide basic information for the establishment of home care nursing system in cancer patients. Methods: Data were collected by the descriptive questionnaires consisting of 42 articles from five fields of nursing services. Patient's symptoms were investigated by the Korean version of EORTC QLQ-C30. Data were analysed using SPSS-PC 12.0. Results: Among the cancer patients (n=182), 40.1% had serious limitations on their usual lives. 74.7% had serious economic burdens. 79.7% agreed strongly with the necessity of home care nursing system, 74.2% were willing to use home care nursing, and 91.2% felt that home care nursing should be mandatory in cancer centers. There was no correlation between the frequency of symptoms or nursing items and the degree of home care nursing requirements. Digestive symptoms, symptoms requiring procedures, and symptoms to meet educational help displayed a high degree of requirement. Conclusion: Home care nursing should be activated for cancer patients as a bridge between hospital-based acute care and community-based chronic care which could increase the quality of care and reduce insurance related payments.
The purpose of this study was to examine the efficacy of child care and the education and the influence of job-stress on job-satisfaction of child care and education teachers. 172 child care and education teachers were chosen from 40 child care centers located in Incheon, Gyeonggido, and Seoul. Data were collected using the efficacy of child care and education index, the job-stress instrument, and the job-satisfaction instrument, and were analyzed using t-test, one-way ANOVA(Duncan test), correlation analysis and multiple regression analysis. There were significant differences in child care and education teacher's job-satisfaction according to the teacher-related variables, including the type of institution, the number of classes, the age of children, the education, the teaching experience, the income, the age of teacher, and the marital status of the teacher. Correlation analysis indicated that the teacher's efficacy of child care and education and the job-satisfaction had significant correlations, especially the satisfaction of job itself indicated high positive correlations. Job-stress and job-satisfaction of the child care and education teachers had significant negative correlations in all sub-variables, especially the stress from the working environment and the satisfaction of administration system indicated high negative correlations. It was also found that stress from the working environment, stress from the overload, stress from the peer relations, and the efficacy of child care and education were all significant predictors of the child care and education teacher's job-satisfaction.
Purpose: There has been a growing recognition that person-centered care enhances the quality of life of nursing home residents with dementia. This study was conducted to develop a person-centered dementia care online education program for direct care staff in long-term care facilities. Methods: Delphi method with expert group was used to validate contents. We developed 61 draft items based on literature review. Twenty experts participated in consecutive three round surveys including 5-point Likert scale questions and open-ended questions. Based on experts' opinions, the content validity ratio for content validity and the coefficient of variation for stability were calculated. Results: Three-round Delphi surveys and additional feedback from the expert panel established a consensus of core contents: 1) dementia (7 categories), 2) person-centered care (6 categories), 3) communication (8 categories), and 4) behavioral and psychological symptoms of dementia (6 categories). Specific sub-categories in each category were differentiated according to the job qualifications (65 sub-categories for registered nurses, 64 sub-categories for nursing aids, and 41 sub-categories for personal care workers). Conclusion: This delphi study identified person-centered dementia education curricula, in which the person-centered approach should be a key policy priority in Korean long-term care system. Now it is urgently needed to develop education programs utilizing online platforms that enable efficient and continuous learning for long-term care staff, which can contribute to behavior changes in the person-centered dementia care approach and improvement of care quality in long-term care facilities.
The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.
Purpose: We evaluated the psychometric properties of a questionnaire on the acceptance of the quality improvement information system (QIIS) among long-term care workers (mostly nurses). Methods: The questionnaire composes of 21 preliminary questions with 5 domains based on the Technology Acceptance Model and related literature reviews. We developed a prototype web-based comprehensive resident assessment system, and collected data from 126 subjects at 75 long-term care facilities and hospitals, who used the system and responded to the questionnaire. A priori factor structure was developed using an exploratory factor analysis and validated by a confirmatory factor analysis; its reliability was also evaluated. Results: A total of 16 items were yielded, and 5 factors were extracted from the explanatory factor analysis: Usage Intention, Perceived Usefulness, Perceived Ease of Use, Social Influence, and Innovative Characteristics. The five-factor structure model had a good fit (Tucker-Lewis index [TLI]=.976; comparative fit index [CFI]=.969; standardized root mean squared residual [SRMR]=.052; root mean square error of approximation [RMSEA]=.048), and the items were internally consistent(Cronbach's ${\alpha}=.91$). Conclusion: The questionnaire was valid and reliable to measure the technology acceptance of QIIS among long-term care workers, using the prototype.
1. Introduction Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project in order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was needed. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myun. 2. Survey Method An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing techniques for three days. The team consisted of a public health nurse, four nurse-aides, a sanitarian and four health extension workers who are working in our project, The survey was carried out during the period November 1971 to March 1972. 3. Project area 1) Population of Soyang-Myun was 11,668; male, 5,962 and female, 5,706. Sex ratio: 104.5. 2) Households : 1,858 3) Family size: The average household consisted of 6.3 persons. 4) Educational level of householder a. Illiterate 13% b. No schooling but able to read 10% c. Preschool children 19% d. Primary school 47% e. Middle school 7% f. High school 3% g. College or University 1% 5) Occupational distribution of householders a. Farmer 67% b. Laborer 13% c. Office worker 4% d. Merchant 4% e. Industrial worker 2% f. Unemployed 8% g. Miscellaneous 2% 6) Religious affiliation a. No religion 74% b. Buddhist 12% c. Protestant 10% d. Catholic 4% 4. Survey results Living Environment : a. Home ownership 95% b. Kinds of roofing Straw-thatched house 84% Tile-roofed house 10% Slate-roofed house 5% Other 1% c. Floor space Less than 6 pyong 10% 6-10 pyong 53% 11-15 pyong 24% 16-20 pyong 9% More than 20 pyong 4% d. Radio ownership 80% Environmental Sanitation : a. the source of drinking water public well 49% private well 30% drainage water 9% steam water 8% well pump 3% water distribution system 1% b. Distance between well and toilet more than 16meters 38% 6-10 meter 31% 11-15 meters 14% Less than 6 meters 17% c. The status of well management Bad 72% Fair 26% Good 2% d. General sanitary state of house Bad 37% Fair 51% Good 12% e. House drainage system had no house drainage. 77% Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods 1oop 68% oral pill 16% vasectomy 4% condom 1% tubal ligation 1% two or more methods 10% Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26% 6 times 11% 5 times 11% 4 times 9% b. The place of delivery own house 88% hospital 1% others 11% Treatment of general sickness : a. The place of treatment Soyang Health Center 31% Hospital (private or otherwise) 26% Pharmacy 14% Herb medicine 5% Private care 5% No treatment 12% Miscellaneous 7% b. Usual causes of diseases Unknown 46% Tuberculosis 29% Neuralgia 8% CVA 3% Bronchitis 3% Others 11%
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