• Title/Summary/Keyword: Community Health Nurses

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Standing Issues and Policy Tasks of the Korean Dental Community - The direction of reforming the country's health insurance system (치과의료계의 현안과 정책과제 - 건강보험제도의 현안과 발전방향 모색)

  • Lee, Soo-Ku
    • The Journal of the Korean dental association
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    • v.48 no.1
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    • pp.6-11
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    • 2010
  • Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

An Evaluation Study on Home Care Clinical Practicum (일 가정간호 실습교육 평가 연구)

  • Kang, Kyu-Sook;Kim, Cho-Ja;Seo, Mi-Hye;Baek, Hee-Chong;Margaret, Storey
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.78-87
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    • 1999
  • From 1990 to 1997 Home Care Education Programs have been offered at 11 Home Care Education Institutes. But there have been no revisions in the program. Especially in the clinical practicum, the Ministry of Health and Welfare proposed 248 hours as 'Family Nursing and Practice'. But each of institutes has developed their own program, and the clinical practicum is very different. Institutions for home care practice have been very limited and even now only 40 hospitals started home care in the second demonstration project. A few community-based institutions have also been offering home care services. This study was conducted to analyze home care clinical practicum offered at Y university, and plan for a revised home care clinical practicum. Y university clinical practicum was revised to include 'visits to community institutions', 'laboratory practice', 'hospital practice', 'discharge planning and home care practice', and 'home care specialty practice'. The results of the evaluation and plan for a revision are as follows: 'Visits to community institutions' is a practice that helps the students understand community resources which are available to home care nurses, and as an orientation to institutions for practice. 'Laboratory practice' is to used to improve nursing skills that are applicable to home care. Problems that the students identified in the laboratory practice were 'lack of opportunity for individual practice', and 'inadequate theoretical preparation for practice'. To address these problems the basic nursing skills laboratory was open and could be used freely by the home care students, and practice could be done after the theoretical lectures. 'Hospital practice' is a practicum in which the students apply nursing skills to patients and to obtain assessment skills for discharge planning. Using a preceptorship, five days for hospital practice should be offered. 'Discharge planning and home care practice' was done at Wonju Christian Hospital. This institute is too far away that this practice should be provided at different institutions as soon as it is possible to contract with home care institutions. Patients groups in different home care institutions are very different, so the 'Home care specialty practice' should be done after analyzing patient groups and choosing specialty areas. These areas are' care of patients with respiratory dysfunction', 'care of patients with neurologic dysfunction', 'care of cancer patients', 'care of patients on dialysis', and 'wound care'. This practice should be offered with a preceptorship, so preceptors, clinical directors, and students should meet for home visit orientation.

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An Analysis on Curriculum Content of child Nursing in Korea (아동간호학 국가시험문제 보완을 위한 교과목 강의 내용 분석)

  • Cho Kyoul Ja;Song Ji Ho;Choe Myoung Ae;Shin Hee Sun;Kim Soon Ae;Jung Hyun Sook;Tak Young Ran
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.5-16
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    • 1998
  • The purpose of nursing education is to prepare the professional pratictioner as nurse who will be interesteed in the health and the related aspects of community and will assume responsibility for con tributing toward the improvement of the health for the all. This means that nursing education must provide opportunities for the development of knowledge, skills, and attitudes which make this possible. Consequently, this approach has relavence for nursing education. Faculty engaged in endless debates about what is to be included, and to what de1th, and what will be given short shrift as a result. Thus, it can be seen why there is so much confusion and lack of agreement between the emphasis and objectives in nursing. This study attempted to review and identify the curriculum content of child nursing in Korea to build and develop the standard curriculum contents for national board examination for nurses and child's health needs for the coming 21st centry. The questionnaire was consisted of items for selection and organization of the knowledge components and type of unit with weigh to be attained in child nursing. Response of 34% of nursing program in university and junior college. Content analysis was done by using consensual validation of essential knowledge for curriculum content to identify what is obvious or trivial. This study pointed out that it is not yet apparent that demographic fact has greatly influenced child nursing curriculum content. In a similar vein the majority of content of child nursing devote little time and weigh to social and epidemically significant to child health. It seems to be needed that the content of child nursing may push the paradigm shift in nursing education such as health promotion and prevention for potentional roles of child and family. In conclusion, it is the time to convoke and debate for convergence of model on essential content and standarization on job analysis for national board exam for nurses in Korea.

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The Relationship between Health Belief.Self-efficacy and Exercise.Diet Compliance in Coronary Heart Disease Patients (관상동맥질환자의 건강신념 및 자기효능감과 운동 및 식이요법 이행과의 관계)

  • Nam, Myung-Hee;Kim, Chung-Nam;Oh, Yun-Jung
    • Research in Community and Public Health Nursing
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    • v.8 no.2
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    • pp.262-276
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    • 1997
  • This study evaluates the relationship between health belief. self-efficacy and exercise and diet compliance in coronary heart disease patients. The study subjects were 96 CHD patients who visited the outpatient clinic at 3 general hospitals in Taegu city from April 3, 1997 to May 3, 1997. Data was collected by the researcher and two registered nurses who work at a cardiac outpatient clinic. Face-to-face interview was conducted. Moon's health belief scale(l990) and Hicky and others' Cardiac Diet Self-Efficacy Instrument (CDSEI, 1992), Cardiac Exercise Self-Efficacy Instrument (CESEI, 1992) were used. The instrument developed by the researcher based on the reference review was used to measure exercise and diet compliance. The data were analyzed by using descriptive statistics, Pearson correlation coefficient, t-test, ANOVA, Tukey verification and Stepwise multiple regression with the SAS program. The results of this study were as follows; 1. The degree of health belief(score range: 1-4) perceived benefit: 3.06 barrier: 2.04 severity: 2.93 2. The degree of self-efficacy(score range: 1-5) exercise self-efficacy: 2.91 diet self-efficacy: 3.32 3. The degree of compliance (score range: 1-4) exercise compliance: 2.34 diet compliance: 2.95 4. The exercise compliance had a positive correlation with perceived benefit(r=0.5327, p=0. 0001), severity(r=0.2780, p=0.0061), exercise self-efficacy(r=0.6675, p=0.0001), and a negative correlation with barrier{r= -0.4236, p=0.0001). The diet compliance had a positive correlation with perceived benefit (r=0.6439, p=0.0001), severity(r=0.4244, p=0.0001), diet self-efficacy(r=0.6629, p=0.0001), and a negative correlation with barrier{r= -0.5098, p=0.0001). 5. According to pt's education level, (F=3.02, p=0.0336), received massage from mass media on exercise and diet(t=3.81, p=0.0002), presence of cardiac patients in the family members or friends(t=2.00, p=0.0478), created significant differences in exercise compliance. According to occuption(F=3.03, p=0.0215), hospitalized experience(t=4.59, p=0.0000), presence of chest pain(t=3.63, p=0.0005), there was also a significant difference in diet compliance. 6. The combination of exercise self-efficacy, perceived benefit and pt's education level explained 50.18% of the variance in exercise compliance. The combination of diet self-efficacy, perceived benefit and barrier explained 56.76% of the variance in diet compliance. On the basis of the above findings, the follow ing recommendations are suggested: 1. To promote the exercise. diet compliance for CHD patients, a well organized health teaching and nursing intervention program should be developed. 2. More research is needed to investigate other variables affecting exercise and diet compliance of CHD patients. 3. To promote self-efficacy and a positive health belief in CHD patients, a well organized and an approachable nursing intervention program should be developed. 4. Factors other than diet. exercise compliance should be evaluated to discover the impact on CHD patients.

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Risk Factors of Arthritis in Middle-aged Women in Korea (중년여성의 관절염 발생 영향요인 분석)

  • Yang, Kyung-Mi;Lee, Jong-Eun;Jung, Hye-Sun;Kim, Sook-In;Lee, So-Young;Lee, Yoon-Jung;Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.17 no.4
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    • pp.512-520
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    • 2006
  • Purpose: To investigate the risk factors of arthritis, this study was carried out with 1,829 Korean women aged between 40-64 who responded to a health behavior survey. Methods: Data were extracted from the results of the 2001 National Survey on Health and Nutrition conducted by the Ministry of Health and Welfare. Results: 1 Financial difficulty and continuous anxiety about health were directly associated with arthritis. The odd ratios of these two factors of arthritis were 1.43 and 1.82 respectively. 2. With regard to the presence or absence of arthritis according to demographic characteristic, the incidence of arthritis was higher in the age between 50-64, in the group whose education level was middle school or lower, and in those who experienced the death of spouse, divorce or separation. Nevertheless, it was not significantly different according to financial status and employment status. 3. Concerning the presence or absence of arthritis according to psychological characteristic, the incidence of arthritis was found to be higher in those who were not healthy by subjective health assessment, in those who were always anxious about their health, in those who were always depressed and sad, and in those who felt heavy stress. 4. With regard to the presence or absence of arthritis according to the health behavior, the incidence of arthritis was higher in postmenopausal cases and cases who were having hormone therapy, and the incidence of arthritis was higher in those who did not drink alcohol, those with BMI higher than 25, and those who slept shorter than 7 hours a day. Conclusion: Based on the above results, it is required to provide a means applicable to communities by developing preventive education that can prevent the incidence of arthritis in middle-aged women as well as intervention programs.

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Predictors of the Compliance of Breast Self-Examination among Christian Women in Pusan and Ulsan Areas (부산, 울산지역 기독교여성의 유방 자가검진 이행 예측요인)

  • 김은경;이해정;안숙희;정은순
    • Korean Journal of Health Education and Promotion
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    • v.20 no.3
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    • pp.77-90
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    • 2003
  • The purpose of this study was to identify the influencing factors on the compliance of breast self-examination (BSE) among 205 Christian women living in Pusan and U1san areas. Structured self-administered questionnaires were used. Knowledge levels were measured by the instrument developed by Choi(l996). Self- efficacy and health belief were measured by the instruments developed by Champion (1993) and modified by Choi(1996). Women who did BSE more than once within 6 months were categorised as compliant. Data was analyzed by descriptive statistics, t- test, χ² test and logistic regression analysis using SPSS WIN program. The results of this study were summarized as follows; 1. 15.1% of women performed the BSE at least once during the last 6 months. 2. Non-complier and compliant women showed statistically significant differences in the level of self efficacy and barriers. 3. Predictors of BSE compliance were ‘history of having breast disease’, ‘experience of receiving recommendation for BSE’, ‘barriers’, and ‘experience of meeting with breast cancer patients’ and explained 14.8% of variance in compliance of BSE. For future clinical practice, health professionals, including nurses, need to actively suggest to women the importance of BSE, and to distribute the information through posters and pamphlets at clinics and public health centers. Including the opportunity to meet patients in health education centers can be another strategy to increase women's motivation for BSE. For future research, it is necessary to recruit women from broader geographic areas utilizing various sources such as community centers to increase generalizability of the findings.

Effects of Health Characteristics on Depression of Elderly Beneficiaries of the National Basic Livelihood Scheme (국민기초생활보장수급자 노인의 건강 특성이 우울에 미치는 영향)

  • Hur, Jungyi;Yi, Yunjeong;Lee, Keum-Jae;Kim, Hee Gerl
    • Journal of Korean Public Health Nursing
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    • v.27 no.2
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    • pp.327-337
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    • 2013
  • Purpose: This study was conducted to determine the prevalence rate of depression and the associated factors affecting the depression among the elderly beneficiaries of the national basic livelihood scheme. Methods: From the beneficiaries of the "visiting health care program" in a city the beneficiaries (aged 65 years or older) of the national basic livelihood scheme were selected. A total of 677 subjects were included in the study and hence for data analyses. Results: The observed prevalence rate of depression was 80.5% (mild depression was 60.2%, and severe depression was 20.3%). The factors influencing depression were indicative of subjective health status, walking exercise, hypertension, and diabetes. Conclusion: On the basis of our study results, as a strategy to reduce the prevalence rate of depression among the elderly concerned, we are of the opinion that it is very much necessary to motivate them to practice continuous and regular walking exercises in easily accessible places by mobilizing community resources such as visiting nurses and volunteers. Such efforts may not only immediately reduce the morbidity rate of depression among the low-income elderly, but also, in the long run, prevent suicides and contribute to improving their mental health status to an appreciable extent.

Factors Affecting on the Work-related Performance Level of TB Control Manpower (결핵관리전담요원의 업무수행정도와 영향요인)

  • Lee, Jin Beom;Kim, Young Im;Choi, Sook Ja;Choi, Young
    • Korean Journal of Occupational Health Nursing
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    • v.23 no.4
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    • pp.254-261
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    • 2014
  • Purpose: The purpose of this study was to investigate the degree of performance of TB control manpower in Korea and to identify the affecting factors associated with it. Methods: This study employed a quantitative observational with cross-sectional design and the subjects were consisted of 189 TB (Tuberculosis) control manpower who were working in both community health centers and private hospitals. Variables included in this study were demographic, social, work-related characteristics, aqhnd self-efficacy. A reliability of the instrument for the performance was Cronbach's ${\alpha}$=.91. Data were analyzed by t-test, ANOVA and multiple regression using SPSS (19th version). Results: The mean value of the degree of work-related performance of TB control manpower was $4.4{\pm}0.49$9 and it was higher than those of general nurses working in any other health care departments. The mean differences in the degree of work-related performance were in self-efficacy, workplace, the number of full charge manpower in TB, the number of participation in in-depth education, and the willingness to job maintenance. In multiple regression analysis, factors associated with TB control manpower' work-related performance were self-efficacy (${\beta}$=.164, p=.025), workplace (${\beta}$=-.186, p=.023), the number of participation in in-depth education(${\beta}$=.339, p<.002), and the willingness to job maintenance (${\beta}$=-.157, p=.036). Conclusion: Results of this study showed that work-related performances of manpower working in private hospital were higher than those of manpower in public health centers. So, it is necessary to enhance nation's active intervention to improve effectiveness and reduction of risk factors in TB policy.

A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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The Effects of Self-Management Program and Its Measurement for the Elderly with Chronic Illness in the community (국내 지역사회 거주 만성질환 노인 대상 자기관리 프로그램의 효과 및 측정도구에 대한 고찰)

  • Shin, Ga-In;Park, Hae Yean
    • 한국노년학
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    • v.40 no.2
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    • pp.257-267
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    • 2020
  • The purpose of this study is to identify the effectiveness of self-management programs and the measurement used for elderly people with chronic illness living in the community. Databases used for study search were Google Scholar, RISS, and Dbpia. And research questions were selected based on the PICO framework. We searched the study published from January 2010 to September 2019 and selected the final six studies by applying inclusion criteria and exclusion criteria. As a result, the selected study had qualitative level of Level 1-2. In general characteristics of the program, nurses conducted the most programs, and the program was operated for 50 elderly people or less. In addition, the program was conducted mainly in public health centers, senior centers. The subjects were the most studies for chronic patients with hypertension. The dependent variables of the program covered the cognitive domains in all the studies, and many of the studies measured the physical domains as the dependent variables. The results of this study provide the effectiveness of self-management intervention for the elderly with chronic diseases living in the community, and highlight the need for the development of programs for chronic diseases in the community. In addition, this study suggests measuring tools related to various cognitive, physical, mental, social and quality of life of the elderly, and suggests the necessity of multidisciplinary research.