• 가정∙방문간호학회지
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• 제5권
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• 지역사회간호학회지
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• 제10권1호
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• pp.5-18
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• 1999

The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.355-367
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• 2018

본 연구는 C시에 소재한 보건소의 방문건강관리 대상 노인 중 만성 관절통증이 있는 65세이상 취약계층 재가 여성노인 234명을 대상으로 삶의 질에 영향을 미치는 주요 요인을 파악하기 위한 서술적 상관관계 연구이다. 본 연구의 자료는 일반적 특성, 통증양상, 통증정도, 지각된 건강상태, 일상생활능력, 수면양상, 우울, 삶의 질로 구성된 구조화된 설문지를 통해 2017년 2월 16일부터 3월 13일에 걸쳐 수집되었으며, t-test, ANOVA, 상관분석, 위계적 다중 회귀분석으로 분석하였다. 연구결과, 대상자의 일반적 특성을 포함하여 대상자의 삶의 질에 영향을 미친 변수는 우울(${\beta}=-.60$, p<.001), 통증정도(${\beta}=-.15$, p=.007), 의료보장 유형(${\beta}=.15$, p=.001), 지각된 건강상태(${\beta}=.14$, p=.007), 통증지속기간(${\beta}=-.10$, p=.019), 결혼상태(${\beta}=.10$, p=.024), 일상생활능력(${\beta}=.09$, p=.036)순으로 나타났으며, 모형의 총 설명력은 63.1%였다. 본 연구를 통해 만성 관절통증이 있는 재가 여성노인의 삶의 질을 향상시키기 위해서는 지역사회 중심의 체계적인 우울 예방 및 관리 프로그램 운영이 우선 실시되어야 하며, 특히 경제적으로 취약한 공적부조 대상 노인의 삶의 질에 관심을 기울여야 하고, 통증 발현 초기부터 통증에 대한 정확한 사정을 토대로 통증완화중재 개입을 시행해야 한다.

• 의료법학
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• 제9권1호
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• 한국학교보건학회지
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• 제10권2호
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• pp.193-211
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• 1997

The study was designed to gain necessary basic data in order to grasp the health knowledge, attitude, and practice level of students and teachers of elementary, middle and high schools. This study was conducted through interviews of 3,400 students and 1,022 teachers attending 14 different schools large, middle and small cities and rural towns during a period of nine months (from Oct. 2 1995 to Jun. 30 1996). By the results of this study, the recommendations can be summarized as follows: 1. A school health development committee should be established of 10 members: school health related teachers (physical trainers, nurses, and teachers in charge of health), parents, persons related to health administration, local medical doctors, and student reprensentatives in order to support and immplement school health development plans. 2. Like advanced countries, a health class of 2~4 hours should beplaced in middle and high schools. A nurse majoring in health from a university should be the teacher. 3. A curriculum of health should contain the following: education on health, sex, alcohol, tabacco, the misuse of the drugs, the structure and function of human body, the growth of the body, mental health, safety and emergency care, the prevention of disease, proper eating habits and nutrition, daily health life, family health education, society health, community health, environmental pollution and individual responsibility. 4. Create a school health promotion center, with a nurse's office, and a sports center which has health machines (bars, aerobics, training, twist machine, belt massage, running machine, bench press, chest waist, hack hip extension machine) as well as a physical strength measuring machine (muscular strength, alertness, flexibility, endurance, lung functions and so on), so that the teaching staff and students can use them and train their bodies. 5. Through a refresher education program, urge teachers to understand school health promotion services. 6. Regulate a standard and establish a system of monitoring the physical enviroment of the school (the height of desks and chairs, illumination facilities, ventilation facilities, safe drinking water). 7. Create a check list of health to evaluate improvement.

• 여성건강간호학회지
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• 제29권1호
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• pp.20-31
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• 2023

Purpose: As more newborns have received expanded newborn screening (NBS) for metabolic disorders, the overall number of false-positive results has increased. The purpose of this study was to explore the psychological impacts experienced by mothers related to the NBS process. Methods: An online parenting community in Korea was selected, and questions regarding NBS were collected using web crawling for the period from October 2018 to August 2021. In total, 634 posts were analyzed. The collected unstructured text data were preprocessed, and keyword analysis, topic modeling, and visualization were performed. Results: Of 1,057 words extracted from posts, the top keyword based on 'term frequency-inverse document frequency' values was "hypothyroidism," followed by "discharge," "close examination," "thyroid-stimulating hormone levels," and "jaundice." The top keyword based on the simple frequency of appearance was "XXX hospital," followed by "close examination," "discharge," "breastfeeding," "hypothyroidism," and "professor." As a result of LDA topic modeling, posts related to inborn errors of metabolism (IEMs) were classified into four main themes: "confirmatory tests of IEMs," "mother and newborn with thyroid function problems," "retests of IEMs," and "feeding related to IEMs." Mothers experienced substantial frustration, stress, and anxiety when they received positive NBS results. Conclusion: The online parenting community played an important role in acquiring and sharing information, as well as psychological support related to NBS in newborn mothers. Nurses can use this study's findings to develop timely and evidence-based information for parents whose children receive positive NBS results to reduce the negative psychological impact.

• 보건행정학회지
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• 제27권3호
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• pp.256-266
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• 2017

Background: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. Methods: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. Results: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. Conclusion: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

• 지역사회간호학회지
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• 제9권1호
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• pp.72-88
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• 1998

This study was designed to identify the relationship between health perception arid health promoting behavior in the elderly. The subjects for this study were 92 persons over 65, who could be easily met in households, pavilions for the aged, and parks. The data were collected during the period from March 24th to April 12th, 1997 by interviews with a structured questionnaire. The instruments used for this study are as follows: The Health Perception Questionnaire developed by Ware (1979) and translated by Yu Ji-Su(1985). The Health Promotion Lifestyle Profile(HPLP) developed by Walker, Sechrist & Pender (1987) and partially amended by the author of this study. The Health Promotion Lifestyle Profile(HPLP) was parameterized by nutrition, exercise, stress management, self actualization, health responsibility, and interpersonal support. The data was analyzed by frequency, percentage, mean, standard deviation, t - test, ANOVA, and Pearson's correlation using an SPSS program. The results of this study were as follows: 1. Hypothesis 1 : 'The higher the level of health perception in the elderly, the higher the practice of health promoting behavior in the elderly' was supported(r=0.449, p<0.001). 2. The health perception mean score on a four point scale was 2.564. 3. For health promoting behavior, the mean score on a four point scale was 2.560. The factor of the highest mean score was interpersonal support(2.850) and factor of the lowest mean score was exercise(1.964). 4. Among the general characteristic variables, sex(t=4.12, p<0.001), religion(t=2.47, p<0.05), education(F=3.27, p<0.05), marital status (t=2.22, p<0.05), living situation(F=3.50, p<0.05), and hobby(t= -2.57, p<0.05) showed strong connections to health perception. 5. Among the general characteristic variables, religion(t = 1.83, p<0.05), and marital status(t= 2.12, p<0.05) showed strong connections to health promoting behavior. In conclusion, this study revealed that health perception is an important factor related to health promoting behavior in the elderly. The general characteristic variables showed strong connections to health perception and health promoting behavior. Therefore, nurses should consider health perception and general characteristic variables when they plan nursing intervention for the elderly. Also, educational programs encouraging constructive health perception should be developed.

• 한국융합학회논문지
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• 제7권6호
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• pp.213-218
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• 2016

최근 한국에서는 고령화가 본격적으로 진행되어 가족이나 개인중심의 노인돌봄시스템이 한계에 도달하였다. 본 연구는 장기요양등급자로 재가서비스를 받고 있거나 등급외자로 돌봄서비스를 받고 있는 노인을 대상으로 하는 재활 및 건강증진, 삶의 질 향상을 위한 적절한 서비스를 개발하는 목적을 갖는다. 특히 공급자입장의 품질 관리 측면에서 접근하였으며 서비스관리공급자인 기관 및 서비스제공자인 요양보호사를 대상으로 FGI 조사를 실시하고, 지역사회복지사와 방문간호사 대상 심층면접을 실시하였다. 연구결과에서는 서비스 공급자 및 제공자 간 서비스 내용에 대한 의식차이가 나타났고 또한 적절한 서비스를 제공하기 위해서는 지역사회에서 영역별로 분리되어 있는 케어서비스를 융합하기 위한 통합 교육 및 팀워크 훈련 등이 필요한 것으로 나타났다.

• 지역사회간호학회지
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• 제14권2호
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• pp.274-286
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• 2003

Purpose: The purpose of this study is to provide a basic data that may help develop health promotion programs by identifying health problems and perceived health status of the rural elderly. Method: The subjects of the study were 366 elders recruited from 24 villages located in Mari Myun, Geochang Gun, Korea. The sample was selected using a quota sampling method. The instruments used in the study included 117 items for health problems and 4 items for perceived health status. The data were analyzed with descriptive statistics, Pearson correlation coefficient, t-test, ANOVA and scheffe test using SPSS program. Results: 1) The most prevalent health problem was ailments in 'musculoskeletal system', followed by 'fatigue', 'eyes and ears', 'genitourinary system', 'mood & temper patterns', 'cardiovascular system', 'digestive system', 'nervous system', 'respiratory system' and 'skin'. 2) Womens health problems were more prevalent than men's health problems. 3) The mean score of perceived health status was 7.68. 4) Health problems of the rural elderly were significantly correlated with demographic variables such as education (F=9.532, p=0.000), gender (t=-4.246, p=0.000), marital status (t=-3.531, p=0.000), family type (F=5.742, p=0.00l), and occupation (t=3.356, p=0.001). 5) Perceived health status of the rural elderly was significantly correlated with demographic variables such as education (F=6.408, p=0.002), gender (t=2.949, p=0.003), marital status (t=0.802, p=0.034), family type (F=4.844, p=0.003), and occupation (t=-2.485, p=0.011). 6) Health problems of the rural elderly were significantly correlated with life style pattern variables such as drinking (F=5.223, p=0.006), smoking (F=4.087, p=0.007), salty food intake (F=3.424, p=0.034), greenish yellow vegetables intake (F=6.343, p=0.002) and fat food intake (F=5.327, p=0.005). 7) Perceived health status of the rural elderly was significantly correlated with life style pattern variables such as sleeping hours (F=3.966, p=0.020) and drinking (F=7.231. p=0.001). Conclusion: The findings of this study indicate that nurses need to understand health problems and perceived health status of the rural elderly and to develop health promotion programs for them in the future in the consideration of regional and environmental elements.