• Health Policy and Management
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• v.29 no.4
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• pp.379-381
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• 2019

Korea's healthcare is in great danger of sustainability. In 2020, the baby boomer will begin to be older, and there is no promise that the total fertility rate of 1.0 or less will rebound, and Korea's economic growth rate is predicted to be less than 2%. Together with these phenomena, Plan for Benefit Expansion in Nation Health Insurance (Moon Jae-in Care) will seriously threaten the sustainability of health insurance finance. In addition, health care in Korea has many problems: excessive medical utilization, rapidly increasing elderly medical costs, concentrating patients into big hospitals, low healthcare personnel but many healthcare facilities and equipment, bad quality of primary and mental care, and fast-growing health expenditure. For sustainability, healthcare of Korea should be reformed. The direction of the reform is people-centered and integrated healthcare in the community which is composed of empowering and engaging people, strengthening governance and accountability, reorienting the model of care, coordinating services, and creating an enabling environment.

• Journal of Korean Public Health Nursing
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• v.10 no.2
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• pp.146-161
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• 1996

This study was purposed to find health promotion and care needs of the elderly in rural area of Korea. As the rural elderly are limited in accessibility to health care resources and could not immediately solve their health care needs when they need. health promotion and care services are expected to bring better and more practical solutions of their health care needs. Thus, the type of health care services to be developed in Korea rural area is discussed to have emphasis on health care service component in addition to health promoting components. Methods of this study was based on survey data analysis : total 322 persons aged older than 55 living at one 'Kun' in Korea administrative unit were interviewed by health workers working at the region and also get trained for this study data collection. The data collection interview was continued from February till May in 1996. The interview questions were modified with adjustment to Korea situation. with basis of the WHO's health promotion program components. The collected data were analyzed using SAS program for frequency, correlation, regressions. The major findings were as follows : (1) $74.8\%$ of the surveyed were sick at the survey time point. and $95.9\%$ known the diagnosis name of the disease. The most frequently complained diseases were Muscular-Skeletal diseases $(43.7\%)$. $34\%$ of those sick had never treated or discontinued therapeutic procedures. so that shown the necessity of systematic and usual health care services with health promotion program development for the elderly. (2) The percent of those who make social participation was $95.3\%$. and the activities were visiting neighbors $(70.4\%)$ and lack of qualified social activity programs. (3) $78.1\%$ of the surveyed had health counseling and education from professional health workers. Those ceased smoking and drinking were $59.6\%,\; 60.3\%$. respectively. Those had no application of therapeutic drugs or nutrion supplements was $40.7\%\;and\;94.1\%$ had regular meals. Those practiced exercises was low remarking $17.7\%$. (4) Positive health behaviors were better carried out by sick groups than by the healthier. except smoking. regular meals. and exercise. $17.5\%$ of sick group smoke more than one case of cigarettes. in contrast to $9.5\%$ of the healthier. (5) Mental health status was heathier among positive health behavior earners. Health counseling and education shown better score of mental health than those never counseled. (6) Positive health behavior practice frequency did not show significant differences when crossed by social activity participation status. (7) Health behaviors of the rural elderly people were carried out better when they had positive 'continuency in therapeutic procedure' 'health status'. 'familial relationship'. 'Health Status' of the rural olderly were explained by 'exercise'. 'drinking'. 'familial relationship'. 'activities of daily living'. Thus, health behaviors practice mutually interact with health status. In conclusion. the health promotion and care program component are recommended to include ation on the necessity of positive health promotion active social acitivities. pleasant life style, adaption into changes on the elderly, safety in residential area. community acitivity and resource utilization. etc .. in addition to the elderly's disability and sickness caring services.

• Research in Community and Public Health Nursing
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• v.10 no.1
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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.

• Research in Community and Public Health Nursing
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• v.12 no.2
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• pp.329-337
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• 2001

Purpose: This study was to develop a critical pathway for COPD clients in home health care. Method: Review of literature. Analysis of 10 cases of home health records of COPD clients without other major chronic illness, and Contents validity test Results 1. Vertical axis(l4 activities) physical and mental assessment, family assessment. environment assessment, rights and duties of client, oxygen use and safety, education of disease process and symptom, medication, nutrition and elimination, tests, activities, respiratory exercise, sleeping pattern. consultations and discharge planning. 2. Horizontal axis was set by the number of visits(average number of visits is 6.4) and vertical axis was set with 14 activities and the contents which should have occurred, according to the time frames of the horizontal axis. 3. According to the contents validity test, among the total of 234 items, 176 items showed over 83% agreement and 58 items showed less than 83% agreement. Those items with less than 83% agreements were either deleted or revised. Conclusion this critical pathway is applicable to the home health care of COPD clients to provide quality home nursing care services at lower cost.

• Korean Journal of Social Welfare
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• v.65 no.3
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• pp.239-263
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• 2013

This research was carried out in order to develop and validate the Korean Version of Working Relationship Scale for Mentally Disabled Persons, which measures the working relationship between a mentally disabled person and his or her case manager. The first step taken to develop this scale was to construct sample items for the Working Relationship Scale using literature research and three focus group interviews of mentally disabled persons who use local mental health services. Secondly, mentally disabled people were surveyed with these sample items and two professors from the department of social work who specialize in mental health social work and two licensed mental health social workers working in the community mental health field reviewed these sample items to select and compile a final version of the scale. Lastly, the scale's reliability and validity was verified through an empirical study of 569 mentally disabled persons who surveyed the final selection of items. An explanatory factor analysis showed that the sample items can be grouped into three factors. Factor 1 is 'Professional Contribution Factor,' which is related to the professional practice of the case manager; Factor 2 is 'Negative Working Relationship Factor'; and Factor 3 is 'Emotional Bond Factor,' which measures the intimacy between the case manager and the mentally disabled person. A confirmatory analysis of the three-factor format that was discovered in the explanatory factor analysis was carried out with the rest of the randomly divided data, which showed that the model demonstrated a goodness-of-fit. The convergence validity between similar concepts appeared to be appropriate as well. Based on these results, the Korean Version of Working Relationship Scale for Mentally Disabled Persons consisting of a final 33 items is developed and proposed and its implications in social work are discussed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.151-161
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• 2021

The purpose of this study was to identify citizens' needs and what they perceive the health-related problems are so public opinion can be reflected in the Daegu Community Health Plan. A citizen participation group was organized, and two roundtable discussions were held in June and July 2018. The number of participants in the first and second round was 40 and 44, respectively. Customer itinerary guidance, DVDM (Definition, Value, Difficulty, and Method) Map, and Persona-based scenario method were used for the roundtable discussions. The measures to improve the health status proposed by the citizens included expanding access to health services, establishing health services centered on small-living areas, expanding mental health services, creating health-friendly environments, resolving environmental problems, and improving social health. In addition, enhancing communication and creating harmonized environments, improving access to healthcare, generating pleasant physical environments, and assigning socials roles for vulnerable individuals were brought up as the means to resolve health disparities. The strength of the present study lies in the fact that, unlike survey methods, the citizens' exact needs were identified by sharing their thoughts. Moreover, it was proven that practical measures would be needed to implement citizen participation in planning health-related projects.

• Korean Journal of Social Welfare Studies
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• no.36
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• pp.281-299
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• 2008

The objective of this study was to examine the association between personal, housing, program, and service characteristics and quality of life among persons with severe mental illness living in supported housing. A cross sectional survey of a random sample of 237 clients residing in supported housing in Philadelphia was used to assess the association between personal and environmental characteristics, and quality of life. Data were collected from structured interviews, administrative data, the 2000 U.S. Census data file and the Philadelphia police crime database. Multiple regression analyses were used to identify personal and environment characteristics that are associated with quality of life. Clients with diagnoses of schizophrenia, those with lower levels of psychiatric symptoms, those with higher levels of physical health status, and those with higher levels of perceived supportiveness with staff had higher levels of quality of life. Findings of this study suggested that clients' clinical characteristics and consumer staff relationships can be important variables for understanding quality of life among supported housing residents. Factors associated with quality of life identified in this study may help service providers design and plan services to promote quality of life and stable independent living in the community of supported housing residents.

• Research in Community and Public Health Nursing
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• v.31 no.4
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• pp.436-446
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• 2020

Purpose: This study aims to explore the association between unemployment and depression in people from different age groups ranging from 18 to 65 years old. Methods: This study used a cross-sectional design. We performed bivariate analysis and multivariable logistic regression on the 2010 Behavioral Risk Factor Surveillance System (BRFSS) data from 12 states in the United States. Results: On a sample comprised of n=53,406 individuals, of whom 2,546 (7.8%) were identified as being depressed and 3,448 (10.6%) as unemployed, we found that individuals aged 61~65 years have a lower depression risk compared to those aged 18-25 after adjusting for other variables including employment status. However, people from 61~65 have higher increased risk of depression when unemployed compared to other age groups in all three models tested (3.95 times higher in unemployed people in model 1, and 2.81 times higher in model 2 and model 3). Conclusion: Our findings indicate that there may need to be more focus on older adults who are unemployed, with associated support services for their mental health. The results of our study indicate that although older adults are less likely to be unemployed, there are more likely to experience depression if they are unemployed (once other confounding factors are taken into account) than younger adults. Policies and interventions can be developed to address not only the physical difficulties but also the mental challenges with which older adults can be at risk facing in case of unemployment.

• Korean Journal of Social Welfare
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• v.61 no.3
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• pp.103-127
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• 2009

This study examined the relationships among the case management implementation factors, client satisfaction and quality of life among the persons with mental illness. The survey and interviews were conducted to the 18 community-based mental health service agencies which were implementing case management, and the 381 mentally ill persons who were living in the community and were receiving services from the agencies. The path analysis and the hierarchical linear modeling were used to examine the association among the independent, mediator, and dependent variables. The major finding of this study were that the caseload had the direct relationship with the quality of life. The case management team approach had the direct relationship with the client satisfaction. The suggestions were made that more focus should be on the maintenance of the appropriate caseload, the increase of the number of the case manager, and the team approach.

• Korean Journal of Community Nutrition
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• v.27 no.4
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• pp.273-285
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• 2022

Objectives: This study compared the nutritional intakes of early and late preterm infants in a neonatal intensive care unit (NICU) and at home. The dietary problems and the need for community care services for premature infants were further investigated. Methods: This is a cross-sectional and descriptive study on 125 preterm infants and their parents (Early preterm n = 70, Late preterm n = 55). The data were collected by surveying the parents of preterm infants and from hospital medical records. Results: No significant differences were obtained between the early and late preterm infant groups when considering the proportion of feeding types in the NICU and at home. Early preterm infants were fed with a greater amount of additional calories at home and had more hours of tube feeding (P = 0.022). Most preterm infants had feeding problems. However, there was no significant difference between early and late preterm infants in the mental pain of parents, sleeping, feeding, and weaning problems at home. Many parents of preterm babies had no external support, and more than half the parents required community care to take care of their preterm babies. Conclusions: Regardless of the gestational age, most preterm infants have several problems with dietary intake. Our study indicates the need to establish community care services for preterm infants.