• 가정∙방문간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• 대한간호
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• 제34권5호
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• pp.68-81
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• 1996

In order to see the development of nursing related research activities in Korea over the last three decades, abstracts of almost all of the Masters and Ph. D. theses that had appeared from 1961 up to August 1991 were collected. Number of theses amounted to 1779(76%) out of a total of 2354 theses. We analysed the papers research patterns, which are research problem, research design, population, place. Here is what we have found. 1). The types of research problems were as follows. 58.0% papers did factor-analysis, 29.1% studied factor~relations, 11.4% situation relations and 1.5% did situation~creations. With respect to the years, we found that the factor-analysis papers decreased with time but the factor~relating, the situation -relating, and the situation~creating papers were increased. Especially the situation-creating paper increased notably since the 80s'. Relating to the kind of degrees, we found that for M.S.theses 60.2% of the papers did factor-analysis, 29.0% the factor-relating studies, 10.4% the situation-relating studies, and 0.4% the situation -creating studies. For the Ph.D. theses 30.5% did the factor~relating, 30.5% the situation-relating. and 20.0% the situation-creating papers. Considering the graduate schools, we found that the regular graduate schools and the graduate school of education produced about the same number of papers of each kind, but 81.2% and 64.6% papers produced by the graduate school of public health and the graduate school of public administration, respectively, did the factor-analysis thus taking majority of the papers. 2). Research designs were as follows : 10.8% experimental studies, 89.0% non experimental studies, and 0.2% quality studies were found. So the majority of the research designs were nonexperimental. We see a meaningful difference between the M.S.theses showing 9.8% experimental studies and 90. 1% nonexperimental studies. and Ph.D. theses showing 28.4% experimental studies and 68. 4% nonexperimental studies. Relating to the graduate schools, we find that the regular graduate schools and the graduate school of education with 15.8% and 10.6% experimental studies respectively, did a little more experimental studies than other schools. but still the regular graduate schools, the graduate school of public health, and the graduate school of education each show 83.8%, 97.4%, and 89.4% nonexperimental studies, so most schools are concentrating on nonexperimental studies. 3). On the relation between research problem and research design, experimental studies show 88.0% of situation-relations and 6.8% of factor-relations. Nonexperimental studies had factor-analysis taking the majority by 64.4% and 31.9% were factor-relations. 4). On the research subjects, we have 90.8% of the papers dealing with a single subject and 9.2% of the papers dealing with two or more subjects. Most of the research subjects are patients or nurses for the regular graduate schools and the graduate school of education, but for the graduate school of administration as much as. 60% of the studies took nurses as subjects. Subjects taken were patients, nurses. and students in decreasing order for the M.S. theses and for patients, women, and nurses again in decreasing order for the Ph.D.theses. 5). On the places of study, we've had 47, 8% of the studies done in hospital rooms, 15, 1% in schools, and 9, 6% in the local community, With respect to the years, we found 36.7% in the hospital rooms, 22.4% in the schools, and 14, 8% in the local communities in the 1970's and 50.1%in the hospital rooms, 13.4% in the schools. and 9, 2% in the local communities in the 80's.

• 대한간호
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• 제31권3호
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• pp.76-87
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• 1992

The purposes of study was: 1. To identify the direction and scope of research activities in Korean Nursing. 2. To discuss the unique problems present in Korea that warrant nursing research. 3. To delineate the factors that facilitate and/or hinder nursing research in Korea. This study was conducted at six colleges of nursing in Korea. The schools which were selected had doctoral programs at the time, the data were collected in 1990. Four of the schools were located in the metropolitan area of the capital city, Seoul, and two were in two other cities similar in size. The total population of the study was 283 nurses. The instrument for the research was the English version of Research Profile Questionnaire which was translated into Korean by the researchers and was validated in its translation by two professors. A pretest procedure was done before the data collection process. Of the population of 283, 210 subjects received the questionnaire and 150 subjects responded(71.4%). Excluding incomplete questionnaires, 141 questionnaires were utilized for data analysis. Data were analyzed using descriptive statistics. Responses to open-ended questions were content analyzed for themes and categories. Results of the study were as follows : Respondents currently , involved in nursing research numbered 108(76.6%), but 33(23.4%) did not have any research experience. The inexperienced respondenLs tended to be younger than the experienced subjects and most( 60.6%) were employed in hospitals, while 82.4 percent of the experienced nurses were employed in nursing schools. Among the respondents with research experience, 68.5 percent were involved in one to three projects and 31.5 percent were engaged in four or more projects. The experienced nurses indicated that nursing research in Korea is active. On the other hand, the responses of the inexperienced were that nursing research is not active. The most frequently selected research subjects were patients(76.9%, 83 respondents) followed by nurses, healthy persons and nursing students. The relatively high percentage of healthy persons as study subjects, could be explained as a concern of nurses for healthy persons as well as for ill patients. The aforememioned literature review showed a dramatic change in the kinds of study subjects; approximately 33 percent were patients but 25 percent were healthy subjects of various ages. The hospital was the prevailing research setting(67.6%) but at the same time various community settings were used. This is a changing phenomena in nursing research of Korea. Current research designed to build on previous studies amounted to 75 percent; about 39.8 percem were theory and hypothesis generated. Over 65 recommended additional research focusing on hypothesis-testing 0:' theory building. The previously quoted literature review found that only 4.0 percent of the study quescions were developed from a theoretical framework. The most frequently listed current major focus of nursmg research was stress and adaptation. Patients with cancer, pain, social support and care of the elderly were the next most frequently reported. These concerns may reflect problems associated with a technological and industrializing societyl. The most frequently identified problem was lack of clinical research. The need for replication research and research that contributes to the accumulation of nursing knowledge were found to be rare in Korean research. A need for theory testing and theory construction research was also identified. Although advanced statistical methods were often utilized in nursing research, the results were frequently considered by the interviewers not to be applicable in practice, and readers had difficulty in comprehending the findings. Even though the number of clinical nurses involved in research is increasing, it is still considered inadequate. Among 108 respondents, 83(76.9%) gave lack of time as a barrier to conducting nursing research. Over fifty percent of the respondents reported lack of funding or, personally, low confidence in research skills as barriers. The respondents offered 183 suggestions for future emphasis in nursing research. Among the 51 areas of emphasis, clinical research received the highest number and nursing intervention was next. The findings suggested that nursing research should be based on theory, be related to practice and relevant to the situation of a unique Korean culture.

• 한국철학논집
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• 제50호
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• pp.37-74
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• 2016

송준길은 '존중화 양이적'(尊中華 攘夷狄)이라는 춘추사상을 바탕으로 조정에서 '존명배청'(尊明排淸)과 '복수설치'(復讐雪恥) 운동을 추진했다. 그러나 송준길이 조정에 나가 재임하는 기간 동안 조선은 국내적으로는 수년간 지속된 대기근과 국외적으로는 복명(復明) 세력 몰락과 청의 대약진이라는 악조건 속에 처했다. 이에 현실적으로 송준길이 추진한 현실 정책은 '내수외양'(內修外攘)으로 요약된다. 송준길은 군사적 북벌 준비에 앞서 백성 구제를 우선시 했다. 당시 수년간 계속되었던 대기근으로 인해 송준길은 '내치 근본', '안민 우선'을 기본 정책으로 삼아, 북벌을 위한 군사력 증강 보다는 국내의 민생 구제, 군심(君心) 수양 등에 치중하지 않을 수 없었다. 송준길의 '복수설치' 의리 실천은 '내수외양'에 입각하여, 시행정책은 '양민(養民)을 먼저하고 치병(治兵)을 뒤로 한다'는 것이었다. 또한 내수 방침은 '양민'과 함께 '격군심'(格君心)이 핵심이었다. 송준길은 군주의 덕성 함양과 심성 수양이 곧 치국 평천하의 근본이라고 주장했다. 송준길은 안민(安民)이 우선이고 외양(外攘)은 그 다음 일이며, '내치(內治)는 외양(外攘)의 근본'이고, '치병(治兵)은 안민이 우선'이라고 했다. 또한 송준길은 복명(復明) 세력이 몰락해 가는 가운데에서도 남경에 잔존하고 있던 남명(南明) 정부에 사신을 파견하여 신하국으로서 충의를 다해야 한다고 건의하여, 춘추사상과 사업을 지속적으로 행하기 위해 외교 정책의 대의명분을 바르게 해야 한다고 주장했다.