• 제목/요약/키워드: Community health nurse

검색결과 396건 처리시간 0.022초

우리나라 가정간호제도화 방안에 관한 고찰 (A Consideration on the Instituting Home Health Care in Korea)

  • 윤순녕;황나미;현혜진;최정명;권미경
    • 가정간호학회지
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    • 제2권
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    • pp.5-18
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    • 1995
  • While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

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간호사-지역사회건강상담자팀의 미국 도시지역 젊은 흑인 남자 집단의 고혈압 관리를 위한 전략 활동의 교육-행위진단 (The Diagnosis for Educational Behavioral Strategies of Community Health Nurse-Community Health Worker for Control of Hypertensive Urban Young Black Men in America)

  • 박경민
    • 지역사회간호학회지
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    • 제7권1호
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    • pp.80-99
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    • 1996
  • Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio-demographic, medical characteristics, and behaviors(importance of and difficulty with HBP control behaviors, or worry about mdication) for experimental intervention study(educational- behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of $11.0{\pm}2.4$ years; only 23.1% were employed full- or part-time while 26% were on disability ; and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication(35.3%) was $148.2/95.1{\pm}19.5/11.3$ compared to those men not taking HBP care $153.7/99.1{\pm}14.0/9.8(p<.05)$. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9, 9.6, and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity induded heart disease 7.8%, diabetes 8.9%, high cholesterol 18.2%, CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p<.05). The problems of with sex life, physicl activity and dearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of 'during the past month, on how many days did you have 5 or more drinks (bottles) of any alcoholic beverag?' and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6%, respectively. HBP control behaviors was assessed with 1-5 point Likert subscales(5=extreme, 1-none at all), In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors; importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale(1=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Average ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8), 2.8 (SD=1.6) respectively(p<.05). These data support the need for educational-behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.

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의료기술외적 병원써비스가 병원이용태도에 미치는 영향 (Effect of the non-Medical Services on Attitude to Hospital Utilization)

  • 이현경;장임원
    • Journal of Preventive Medicine and Public Health
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    • 제21권2호
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    • pp.442-450
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    • 1988
  • 충남지역에 소재한 모 대학 병원에 1986년 11월부터 1987년 11월까지의 기간중에 입원한 환자 1,400명중 본 조사에 응한 1,319명을 조사대상으로 병원써비스의 사회적 작용 과정 측면에서의 의료기술외적 제조건들이 병원 선택 태도에 미치는 영향을 설문지 조사방법으로 실시한 바 아래와 같은 결과를 얻어 요약한다. 1. 창구직원의 친절, 환자의 병실 방문 요청에 대한 의사 또는 간호사의 반응, 의사의 병세 설명에 대한 성실성, 주치의의 진료성실성, 의사에 대한 환자의 신뢰감, 간호사의 친절, 간호사에 대한 환자의 신뢰감, 병원의 청결, 환의의 청결, 침구의 청결, 병원식, 배선원의 친절, 병원의 휴식분위기 등 모든 조건이 비록 결정적인 병원선택의 조건은 아니나 복합적으로 작용하여 병원선택의 기준이 되고 있다. 2.사회적 작용 과정 측면에서의 병원써비스 조건들은 의료시설 또는 의료기술을 동기로 병원에 입원한 경우보다 단순히 교통조건을 동기로 병원에 입원한 경우가 차후 병원선택의 태도에 더욱 더 영향을 미치는 것으로 추정된다.

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우울 청소년의 건강경험 - Newman의 실무연구방법론을 근거로 - (Health Experience of Depressive Adolescents: Reflected from Newman's Praxis Methodology)

  • 권영란;이정숙
    • 대한간호학회지
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    • 제39권2호
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    • pp.217-228
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    • 2009
  • Purpose: Guided by Newman's theory of health as expanding consciousness, this study was done to explore the health experience of adolescents having depression. Methods: The researcher engaged in six to eight in-depth interviews with six adolescents. To begin the dialog, the researcher asked each participant to recount the first important memory he/ she had. All the narrative and diagram sharing between the researcher and participants were summarized according to recognized patterns and later elaborated in following interviews based on Newman's praxis methodology. Results: The significant individual pattern of early health experience was during the binding stage. At the turning point, individual patterns for participants revealed a personal journey of self-discovery and then emergence of reflecting behaviors. After the turning point, the participants changed as they evolved from the initial period of disruption and disorganization to organization at a higher level. The results suggest that adolescents who are depressive find new ways of relating to friends, family, healthcare providers, and the community by expanding their consciousness. Conclusion: Newman's praxis methodology is a good way of helping and studying adolescents with depression because it emphasizes participant-nurse/researcher partnership and pattern recognition as nursing practice.

일 지역 초.중.고등학교 사고 유형과 이에 따른 응급처치 실태 (A Study on the Types of School Accidents and First Aids at Elementary, Middle, and High Schools in a Local Province)

  • 조병준
    • 한국학교보건학회지
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    • 제20권1호
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    • pp.45-52
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    • 2007
  • Purpose: The purpose of this study was to examine the types of school accidents and their first aids at Elementary, Middle, High Schools in a local area. Methods: The subjects were 1062 students who have had episodes of school accidents from 730 (Elementary = 429, Middle = 188, High = 113) schools in Chungnam province from January to December, 2006. Data were collected from accident-related record from school nurse and 'School Safety Fund', and analyzed using the SPSS Version 13.0 programs and the results and conclusions are as follows: Results: The proportion of school accidents occurred were in middle(0.43%), high(0.35%), primary(0.30%) school students. And the most frequent type of accident was fracture and then sprain. Most school accidents broke out in playground during resting time, and followed by physical education class. The most frequent cause of school accidents was carelessness and first aid was fixation the injury. Conclusion: Based on these findings, school-based and continuous safety education programs and emergency care system within school and in community can be suggested in collaboration with health-related resources. Further longitudinal study to identify causes and kinds of school accidents and can also be recommended.

가족발달단계에 따른 간호요구영역에 관한 연구 (Study of The Area of Nursing Need by the Family Developmental Stage)

  • 최부옥
    • 대한간호학회지
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    • 제7권2호
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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일제강점기 ‘간호부규칙(看護婦規則)’에 관한 연구 (The 'Nurses Ordinance' of Korea under Japanese Rule)

  • 이꽃메;김화중
    • 지역사회간호학회지
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    • 제9권2호
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    • pp.291-302
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    • 1998
  • The Japanese colonial authorities promulgated the 'Nurses Ordinance(Kanhoboo Kyuchick), in 1914. It was the first act that regulated nurses' licensure in Korea. The gendarme did the administrational work of the ordinance. After the Nurses Ordinance of 1914, nurses without licenses could no longer work with the name of nurse, and Korean nursing gained a more professional status. After the March 1st Movement of 1919, Japan realized that its iron rule had to be more sophisticated. The gendarme gave way to an ordinary constabulary force. The Nurses Ordinance was amended to set the nurses quality as good as that of Japanese nurses, and the nurses licensure of Korea could also be used in Japan. In 1931 the Japanese war against China began, and the Japanese imposed military rule once again. The Nurses Ordinance was amended to 'The Korea Nurses Ordinance'. After the outbreak of the Sino-Japanese War(1937) and of World War II in the Pacific(1941), the Japanese desperately needed additional manpower to re plenish the dwindling ranks of their military and labour forces. To produce more nurses, the colonial authorities amended the 'Korea Nurses Ordinance' and lowered the age and educational status of nurses to produce more numbers. Until the Japanese surrender in August 1945, Korea was under Japanese rule. Koreans had no say in the passing of these acts, and the colonial authority could make and pass any act at will.

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유방암 수술 환자에 대한 가정간호서비스의 경제성 평가 (Economic Evaluation of Hospital-based Home Care Services for the Breast Cancer Surgery Patients)

  • 고정연;윤주영
    • 지역사회간호학회지
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    • 제32권3호
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    • pp.356-367
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    • 2021
  • Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

청소년기의 건강증진과 학교보건교육의 발전방향 (Adolescent Health Promotion and Development of School Health Education)

  • 유재순
    • 한국학교보건학회지
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    • 제11권1호
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    • pp.27-50
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    • 1998
  • Adolescent health is considered to contribute to health promotion in the home and community in the near future as well as individual health. However, adolescent health has been neglected from education field because of competitive school education focused on the university entrance examination That's why I suggest in this study that we should pay much more attention to adolescent health condition and try to make It better, in terms of man-power development and life-health promotion for nation development The purposes of this study are as follows First, to look into a variety of adolescent health problems Second, to find out the situation and problems of current adolescent health promotion and school health education Third, to make an effort to find, based on the current situation, various developments of adolescent health promotion and school health education in terms of practical, political and environmental change There are used study methods as adolescent-related, school heath-related literature review and anlysis of statistical data The results and suggestions are as follows Teenagers have a great variey of health problems including most Important physical, mental and social developments Recently, chronic diseases, emotional problems, health-risk behaviors linked With adolescents are on increase The complicated disorders of physical, mental, social health rather than paricular aspects of health or health-behavior problems influence adolescent health problems adolescence is regarded as the period when most health-related behaviors are formed. Therefore, adolescent health promotion would he assured by developing the ability of controlling multi-dimensional health determinants in the early stage. Health promotion is a positive concept that each individual, family and community makes real efforts to improve their health To achive this, we need health educational, organizational, political and environmental supports. Adolescent health promotion in Korea has been systematically treated in the category of school health Current school health services have had lots of systemic, constitutional, administrative and educational flaws Accordingly, I'm concerned that we can afford to accept a variety of adolescent health needs However, I would say that if were not to make those flaws better, it's certain that Korean national competitive power and the quality of the lives of most Koreans Will he threatened someday We have to develop Comprehensive School Health Crriculum(CSHC) and set up its standards to Improve adolescent health. CSHC is an organizational and costant process. CSHC means an Important part of overall curriculums. In addition, I could say that it's an Important school health education acivity including current school health services-health care service and school health environment. In conclusion, in order to develop CSHC, we require school nurse's role changes, establishment and management of intergrated subject of health education, striking revision of school health law(or legislation of school health promotion law), reorganization of administration system, big changes in curriculum for school health educators.

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양호겸직교사 연수과정에 관한 연구 -경상남도를 중심으로- (A Study on the Training Course for Teachers Holding Additional Job of School Health Nursing in Kyeong Nam Province)

  • 강영실;정인숙
    • 한국보건간호학회지
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    • 제3권2호
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    • pp.133-142
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    • 1989
  • The purpose of this paper is to provide the basic information concerning school health nursing activities in schools lacking in a school nurse, and the degree of satisfaction of trainess to the training course of school health nursing. The data for this study were collected by means of questionnaire from 150 teachers(100 of primary school and 50 of middle school)who attended the training course superintended by the Board of Education of Kyeong Nam Province from July 27 to August 6 in 1987. The main results of this study can be summarized as following; 1. General characteristics of the trainees: The majority of the trainees (71.3%) were in the age of twenties, 86.5% graduated from four-year teachers' college, 63.5% had less than five-year experience as a teacher. 2. 60.5% of the trainees were actually offering school health nursing services. 67.8% decided voluntarily to participate in the training course, and 62.7% attended the course for the purpose of obtaining health knowledge. 3. Only 4.2% of schools established appropriate health organization, and 34.5% were equipped with nursing clinic. But the main reason school health nursing activities were not performed very well was the insufficient supply of needed medicines and related materials. 4. School health nursing services in schools lacking in a school nurse were offered mainly by the teacher holding additional job of school health. class teacher and atheletic teacher. But the sanitary management for school meal services and community health activities were not carried out at all in many schools. 5. As a whole, trainees were satisfied with training program. But some subjects of the course did not satisfy them because those ones were so theoretical without any practice. 6. Many trainees wished the training course to be more concentrated on case studies which are helpful to solve actual problems. 7. 75% of trainees answered to have decided to perform school health nursing activities more actively than before. 8. Any significant relationship can not be found between trainees' general characteristics and their attitude to school health nursing activities after the training course. Only one factor-motivation to attend the training course-had the statistical significance of 8.7%.

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