• 농촌의학ㆍ지역보건
• /
• 제16권2호
• /
• pp.125-133
• /
• 1991

The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.

• 간호행정학회지
• /
• 제12권3호
• /
• pp.464-472
• /
• 2006

Purpose: The aim of this study was to define the health problem in the community-dwelling elderly of Korea and to compare differences of CAPs(Client Assessment Protocols) by characteristics. Method: Data was collected by visiting nurse from 556 elderly over 65 years in selected metropolitan areas. To evaluate the functional state of elderly in the community, I used "RAI-MDS HC; Residental Assessment Instrument Minimum Data Set-Home Care(2.0 version)" and established information exchange system among resources, by developing the data into a computer program. Results: The health problem of 'preventive health measures' was the largest(99.6%), and then 'health promotion(85.3%)', 'visual function(75.5%)', 'psychologic drug(68.9%)', 'pain(68.5%)', ‘social function(59.2%)', 'communication disorders(56.2%)', 'environmental assessment(53.2%)', 'depression & anxiety(46.9%)', 'oral health(43.4%)' followed. The number of health problems was average 10.16 in the community-dwelling elderly. Conclusion: The results suggest the need to emphasize the importance of assessment of the health problem of the elderly. We can apply it in the distribution of community resources and the development of service providing programs by figure out the health problem and resource in need for the elderly in the community.

• 여성건강간호학회지
• /
• 제5권1호
• /
• pp.133-145
• /
• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• 보건교육건강증진학회지
• /
• 제32권4호
• /
• pp.59-65
• /
• 2015

Objectives: Health screening in Korea is very active in both the public and private sector. However, primary prevention for health promotion has not been activated yet. Quaternary prevention is the prevention of unnecessary medical interventions or the prevention of overmedicalization. Methods: Data was collected after a search of the literature focusing on keyword. The curriculum guidelines for family medicine residents were collected from the homepage of the American Academy of Family Physicians. Results: This quaternary prevention is just beginning. The first step to enhance the health promotion services in the community is to identify the barriers pertaining to the delivering of health promotion activities. These barriers are related to the patient, the physician, attitudes, health promotion programs and the healthcare system. The second step is to establish new changes, such as expansion of insurance coverage, improvement of medical payment system, provision of consumer-oriented services, connection and integration of providers, and the service provider education and training. Conclusions: In order to enhance the health promotion services in the community we need to identify the barriers and to establish several changes to overcome them.

• 한국농촌간호학회지
• /
• 제2권2호
• /
• pp.91-101
• /
• 2007

Purpose: The purpose of this study was to identify health promotion services in rural areas and factors influencing this service. Method: From March to April, 2007, a structured questionnaire on services in 2006 was used to collect data from community health practitioners in all of the Primary Health Care Posts (PHCP) in North Chungchong Province. Collected data were analyzed using SPSS 12.0 Win program. Results: The most frequently offered programs were health gymnastics, walking exercise, bathing and vaccination service, and hypertension management. The main obstacles to these health services were lack of adequate space, insufficient budget, and overwork. The most frequently offered health education programs were education on hypertension, exercise, diabetes, volunteer work, and smoking cessation. The main obstacles to health education were lack of adequate space, insufficient education materials and equipment, and lack of cooperation from the citizens. Improvement and reinforcement of health promotion programs should include support of specialist, development of appropriate methods of service delivery, and education materials, and increase ease in using community resources. Conclusions: The research results show that a new model of health promotion must be developed for efficient health promotion programs in rural PHCP.

• 대한물리의학회지
• /
• 제19권1호
• /
• pp.1-10
• /
• 2024

PURPOSE: This pre-post intervention study aimed to examine the effects of a 12-week supervised modified Taekwondo exercise program on the functional fitness of community-dwelling older adults. METHODS: 10 participants (mean age: 72.3 ± 4.6 years) completed the program over a 12-week period. The intervention consisted of Taekwondo-based exercises modified for older persons. Changes to functional fitness were measured using the finger-to-nose test, functional reach test, timed up and go test, 30-second sit-to-stand test, 30-second arm curl test, Chester step test, chair sit-and-reach test, and back scratch test. Participants were assessed prior to the training and after the final training session, changes were measured using descriptive statistics and paired sample 't' tests. RESULTS: Effect sizes ranged from small to large (Cohen's d = .22 to 1.23). The exercise program was well- tolerated by participants, with a high level of engagement and no attrition for the duration of the program. Results showed significant improvements in most measures of functional fitness (p < .05) except for the back scratch test (p = .051). CONCLUSION: These findings suggest a well-designed, supervised, modified Taekwondo exercise program can significantly improve functional fitness in older adults.

• 지역사회간호학회지
• /
• 제23권1호
• /
• pp.51-62
• /
• 2012

Purpose: The purpose of this study was to identify community health nursing activities that community health practitioners perceive and their achievements in community by reviewing the community health nursing activities that community health practitioners have done for the last 30 years. Methods: This study was a qualitative study. Thirty one community health practitioners were interviewed using the focus group interview method and data were analyzed using content analysis. Data were collected from April to June in 2011. Results: Community health practitioners perceived themselves as "Community Vitalizers" and 9 categories were identified. They were 'ground to explore new nursing areas', 'assimilation to community', 'ground to establish community diagnosis', 'everyday life health management in the community', 'increased accessibility to medical services for the residents', 'enforced health practices for the residents', 'reinforced self-reliance of community', 'commitment to making a happy village' and 'mental fence of the community.' Conclusion: This study was meaningful in that it explained the unique identity of the community health practitioners and could be used as important basic materials in the process of re-establishment of the roles of Health Offices. Hereafter in-depth study on community competence reinforcement should be made to identify the roles of community health nurses.

• 한국학교ㆍ지역보건교육학회지
• /
• 제24권3호
• /
• pp.37-50
• /
• 2023

Objectives: The aim of this study was to identify factors influencing communication satisfaction between geriatric caregivers and older adults in urban-rural complex communities. The ultimate goal was to design local community educational programs and policies to enhance communication satisfaction among geriatric caregivers and improve the quality of care services for older adults. Methods: To identify factors influencing communication satisfaction between elderly caregivers and older adults, a survey titled "CCEP: Assessment of Communication Status between Elderly Care Service Providers and Recipients" was conducted from February to July 2020, focusing on rural-urban complex areas. The survey was administered based on providers of elderly healthcare services. The survey targeted 131 respondents involved in providing care services for older adults. The dependent variable of this study was the communication satisfaction reported by elderly caregivers in their interactions with the elderly. The independent variables included perceptions of older adults, factors associated with communication difficulties, and communication efforts. Additionally, gender, working environment, working experience, and the proportion of face-to-face interactions with older adults during caregiving were controlled for the hierarchical multiple regression analysis. Results: The analysis revealed that communication efforts with older adults significantly influenced communication satisfaction (β=.09, p<0.01). However, perceptions of the elderly and communication hindrance factors did not have a significant impact on communication satisfaction among geriatric caregivers. Conclusion: Effective communication between geriatric caregivers and older adults is crucial for identifying and meeting the needs and demands of caregiving services, and it plays a vital role in overall caregiving service satisfaction. To enhance communication skills and satisfaction among geriatric caregivers and ensure the appropriate fulfillment of elderly care needs in the local community, the development of community-centered, specialized health communication programs and other initiatives will be necessary in the future.

• 지역사회간호학회지
• /
• 제10권1호
• /
• pp.121-139
• /
• 1999

Persons with disabilities have increased and among others, number of them in the community is at the high proportion. But they have a difficulty in physical, psychological adjusting and they don't be offered appropriate, sufficient rehabilitation services. Therefore, Community-Based Rehabilitation Services in Health Center be needed. With these backgrounds, this study was conducted to examine factors in relation to job performance of community-based rehabilitation program in Health Centers, and the factors are characteristics of district nurses, internal factors, external-environmental factors. This study provides guidelines for effective management for rehabilitation program. Subject in this study were 122 Health Centers randomly chosen. Data were collected from September, 16, 1998 to October, 9, 1998, and the data for analyses were ones of 105 respondents. The instrument of this study was job performance of community-based rehabilitation program is modified WHO guidelines. Credibility of instruments was 0.73-0.95 in main study. The summary of results was as follows. First, the mean of job performance of com munity-based rehabilitation program was 2.33 of full score 4.00. Significant differences were not obtained on the job performance among areas. Second, stepwise multiple regression analysis revealed that the most powerful predictor to job performance was community-based health program. The number of volunteer workers, the score of cooperation with other institution, the number of visiting nurse, the number of facilities for person with disabilities are accountable factor to the job performance of community-based rehabilitation program. In conclusions, for all the people with disabilities, Health Centers are necessary to promote community-based rehabilitation program and to increase participation of community residents and to cooperate with other institution.

• 농촌의학ㆍ지역보건
• /
• 제25권2호
• /
• pp.217-230
• /
• 2000

For the longest time, our government has played an inconsiderable role in the public health services of Korea, especially as it relates to their investment. Voices have cried out against increases in national health expenditure and for more establishment of public medical facilities. In light of this, the necessity and importance of public medical facilities have come into focus amidst the recent medical crisis. When public medical facilities filled in the gap created by the suspension or closure of private hospitals and clinics as a result of this national crisis and acted as a safety net, the demand for more establishment of such facilities increased. Although patient diagnosis and treatment are the first priority of public medical facilities, they must also deal with scopes that private medical facilities do not deal with, dislike, or have difficulty with. In this respect, the closure or privatization of public hospitals to reduce their number just because of their low profits or financial burdens that must be carried by the government is to ignore their innate importance and social role; therefore, we must do all we can to block such efforts and further empower these public health facilities according to demands of the time. The improvement of public health services can be realized by redefining its goals and roles, increasing government funding, strengthening of existing public health facilities and reorganizing the public health services system. Even if public health facilities were to increase their medical services and be reinforced, they cannot take on all the services related to public health services, Therefore, in a country like ours where public health services come second to private health services in the health care system, the health of citizens can be safeguarded only when private and public facilities cooperate and private medical facilities share the social responsibilities. Only the show of interest and effort by government, politicians, health professionals, professional organizations and public can initiate the improvement that is sought.