• 한국노년학
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• v.39 no.2
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• pp.305-323
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• 2019

In recognition of the increasing social attention paid to the notion of how to die well, this study explored what it is that middle-aged and older Koreans think of as "dying well." Specifically, it was aimed at classifying the perceptions people middle-aged and older have regarding dying well. To this end, we used data from the National Survey on Well-Dying, which was conducted in 2018 by the Korea Institute for Health and Social Affairs, and employed Latent Class Analysis. The demographic characteristics of each of the classified subgroups were identified through technical statistics. The types identified were multilayered depending on the imminence of death, perspectives of the last stages before dying, and the meaning of death in the context of social relationships. These types differed according to gender and subjective health conditions. Based on our findings in this study, we put forward policy suggestions about awareness improvement of personal and social levels, promoting on comprehensive death preparation, providing a system to reduce the cost of medical and nursing expense at the end of one's life, promoting of the right to self-determination regarding death, raising social attention to groups that are least prepared for dying well.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.411-422
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• 1997

The purpose of this study is twofold : (i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception : and (ii) to comprehensive investigate socio-cultural back-grounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing with Taegyo, and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August.1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis. taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's (1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse." "physical check-up," "physical good health, " "praying, " and so on. 2. When the marriod couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are : "having sex at specific time, " "having sex in nice place." "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical. psychological, emotionmental. environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music. " "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things." "to eat food in good shape, " "to avoid drugs," "eating Korean herbal medicine." "sexual abstinence," "to avoid dangerous places," "to keep emotional tranquility," "moderate exercises and rest." "leading a pure life." "praying." "being aware of their words and behavior." "for the couple to keep a good relationship." "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition. the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the mass media. As the husband -and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, her family support, and her neighbor's support. The mass media factors include the broadcasting media, books specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits are leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the development of the unborn child's intelligence and talents, the expectation of the unborn child's good features. shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.

• Korean Journal of Occupational Health Nursing
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• v.4
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Korean Journal of Social Welfare
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• v.59 no.4
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• pp.35-61
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• 2007

This study examines the determinants of employment and wage of new college graduates by using Youth Panel Data(2003-2005) of the Work Information Center, and seeks assignments for mitigating unemployment and wage disparities of new college graduates. Results are summarized as follows. First, an analysis of the determinants of employment shows that the Kyunggi Inchon district in school locations, higher school records, and qualification certificates positively affect the employment rate, while the private college group in the non-capital area negatively affects the employment rate. Second, an analysis of determinants of standard employment demonstrates that the Kyunggi Inchon district in school locations, higher school records, qualification certificates, and the major group of medical science, pharmacy, nursing science and health science, and the major group of education positively affect the employment rate, while the private college group in the non-capital area, the junior college groups in the capital and non-capital areas negatively affect the employment rate. Third, an analysis of determinants of nonstandard employment shows that the junior college graduation in scholarly attainments, the junior college groups in the capital and non-capital areas positively affect the employment rate, while the private college group in the non-capital area negatively affects the employment rate. Fourth, an analysis of the determinants of wages demonstrates that male in sex, the older in ages, the major group of medical science, pharmacy, nursing science and health science, and the major group of education positively affect the wages, while nonstandard employment, Kyunggi Inchon and Cholla districts in school locations negatively affect the wages. These results suggest several implications. First, college education should be reformed to cultivate professional manpower who are required by industries. Second, alternative measures to mitigate sex discrimination in labor markets should be prepared. Third, the process of attaining qualification certificates should be reformed in order that it is actually connected to the abilities of work performances and the improvement of productivity. Fourth, a locally balanced development must be realized through the decentralization of industries. Fifth a systematic and comprehensive program need to be prepared to promote the employment of new college graduates.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.193-201
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• 2010

Early childhood caries (ECC) is a comprehensive terminology that includes nursing bottle caries and rampant dental caries occurred in infants and children. In previous studies, ECC was thought to affect body growth of children negatively. The purpose of this study was to evaluate the effect of ECC on body growth of children in respect of their chronologic age and degree of dental caries. Height and body weight were used as means for physical growth measurements. Children, who visited the pediatric department of Yonsei University Dental Hospital, received oral and physical examinations, and they were divided into the control and ECC groups. Then, each group was subdivided according to their age and gender. Two-sample T test was used to compare the mean height and body weight of the control and ECC groups, and Likelihood Ratio Chi-square test was used to compare their growth percentile distribution. When the mean height and weight were compared, there was a common tendency observed even though statistical significance was not found in all cases. Before the age of 3-4, the mean height and weight tended to be greater in the ECC groups compared to the control groups, whereas after the age of 3-4, the mean height and weight of the ECC group tended to be less compared to the control group. In addition, in groups with age equal or greater than 3-4, which presented significant difference in height and body weight, the percentage of children showing less than 3 percentile growth was greater in the ECC group than the control group. These results imply the negative effects of the ECC on physical growth of the infants and children, and its effects on physical growth may present different characteristics according to chronologic age of the patients.

• Journal of the Korean Institute of Landscape Architecture
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• v.40 no.4
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• pp.36-50
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• 2012

This study was carried out to find contradiction factors on laws for children's activity spaces and facilities and to suggest the rational options to control and manage those spaces and facilities by environmental and landscape planning methods. The results of this study are as follows: 1. The major laws related to the environmental safety for children's activity spaces are "Environmental Health Act (ERA)" for managing the environmental safety of children's activity spaces; "Safety Supervision Law of Children's Play Facilities(SSLCPF)" for the inspection and management for safety of children's play facilities; "Quality Management and Industrial Products Safety Management Law(QMIPSML)" for managing safety certification on children's play equipments. 2. The interior space such as "living room" by the Children's Welfare Law(CWL), "Children Park" by the Act on Urban Parks and Green Spaces(AUPGS), "classroom" on private educational institutes by the Act on Establishment and Operation Private Lesson and Training(AEOPLT) and "nursing room" of child care center smaller than $430m^2$ are needed to be managed as an activity space. 3. In order to reduce industrial burden in the production, establishment, construction, and operation and to minimize unwilling extra burden in the administration effort due to legally double regulate, it is necessary to mitigate the inspections on the equipment certificate from QMIPSML and overlapped or different factors and standards must be unified. With this study, the landscape domain could he enlarged from producing, import of play equipment and establishment, construction and operation of play facilities for a comprehensive range of activity spaces, and the landscape industry such as engineering industry, academic research, management, etc.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.15-29
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• 2003

Objectives: This study was done to find out fatigue and self-reported physical symptoms of Vinylhouse farmers. The results of this study could be used as a basic data to develop health promotion program for Vinylhouse farmers who are suffering from fatigue and physical symptoms. Methods: The 166 respondents, who were working in Vinylhouse and were living in a remoted area where the primary health post located, were participated in this study. Thirty: 30 items of self-reported fatigue scale was used to evaluate the farmers fatigue level which made by Japanese industrial and hygenic association(1988). Twenty four: 24 items of index used by researcher for self-reported physical symptoms was from Lee In Bae's(1999) modified Index which was originated from Cornell Medical Index(1949). Another questionnaires used in this study were developed by researcher through related documents. Results: The results of this study were as follows; Fatigue scores were high in accordance with women(t=-2.212, p<0.05), worse recognized health state(F=20.610, p<.001), lack of sleeping hours(F=3.937, p<0.05), eat irregularly(t=-3.883, p<0.001), don't take a bath after application of chemical(t=-2.950, p<0.01), working time per a day(F=5.633, p<0.01) & working time per a day in Vinylhouse(F=5.247, p<0.01) were long. Subjective physical symptoms were high in accordance with women(t=-3.176, p<0.01), worse recognized health state(F=35.335, p<0.001), and low education(F=3.467, p<0.05). eat irregularly(t=-3.384, p<0.01), alcohol drinking(t=-2.389, p<0.05). When farmers don't take a bath after application of chemical show high(t=-3.188, p<0.01). As a result, the factors affecting to Vinylhouse worker's health were irregular diet habit, scarce exercise, lack of proper rest, symptoms oriented from Vinylhouse work in contaminated environment with high temperature and humidity. Conclusions: Based on this study, health promotion program is necessary for Vinylhouse workers. Also, the development of continuously practical strategy of healthy life style including exercise and comprehensive health promotion program considered the country's social and cultural background are needed.