• Title/Summary/Keyword: Comprehensive Nursing Unit

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영적간호중재가 호스피스 환자의 영적안녕과 우울에 미치는 효과

  • Song, Mi-Ok
    • Korean Journal of Hospice Care
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    • v.3 no.1
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    • pp.42-55
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    • 2003
  • Purpose: The purpose of this study was to elucidate the effects of spiritual nursing intervention on spiritual well-being and depression level of the hospice patients. Method: The subjects for this study were collected from 62 patients who were admitted in the hospice care unit from July 28, 2002 to October 31, 2002 in D city K hospital. Subjects were 31 members of the experimental group and 31 members of the control group. It was devised with a nonequivalent control group pretest-posttest design. The spiritual nursing intervention was given by using the therapeutic use of self, Scripture, prayer, Hymn and music, use of church community involvement and refer to pastors according to assessment of patients' spiritual need for 3 weeks(total 12 times and 1 hour per each intervention). Sangsoon Choi(1990) and Jungho Kang(1996)'s spiritual well-being scale, which was modified from Palautzian and Ellison(1982)'s spiritual well-being scale, was used to investigate patients' spiritual well-being. To investigate level of depression, OkHyun Song(1977)'s Depression Scale, which was modified from Zung(1965)'s Depression Inventory, was used. Data were analyzed by x2-test, t-test, Repeated measures ANOVA with SPSS/Win 10.0 program. Results: 1.The 1st hypothesis, 'total spiritual well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.28, p=0.015, Interaction: p=0.000). 2.The 1-1st sub-hypothesis, 'religious well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=12.75, p=0.001, Interaction: p=0.000). 3.The 1-2nd sub-hypothesis, 'existential well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.87, p=0.016, Interaction: p=0.000). 4.The 2nd hypothesis, 'depression level in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive the spiritual nursing intervention' was supported(F=10.45, p=0.002, Interaction: p=0.000). Conclusion: From the above results, spiritual nursing intervention was an effective program to improve spiritual well-being state and decrease depression level for the hospice patients. In the future, when the spiritual intervention, which the researcher developed, applied on nursing field, the hospice patients can have comprehensive well being including spiritual well being and peaceful dying life.

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영적간호중재가 호스피스 환자의 영적안녕과 우울에 미치는 효과

  • Song, Mi-Ok;Kim, Jeong-Nam
    • Korean Journal of Hospice Care
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    • v.4 no.2
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    • pp.9-20
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    • 2004
  • Purpose: The purpose of this study was to elucidate the effects of spiritual nursing intervention on spiritual wee-being and depression level of the hospice patients. Method: The subjects for this study were collected from 62 patients who were admitted in the hospice care unit from July 28, 2000 to October 31, 2002 in D city K hospital. Subjects were 31 members of the experimental group and 31 members of the control group. It was devised with a nonequivalent control group pretest-posttest design. The spiritual nursing intervention was given by using the therapeutic use of self, Scripture, prayer, Hymn and music, use of church community involvement and refer to pastors according to assessment of patients' spiritual need for 3 weeks(total 12 times and 1 hour per each intervention). Sangsoon Choi(1990) and Jungho Kang(1996)'s spiritual well-being scale, which was modified from Palautzian and Ellison(1982)'s spiritual well-being scale, was used to investigate patients' spiritual well-being. To investigate level of depression, OkHyun Song(1977)'s Depression Scale, which was modified from Zung(1965)'s Depression Inventory, was used. Data were analyzed by x2-test, t-test, Repeated measures ANOVA with SPSS/Win 10.0 program. Results: 1.The 1st hypothesis, 'total spiritual well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.28, p=0.015, Interaction: p=0.000). 2.The 1-1st sub-hypothesis, 'religious well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=12.75, p=0.001, Interaction: p=0.000). 3.The 1-2nd sub-hypothesis, 'existential well-being score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive the spiritual nursing intervention' was supported(F=6.87, p=0.016, Interaction: p=0.000). 4.The 2nd hypothesis, 'depression level in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive the spiritual nursing intervention' was supported(F=10.45, p=0.002, Interaction: p=0.000). Conclusion: From the above results, spiritual nursing intervention was an effective program to improve spiritual well-being state and decrease depression level for the hospice patients. In the future, when the spiritual intervention, which the researcher developed, applied on nursing field, the hospice patients can have comprehensive well being including spiritual well being and peaceful dying life.

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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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

  • 최부옥
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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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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An Analysis on the Korean Rural Health Care Delivery System (농촌의료(農村醫療)의 문제점(問題點)과 대책(對策) - 의료제도(醫療制度)를 중심(中心)으로-)

  • Song, Oh-Dal
    • Journal of agricultural medicine and community health
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    • v.2 no.1
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    • pp.30-35
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    • 1977
  • Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

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Timely Interventions can Increase Smoking Cessation Rate in Men with Ischemic Stroke

  • Lee, Min Jeong;Park, Eunjeong;Kim, Hyeon Chang;Lee, Hye Sun;Cha, Myoung-Jin;Kim, Young Dae;Heo, Ji Hoe;Nam, Hyo Suk
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.610-617
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    • 2016
  • Purpose: Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke. Methods: Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months. Results: Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was $58.25{\pm}11.23$ years and mean initial National Institutes of Health Stroke Scale score was $4.68{\pm}5.46$. The TI group showed a higher point smoking success rate compared with the CC group (p=.003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group. Conclusion: Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

A Comparative Study on the Health Care System of South and North Korea (남북한 보건의료제도의 비교)

  • Lim Gyung Soon;Kim Chung Nam;Park Kyung Min
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.182-201
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    • 2001
  • This Study has attemped to compare the health care systems of South and North Korea. There has been a wide difference in the health care System between the South and North of Korea. In this paper, I have also shown that each health care system has its own unique response to the social, political, and economic conditions of the country. Therefore the author analyzed and summarized the important difference of health care system between the South and the North of Korea as follows. 1. Compared with the Laissez-faire health care system of South Korea, North Korea has the state socialistic health care system which provide health care services to the people free of charge. And the North Korea is marking positive efforts toward the scientification and systemization of Oriental Medicine which is called Dongui-Hak in the North-on the basis of Ju-Che idea. 2. North Korea's health care system appears to be strongly geared toward extensive and preventive treatment and launched the massive sanitary propagation campaign. which have resulted in a great success. North Korea has a system of universal comprehensive care for its population. The government has a central role in planning and regulating health care. 3. The government also employs physicians, nurses, and other professionals to provide health care to patients at public expense. In North Korea, health professionals are government employees. They work for a salary and the system is funded through general taxation. 4. In the North Korea, health services area system of the cities and countre's unit is strictly conducted along with the doctor's area responsibility system. And so without referal card, patients can not use the upper-grade medical facilities. The health care delivery system of North Korea is made up of the fourth level procedue unlike South Korea. 5. General office of Oriental Medicine, Academy of Oriental Medical Science and Guidance Bureau of Oriental Medicine are established in the organization of the Department of Health in the North Korea. And nowadays much emphasis are equally placed on the Oriental Medicine as well as Western Medicine. Both South and North Korea have faced with a critical moment of developing a mutually agreeable and acceptable system of health care for the unified nation.

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A Study on improvement of curriculum in Nursing (간호학 교과과정 개선을 위한 조사 연구)

  • 김애실
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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Development of Dementia Care Model in a Community (지역사회 치매관리 모형 개발 : 광명시의 경우)

  • 배상수;김동현;우영국;오진주;민경복;이수현;이미라;이상숙;표옥정
    • Health Policy and Management
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    • v.9 no.1
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    • pp.30-71
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    • 1999
  • There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

A Study on the Attitude of the Consumers and the ″Referees″ toward the Community Health Nursing Service of a General Hospital in Rural ]Korea (일종합병원의 지역 사회보건 간호사업에 대한 지역 사회 간호써비스 수혜자 및 의뢰자의 태도 조사 연구)

  • 이정렬
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.131-138
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    • 1978
  • The change of society has brought about various health problems which have become to demand comprehensive health services not only for individuals but also for families and communities as the unit. To meet the societal needs W Hospital in a rural Korea established a Department of Community Health Nursing Services and provided nursing services to patients under a early discharge program. This study is to evaluate the community health nursing services carried out the department in general, and has following specific objectives : 1. To learn attitude of the consumers and the "referees" toward early discharge program. 2. To find out attitude toward home care and cure services. 3. To find out the consumers and the "Referees" attitude toward the 15 selected home cue and cure activities by public health nurse. 4. To investigate possibility of charging fee for the 15 selected home care and cure activities by public health nurse. Three different study population were chosen: namely the consumer, the "referee" I and II. Excluding families moved out and not able to be contacted, the total families (77) referred to the department during the study period of September 1974 - December 1975 are defined as the consumer. Thirty seven nurses among 81 nurses who have been working in W Hospital since the inception of the Community Health Nursing Service Program were randomly selected. Thirty two nurses were defined as the "referee"I, because 5 questionnaires were not able to be collected. Twenty four doctors out of 37 who have been working since the Community Health Nursing Service Program started, and who were able to contact were called as the "referee" II. Data collection method employed for the consumers was direct interviewing with preposed interview schedules, and for the "referees"questionnaire method was utilized. x$^2$test and 100-percentage were employed in analyzing the data. The study findings are follows: 1. Attitude toward early discharge: Above 85% of the consumers and the "referees" approved the early discharge: Above 85% of the consumers and the "referees" approved the early discharge program. 2. Attitude toward the home care and cure services: Above 75% of the consumers and the "referees" showed positive attitude toward the home care and cure services by public health nurses. 3. Attitude toward 15 selected home care and curative activities by public health nurses: On the average more than 50% of the consumers and the "referees" expressed an affirmative attitude to perform 15 selected home care and cure services by public health nurses. 4. Attitude toward charging fee for 15 selected home care and curative activities by public health nurses: Above 85% of the consumers thought that they would pay for the services. Only 12.8% of the consumers and 5% of the "referees" what to have the services for nothing. Based upon the findings of this study; That is, the home care and cure services to be given by public health nurse were positively responded by the consumers and the pro-fissionable, one can conclude that the services provided by the Department of Community Health Nursing Service of W Hospital have been well accepted, and that early discharge program of hospital is believed to be a means to lessen the expenses of patients from hospitalization and to promote recovery from illness. It is recommended that hospital centered cure services should be reconsidered and scrutinized to meet community health needs. NOTE : "referees" are nurses and doctors who refer the early discharged Patient to the Department of Community Health Nursing Service.

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