• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.630-641
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• 2014

Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.

• Korean Journal of Social Welfare Studies
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• v.45 no.2
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• pp.99-122
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• 2014

The purpose of this study is to examine how providing care to grandchildren and the continuity of care affects the grandparents' perception on old-age support. Specifically, in this study, providing care is divided into three continuous types: did not provide care, provided care at one point in time and provided care at two points in time. This is done to investigate how the duration of providing care influences the perception on old-age support. The results show that grandparents providing care to their grandchildren prefer to reside with their own children in the future more often than those who do not provide care to their grandchildren. Furthermore, grandparents providing care to their grandchildren during two-time points and grandparents providing care during one-time point prefer to reside with their adult children in the future more than grandparents providing care not once during two-time points. Interestingly, grandparents who provide care to grandchildren during two-time points prefer to reside with their children in the future more frequently than grandparents providing care during just one-time point. These results suggest it is likely that grandparents recognize providing care to their grandchildren as an insurance in care and support for themselves in the future. Additionally, these results suggest that the family plays an efficient and flexible role to meet needs of family members through a reciprocal relationship in Korean society where the public sector is weak. These findings have suggested theoretical implications.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.148-158
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• 2001

Purpose: This study is to investigate the attitudes on the Home Health Care among the physicians and nurses in P University. Method: Data were gathered from 71 physicians and 264 nurses. working at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and Fisher exact test. Results: 1) As to the previous information about home health care program, those who have been familiar to it were 100% of physicians, and 99.6% of nurses, and 39% of the physicians and 66.1% of the nurses. were found to have responded with right answers, 2) As to the acceptance of the home health care program, 87% of physicians and 98.5% of nurses were found to be positive and there showed a significant difference(p= .019), 3) The main reasons for accepting the system were: the alleviation of the family burden of time, the maintenance of continuity of care, and the reasons for opposing the system were incomplete legal assurance. the possibility of providing illegal medical services. 4) The physician's intention rate of patient referrals to home care program reveled 49.2%. 5) According to the services related to Home Health Care. the orders of acceptance rates were medical tests related services (77.8%, 92%); therapeutic nursing interventions(69.0%, 88.2%): and services for medication(68.3%, 82.5%) among physicians and nurses. respectively. Conclusion: For the stabilization and successful implementation of home health care system. it should be accompanied with education for physicians about home care. setting specific laws and regulations for home care. legal assurance of home care business. outcome research for home care recipients. and support systems of hospital administration.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.156-167
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• 2000

Background: Emphasis in healthcare during the 1990s has been to provide both optimal wellness and function with quality in a Cost-effective manner. Critical pathway was developed to meet the need to guide clients along the continunm of care and to achieve continuity of care. The purpose of this study is to review and analyze articles related to the critical pathway that had developed and applied in Korea and abroad from 1995 to 1999. Methods: Total 39 studies were analyzed in terms of group of application, need of development, horizontal axis: time frame, vertical axis : items of care, task force team, identification of preliminary critical pathway, validation of preliminary critical pathway, types of final critical pathway, a person who coordinates and effects on critical pathway. Results: In the aspect of group of application, there were various diseases in the overseas than in Korea. In domestic and overseas, the horizontal axis included mainly the time from the start of hospitalization to discharge and vertical axis of the critical pathway included commonly the following nine items : tests, diet, medications, consultations, activity, assessments, treatments, education, discharge planning. Preliminary critical pathway was mainly drawn up through chart review in both. Types of final critical pathway were mostly for medical team use in Korea and were for medical team and patient use in abroad. A person who coordinates critical pathway was mostly nurse in abroad. There was positive effects on critical pathway in both. Conclusion: Staff education and information about critical pathway are needed to use it effectively.

• The Journal of Korean Medical History
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• v.34 no.2
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• pp.1-10
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• 2021

During the Joseon Dynasty, Jeju had a unique aspect that differentiated it from other regions in terms of their medical system, such as the exclusive deployment of shimyak dispatched to Gamyeong and Barracks units due to the uniqueness of being an island. This study uses various historical sources to verify that these differences existed throughout the medical system and procedures of Jeju in the late Joseon Dynasty. The following significant conclusions were drawn: 1) Looking at the work and characters of Jejushimyak reveals the inherent limitations of Jeju medical care in the Joseon Dynasty. Compared to other regions' shimyak, Jejushimyak had two limitations: it was difficult to engage in only medicine and the quality of medical doctors declined due to the avoidance of major medical doctors' households. 2) The establishment of public health care in Jeju through Medical Cadets failed. Jeju medical science obviously played an essential role in public health care in the early 18th century. However, there was no continuity in the garden, etc. Hyangri, who was in charge of Medical Cadets, was in charge of various fragrances as needed. Thus expertise in medicine was lacking. 3) The cultivated herbs of Jeju's herb field show the failure to supply herbs for institutional medicine. It was impossible to supply enough herbs to implement institutional medicine in Jeju. In that case, it would have been necessary to discover alternative local herbs or to bring them in from outside, but there was barely any such effort. In conclusion, in the late Joseon Dynasty, Jeju failed to establish a foundation for centrally administered institutional medicine. There was a lack of all the entities that provided medical care and herbs that could be used for medical care. The reason that Jeju continued to follow traditional shaman medicine in the late Joseon Dynasty was because there was no other alternative.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.72-111
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• 1996

Background: Group occupational health program by non-for-profit agency, started five years ago, for management of health problems in small and medium sized industries, is one of the measures to cope with limited human and financial resources in occupational health. The program has been rapidly expanding to include 54 participating institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. Objectives : The aim of this study are to develop and apply criteria to assess quality of newly developed Korean group occupational health program. Methods : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, we included followings as core elements of sound occupational health program; accessibility, continuity, intersectoral collaboration, comprehensiveness, community participation, technical quality, adequacy, focus on preventive services, acceptability, and workers' satisfaction. Again we divided each elements into five major components of national health system infrastructures developed by World Health Organization; development of health resources organized arrangement or resources, delivery of health care, economic support, and management. In turn, we categorized each component into input, process and outcome aspects. After discussions in expert panel, several criteria were selected for evaluation of program. The criteria were modified according to each group of interviewees. Results: We developed five sets of questionnaire that evaluate the quality of 'Group occupational health program'. Conclusion : The refining of the measurement tool and the continuing evaluation process for the 'Group occupational health institute' should be done further.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.26-43
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• 2019

Purpose:The objective of this study was to identify the conceptual constructs of patient centeredness from the perspective of patients and family members in Korea, and to compare them with those included in the Picker Institute framework. Methods: Two focus group discussions were conducted. Each focus group consisted of six participants who had experienced being either a patient or a caregiver. We carried out a thematic analysis, and then compared the contents of our focus group discussions with the components of patient-centered care outlined by the Picker Institute. Results: Six conceptual constructs of patient centeredness emerged from the focus group discussions. Five of these overlapped with those outlined by the Picker Institute: 1)respect for patients' values, preferences, and needs, 2) coordination and integration of care, 3) information, communication, and education, 4) physical comfort, and 5) emotional support and alleviation for fear and anxiety. A new component that was not mentioned in the Picker Institute framework emerged from this study: "ease of making a complaint." Currently, "involvement of family and friends" and "continuity and transition" were not prominent components of patient centeredness according to our focus group discussions. Conclusions: This study presents the conceptual constructs of patient centeredness, five of which overlap with those outlined by the Picker Institute, and provides a qualitative basis of the patient experience survey currently being implemented by the Health Insurance Review & Assessment Service in Korea.

• Korean Journal of Human Ecology
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• v.20 no.5
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• pp.897-915
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• 2011

The purpose of this study was to investigate the actual conditions and characteristics of weekly and daily child care programs for infants, to provide a basis for the improvement of infant care quality. Weekly and daily curricula of 18 classes for one and two-year-olds classes (9 for each ages) from childcare centers in D city were collected from Nov. 2009 to February 2010. The results are as following: first, classes for one-year-olds plan 6-25 activities and classes for two-year-olds plan 12-30 activities weekly, with differences in the number of weekly activities according to the childcare centers. The number of weekly activities should be planned considering infants' interest as well as educational continuity of the activities. Second, the investigation of daily activities showed that the routine activities planned for one-year-olds were for total of 310-600 minutes and for two-year-olds 310-540 minutes. Among these, on average of 66% of the time was planned for everyday life such as eating and napping. The rest of time was dedicated to indoor and outdoor free play. However a few centers allocated more time for group activities according to subjects compared to free play. A curriculum composed of group activities ignoring infants' individual developmental differences should not be encouraged. Last, the results of cluster analyses on weekly and daily curricula in terms of the number of activities and time, duration, number of group activities and time showed that curricula for infants could be characterized into two types: "free play" and "group activity" curricula.

• Journal of Home Health Care Nursing
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• v.6
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• pp.66-77
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• 1999

The purpose of this study was to find the effects of an educational program for primiparas on maternal confidence and continuity of breastfeeding. The subjects of this study were the healthy mothers, and the healthy infants whose weight was more than 2.500gm and gestational age was more than 37 weeks. The final targets were thirty seven mothers-19 of intervention group and 18 of control group. Data were collected from 15th of March to 3rd of September, 1999. To the intervention group, education on infant care and breast feeding were provided before discharge. And that, telephone advice was provided within one week after discharge, and at 2 months postpartum. And that, reeducation and counsel were provided at one month and three months postpartum by home-visiting care for the intervention group. For the control group. home visiting was also conducted only for data collection. Data were analyzed by chi-square test and t-test. The results were as follows: 1. The maternal confidence of the experimental group was higher than that of control group at one month postpartum. but the difference of confidence of these two groups were not significant at three months postpartum. 2. For both of experimental and control groups, maternal confidence significantly increased at three months postpartum than one month postpartum. 3. The rate of breastfeeding of the experimental group was higher than that of control group at one month and two months postpartum (p=.050, p=.049). But the difference was not significant at three months, although experimental group continued breastfeeding more(47.4%) than control group(27.8%). In conclusion, educational program for primiparas of this study was effective in the promotion of maternal confidence and breastfeeding.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.168-179
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• 2011

Purpose: The purpose of this study was to identify level of recognition of the importance, satisfaction and contribution of APNs' role by physicians, nurses, and advanced practice nurses. Method: Perceived importance and satisfaction were measured with a 23-item questionnaire on APN role with 5 subcategories. APNs' contribution was investigated using a 13-item outcome questionnaire developed by the researchers. Between August 15 and October 31, 2009, the researchers collected data from 68 physicians, 265 nurses, and 23 APNs all working in a single tertiary hospital. Data were analyzed using descriptive statistics, Kruskal-Wallis Test with Bonferroni's Correction and scatter plot. Result: The importance (3.24~3.39, 4 point scale), satisfaction (3.02~3.13, 4 point scale), and contribution of APNs' role (3.39~4.12, 5 point scale) were well recognized by the health care professionals. All the three health care professional groups rated APNs' contribution high in medical service management, continuity of care, patient accessibility, improvement in patient satisfaction, and patient and family education. 'Importance-Satisfaction Analysis' showed that patient data management by APNs needed greater effort. Conclusions: The findings show that the importance, satisfaction, contribution of APNs' role are recognized, and indicate a need for further development of APNs' role through efforts to overcome the gaps identified through this research.