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Effects of Social Exclusion on Displaced Aggression: the Mediatingon Effect of Stress and Conditional Direct Effect of Social Support (사회적 배제가 전위된 공격성에 미치는 영향: 스트레스의 매개효과 및 사회적지지의 조건부 직접효과)

  • Yoonjae Noh;Sangyeon Yoon
    • Korean Journal of Culture and Social Issue
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    • v.29 no.4
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    • pp.455-476
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    • 2023
  • This study focused on the characteristics of motiveless crimes that mainly originated from interpersonal problems and were acts of revenge against innocent third parties. This study confirmed the relationship between the experience of social exclusion and displaced aggression and examined the relationship between the two variables. We sought to confirm the role of related factors such as stress and social support. For this purpose, we established and tested hypotheses about the mediatingon effect of stress and the moderated mediatingon effect of social support on the effect of social exclusion experience on displaced aggression among 353 adult males aged between 19 and 49 years. The main results are that, first, social exclusion had a positive effect on displaced aggression. Second, stress was found to partially mediate the relationship between social exclusion and displaced aggression. Third, the hypothesis that social support would moderate the mediating effect of stress was not provedvaild, but the conditional direct effect of social support was confirmed in the mediation model. In other words, social support did not affect the indirect effect mediated by stress, but appeared to moderate the direct effect between social exclusion and displaced aggression. Social exclusion's prediction of displaced aggression was significant only in the average social support group (mean) and the high group (M+1SD), and appeared to increase as the group increased. This means that in groups with high social support, displaced aggression is used as a stress control strategy, which is a different result from previous studies that found that social support plays a role in lowerings aggression. People with low levels of social support showed unexpected results in that they used displaced aggression less frequently despite their experiencinge of social exclusion. In the discussion, the social implications of these results were interpreted, and additional research ideas were proposed to specify the relationship between social exclusion and displaced aggression.

Health and quality of life for Korean people in ageing society (고령화 사회에서 한국인의 건강과 삶의 질)

  • Kyung-Hyun Suh
    • Korean Journal of Culture and Social Issue
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    • v.12 no.5_spc
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    • pp.133-147
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    • 2006
  • Korean society is rapidly becoming an ageing society. The Korean may have to live longer than did their parents. Increasing life expectancy and changing social structure, Korean people are getting interested in quality of life, and well-being is becoming a matter of concern. And, the Korean is fully aware of the importance of health for well-being or good life. This concern about health may bring about specific behaviors related to health. Although health care expenditures of Korea are currently smaller than those of other developed countries, it is continuously increasing. Large portion of increased amount of health care expenditures is to spend for disease prevention and expansion of long-term care facilities. Constructs of well-being of the Korean, not living in western culture, may be different from those of people living in western society. Health is not top-ranked to importance for quality of life in previous studies. It does not mean health isn't determinant factor for good life or well-being. Health is an essential element for well-being. It has been proved in several researches which examined poor quality of life caused by certain diseases and management of health-related quality of life. Some theories relate to health-seeking behaviors suggested the health belief or the attitude toward health, intention to do health behavior, perceived behavioral control, and self efficacy as important factors which could predict health-related behaviors. With getting older, people decline in physical and physiological functions and become vulnerable to chronic diseases. Quality of life depends on how to adjust to these changes in senescence. Social supports, especially supports from offspring, are very important to quality of life in senescence, because supports from offspring have influence on pride of the older, they may be afraid of disclose the conflict with their offspring. Avoiding self-disclosure exclude other source of social supports and harm individual's health, therefore psychological intervention is needed to. Increasing life expectancy of the Korean, Korean government has to provide numerous long-term care facilities as well as psychosocial supports. The Korean, so far, does not recognize that psychologist could render great service to promoting individual or community health and improving individual's quality of life. It is highly expected that psychologists take actively interested and involve in health related to quality of life.

Exploring the Model of Social Enterprise in Sport: Focused on Organization Form(Type) and Task (스포츠 분야 사회적기업의 모델 탐색: 조직형태 및 과제)

  • Sang-Hyun Park;Joo-Young Park
    • Journal of Industrial Convergence
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    • v.22 no.2
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    • pp.73-83
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    • 2024
  • The purpose of this study is to diagnose various problems arising around social enterprises in the sport field from the perspective of the organization and derive necessary tasks and implications. In order to achieve the purpose of the study, the study was largely divided into three stages, and the results were derived. First, the main status and characteristics of social enterprises in the sport field were examined. The current status was analyzed focusing on aspects such as background and origin, legislation and policy, organizational goals, organizational structure and procedures, and organizational characteristics. Social enterprises in the sport sector were in their early stages, and the government's social enterprise policy goal tended to focus on increasing the number of social enterprises in a short period of time through financial input. In addition, it was found that most individual companies rely on government subsidy support due to insufficient profit generation capacity. In the second stage, we focused on the situational factors that affect the functional performance of social enterprises in the sport field. As a result of reviewing the value, ideology, technology, and history of the organization, which are situational factors, it was derived that when certified as a social enterprise in the sport field and supported by the central government or local governments, political control is strong to some extent and exposure to the market is not severe. In the last third step, tasks and implications were derived to form an appropriate organization for social enterprises in the sport field. After the social enterprise ecosystem in the sport sector has been established to some extent, it is necessary to gradually move from the current "government-type" organization to the "national enterprise" organization. This is true in light of the government's limited financial level, not in the short term, but in order for the organization of social enterprises in the sports sector to survive in the long term.

Research on the Soundscape for Excavation, Preservation and Promotion of Soundscape Resources in Hongdo Island (홍도의 소리경관 자원의 발굴, 보존 및 육성을 위한 사운드스케이프 조사연구)

  • Han, Myung-Ho;Oh, Yang-Ki;Roh, Tae-Hak
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.4
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    • pp.343-355
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    • 2009
  • In order to restore the identity of sound environment and expand the sound culture of a region, the purpose of this study are to excavate the resources of soundscape and find out the plans for the preservation and promotion of soundscape resources peculiar to the region. For this purpose, this research is conducted through an interview survey of residents and an observation survey using listening walk in Hongdo, one of the southwesten island of Korea. The results of survey confirm that there are so many sounds to hear around Hongdo island, those are, natural sounds such as the song of the birds, the roar of the waves, the whistling sounds, the shriek of the seagulls, and the pebbles sounds washed away by the waves, and artificial sounds such as the steam-whistle signals, the ship's broadcasts, the voice of tourists, the sounds of church bells, lighthouse sirens etc. The results suggest that it is necessary to consider several ways for restoration of an unique soundscape in Hongdo island, those are, improvement for efficient management of a ship's broadcasts in public areas, removal of a ferry in Hongdo swimming beach, management of Dangsanje (a religious service), preservation of a lighthouse siren and a foghorn, restoration and improvement of underground stream, management and control of public fish market, restoration of brooklet, management of cooperative system for a fish market, restoration of PoongO-Gut (a ritual for a large harvest) and a skate festival, management of a Hongdo sports meeting, sound quality modification of a boat whistle, restoration of orientalia such as a funeral bier, ecosystem preservation activity of the shore and ocean, and promotion of amenity for fascination and vitality in a rural community. Also, a sound map is drawn up for many tourists so as to realize the importance of sound environment and identity of soundscape and to gain their experience at first hand in Hongdo island.

A study on Convergence Weapon Systems of Self propelled Mobile Mines and Supercavitating Rocket Torpedoes (자항 기뢰와 초공동 어뢰의 융복합 무기체계 연구)

  • Lee, Eunsu;Shin, Jin
    • Maritime Security
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    • v.7 no.1
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    • pp.31-60
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    • 2023
  • This study proposes a new convergence weapon system that combines the covert placement and detection abilities of a self-propelled mobile mine with the rapid tracking and attack abilities of supercavitating rocket torpedoes. This innovative system has been designed to counter North Korea's new underwater weapon, 'Haeil'. The concept behind this convergence weapon system is to maximize the strengths and minimize the weaknesses of each weapon type. Self-propelled mobile mines, typically placed discreetly on the seabed or in the water, are designed to explode when a vessel or submarine passes near them. They are generally used to defend or control specific areas, like traditional sea mines, and can effectively limit enemy movement and guide them in a desired direction. The advantage that self-propelled mines have over traditional sea mines is their ability to move independently, ensuring the survivability of the platform responsible for placing the sea mines. This allows the mines to be discreetly placed even deeper into enemy lines, significantly reducing the time and cost of mine placement while ensuring the safety of the deployed platforms. However, to cause substantial damage to a target, the mine needs to detonate when the target is very close - typically within a few yards. This makes the timing of the explosion crucial. On the other hand, supercavitating rocket torpedoes are capable of traveling at groundbreaking speeds, many times faster than conventional torpedoes. This rapid movement leaves little room for the target to evade, a significant advantage. However, this comes with notable drawbacks - short range, high noise levels, and guidance issues. The high noise levels and short range is a serious disadvantage that can expose the platform that launched the torpedo. This research proposes the use of a convergence weapon system that leverages the strengths of both weapons while compensating for their weaknesses. This strategy can overcome the limitations of traditional underwater kill-chains, offering swift and precise responses. By adapting the weapon acquisition criteria from the Defense force development Service Order, the effectiveness of the proposed system was independently analyzed and proven in terms of underwater defense sustainability, survivability, and cost-efficiency. Furthermore, the utility of this system was demonstrated through simulated scenarios, revealing its potential to play a critical role in future underwater kill-chain scenarios. However, realizing this system presents significant technical challenges and requires further research.

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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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Consumer's Negative Brand Rumor Acceptance and Rumor Diffusion (소비자의 부정적 브랜드 루머의 수용과 확산)

  • Lee, Won-jun;Lee, Han-Suk
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.65-96
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    • 2012
  • Brand has received much attention from considerable marketing research. When consumers consume product or services, they are exposed to a lot of brand related stimuli. These contain brand personality, brand experience, brand identity, brand communications and so on. A special kind of new crisis occasionally confronting companies' brand management today is the brand related rumor. An important influence on consumers' purchase decision making is the word-of-mouth spread by other consumers and most decisions are influenced by other's recommendations. In light of this influence, firms have reasonable reason to study and understand consumer-to-consumer communication such as brand rumor. The importance of brand rumor to marketers is increasing as the number of internet user and SNS(social network service) site grows. Due to the development of internet technology, people can spread rumors without the limitation of time, space and place. However relatively few studies have been published in marketing journals and little is known about brand rumors in the marketplace. The study of rumor has a long history in all major social science. But very few studies have dealt with the antecedents and consequences of any kind of brand rumor. Rumor has been generally described as a story or statement in general circulation without proper confirmation or certainty as to fact. And it also can be defined as an unconfirmed proposition, passed along from people to people. Rosnow(1991) claimed that rumors were transmitted because people needed to explain ambiguous and uncertain events and talking about them reduced associated anxiety. Especially negative rumors are believed to have the potential to devastate a company's reputation and relations with customers. From the perspective of marketer, negative rumors are considered harmful and extremely difficult to control in general. It is becoming a threat to a company's sustainability and sometimes leads to negative brand image and loss of customers. Thus there is a growing concern that these negative rumors can damage brands' reputations and lead them to financial disaster too. In this study we aimed to distinguish antecedents of brand rumor transmission and investigate the effects of brand rumor characteristics on rumor spread intention. We also found key components in personal acceptance of brand rumor. In contextualist perspective, we tried to unify the traditional psychological and sociological views. In this unified research approach we defined brand rumor's characteristics based on five major variables that had been found to influence the process of rumor spread intention. The five factors of usefulness, source credibility, message credibility, worry, and vividness, encompass multi level elements of brand rumor. We also selected product involvement as a control variable. To perform the empirical research, imaginary Korean 'Kimch' brand and related contamination rumor was created and proposed. Questionnaires were collected from 178 Korean samples. Data were collected from college students who have been experienced the focal product. College students were regarded as good subjects because they have a tendency to express their opinions in detail. PLS(partial least square) method was adopted to analyze the relations between variables in the equation model. The most widely adopted causal modeling method is LISREL. However it is poorly suited to deal with relatively small data samples and can yield not proper solutions in some cases. PLS has been developed to avoid some of these limitations and provide more reliable results. To test the reliability using SPSS 16 s/w, Cronbach alpha was examined and all the values were appropriate showing alpha values between .802 and .953. Subsequently, confirmatory factor analysis was conducted successfully. And structural equation modeling has been used to analyze the research model using smartPLS(ver. 2.0) s/w. Overall, R2 of adoption of rumor is .476 and R2 of intention of rumor transmission is .218. The overall model showed a satisfactory fit. The empirical results can be summarized as follows. According to the results, the variables of brand rumor characteristic such as source credibility, message credibility, worry, and vividness affect argument strength of rumor. And argument strength of rumor also affects rumor intention. On the other hand, the relationship between perceived usefulness and argument strength of rumor is not significant. The moderating effect of product involvement on the relations between argument strength of rumor and rumor W.O.M intention is not supported neither. Consequently this study suggests some managerial and academic implications. We consider some implications for corporate crisis management planning, PR and brand management. This results show marketers that rumor is a critical factor for managing strong brand assets. Also for researchers, brand rumor should become an important thesis of their interests to understand the relationship between consumer and brand. Recently many brand managers and marketers have focused on the short-term view. They just focused on strengthen the positive brand image. According to this study we suggested that effective brand management requires managing negative brand rumors with a long-term view of marketing decisions.

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Taxonomical Classification and Genesis of Jeju Series in Jeju Island (제주도 토양인 제주통의 분류 및 생성)

  • Song, Kwan-Cheol;Hyun, Byung-Geun;Moon, Kyung-Hwan;Jeon, Seung-Jong;Lim, Han-Cheol;Lee, Shin-Chan
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.2
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    • pp.230-236
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    • 2010
  • Jeju Island is a volanic island which is located about 96 km south of Korean Peninsula. Volcanic ejecta, and volcaniclastic materials are widespread as soil parent materials throughout the island. Soils on the island have the characteristics of typical volcanic ash soils. This study was conducted to reclassify Jeju series based on the second edition of Soil Taxonomy and to discuss the formation of Jeju series in Jeju Island. Morphological properties of typifying pedon of Jeju series were investigated, and physico-chemical properties were analyzed according to Soil survey laboratory methods manual. The typifying pedon has dark brown (10YR 3/3) silt clay loam A horizon (0~22 cm), strong brown (7.5YR 4/6) silty clay BAt horizon (22~43 cm), brown (7.5YR 4/4) silty clay Bt1 horizon (43~80 cm), brown (7.5YR 4/6) silty clay loamBt2 horizon (80~105 cm), and brown (10YR 5/4) silty clay loam Bt3 horizon (105~150 cm). It is developed in elevated lava plain, and are derived from basalt, and pyroclastic materials. The typifying pedon contains 1.3~2.1% oxalate extractable (Al + 1/2 Fe), less than 85%phosphate retention, and higher bulk density than 0.90 Mg $m^{-3}$. That can not be classified as Andisol. But it has an argillic horizon from a depth of 22 to 150 cm, and a base saturation (sum of cations) of less than 35% at 125 cm below the upper boundary of the argillic horizon. That can be classified as Ultisol, not as Andisol. Its has 0.9% or more organic carbon in the upper 15 cm of the argillic horizon, and can be classified as Humult. It dose not have fragipan, kandic horizon, sombric horizon, plinthite, etc. in the given depths, and key out as Haplohumult. A hoizon (0~22 cm) has a fine-earth fraction with both a bulk density of 1.0 Mg $cm^{-3}$ or less, and Al plus 1/2 Fe percentages (by ammonium oxalate) totaling more than 1.0. Thus, it keys out as Andic Haplohumult. It has 35% or more clay at the particle-size control section, and has thermic soil temperature regime. Jeju series can be classified as fine, mixed, themic family of Andic Haplohumults, not as ashy, thermic family of Typic Hapludands. In the western, and northern coastal areas which have a relatively dry climate in Jeju Island, non Andisols are widely distributed. Mean annual precipitation increase 110 mm, and mean annual temperature decrease $0.8^{\circ}C$ with increasing elevation of 100m. In the western, and northern mid-mountaineous areas Andisols, and non Andisols are distributed simultaneously. Jeju series distributed mainly in the western and northern mid-mountaineous areas are developed as Ultisols with Andic subgroup.

A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement (한방건강보험 약제 투약 실태 및 활성화 방안 연구)

  • Kwon, Yong-Chan;Yoo, Wang-Keun;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.27 no.2
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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