• Title/Summary/Keyword: Counseling need

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A Case Analysis of Home Health Care for Cesarean Postpartum Women and Their Newborns (제왕절개분만 산욕부와 신생아의 가정간호 사례분석)

  • 김혜숙;최연순;전은미
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.696-705
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    • 1994
  • This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

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The Relationship between Childhood Trauma Experience and Parent-Adolescent Reports of Problem Behavior : Comparison of Delinquent and General Adolescent (아동기 외상 경험과 문제행동에 대한 청소년 자신과 부모 평가 간의 관계 : 비행청소년과 일반청소년 비교)

  • Yu, Jaehak;Seo, Min-Jae;Park, Jisun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.1
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    • pp.36-43
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    • 2013
  • Objectives : The aim of this study was to investigate correlation of childhood trauma experience and parent-adolescents' assessment reports on problem behavior through comparison of delinquent and general adolescents. Methods : First, delinquent adolescents and general adolescents were asked to complete the Childhood Trauma Questionnaire (CTQ). Then, 71 pairs of delinquent adolescents and their parents and 133 pairs of general adolescents and their parents were asked to complete the Korean Youth Self-Report (K-YSR) and the Korean Child Behavior Checklist (K-CBCL). Finally, responses from 410 people were used for the analysis. Results : First, childhood trauma experience score was significantly higher for delinquent adolescents, compared to general adolescents. Second, t-test showed a greater difference between K-YRS and K-CBCL for general adolescents than for delinquent adolescents. Third, in the case of delinquent adolescents, the correlation analysis of K-YSR filled out by adolescents and K-CBCL filled out by parents showed significant correlation in certain areas, including social immaturity, delinquent behaviors, internalization issues, and externalization issues. On the other hand, the correlation analysis of K-YSR and K-CBCL of general adolescents showed significant correlation in all sub-categories. Fourth, the correlation analysis of delinquent adolescents' CTQ and K-YSR showed minimal yet significant correlation in social adaptation, withdrawing, depression/anxiety, and delinquent/aggressive behaviors, however, no correlation was observed between CTQ and K-CBCL. The correlation analysis of general adolescents' CTQ and K-YSR, and CTQ and K-CBCL showed significant correlation in all sub-categories, although the degree of correlation varied. Conclusion : Delinquent adolescents had more childhood traumatic experiences. However, general adolescents' childhood traumatic experiences showed minimal yet significant correlation with various adaptation indicators and their parents responded in a similar way, indicating that general adolescents with childhood traumatic experiences need close care and attention even if they have not shown prominent delinquent behaviors.

Elderly Residents' Behavior Problems as Experienced by Volunteers Working in Low-Income Welfare Facilities (자원봉사자가 경험한 저소득층 복지시설 거주노인의 문제행동)

  • Lee, In-Soo
    • Journal of Families and Better Life
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    • v.25 no.1 s.85
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    • pp.127-144
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    • 2007
  • This study was conducted for the purpose of analyzing volunteer workers' perceptions of and attitudes toward the behavior problems of the elderly residents after caring for the residents voluntarily at low-income nursing homes. Eleven male and female volunteers ranging from age 19 to 52 were asked how they felt about the elderly residents' behavior problems and what kind of behavioral problems they had experienced after doing volunteer works in the three chosen facilities. In particular, they were expected to explain what emotional changes they experienced during their volunteer service. In this study, it was observed that most of the elderly subjects experienced three categories of behavior problems: habitual, repetitious and unreasonable activities caused by the elderly residents' life span backgrounds, unexpected and/or abrupt behaviors resulting from gradual cognitive impairments, and physiological, awkward activities caused from gradual senility. The volunteers tend to believe that the elderly residents are naturally expected to act positively, since they have been provided with well- planned, regular care services such as bathing, counseling, activity programs, and religious guidances. On the other hand, some respondents stated that their experiences at the nursing homes caused them to form negative images of the elderly; they feel that the elderly are not helpful for giving advices on critical decisions, guiding and encouraging their daily lives, and offering any positive influences toward their own lives. Rather, they find themselves getting too much stressed as a result of their intimate contacts with demented or senile residents. Overall, in this study, it is proposed that education for confronting sudden abrupt behavior problems should be intensified more for female volunteers, since they tend to be more susceptible to emotional harassment resulting from the problem behaviors. It is also proposed that young volunteers who have not been systematically trained for confronting aggressive behaviors need to be separately assigned their roles in order to minimize the potential of confronting unseemly situations resulting from male residents whose mental health has deteriorated. Furthermore, it is also suggested that the combination of leisure-related activities for healthy residents and stressful intimate services for the frail residents be systematically planned and implanted for the volunteer program so that the volunteers can lessen the chances of suddenly finding themselves confronted with extremely abrupt agitations.

Results of Public Awareness Survey of Panic Disorder at the 2014 Mental Health Exposition in Seoul (2014년 정신건강박람회 공황장애 인식도 조사)

  • Rho, Seung Sun;Huh, Hyu Jung;Chae, Jeong Ho;Kim, Daeho;Lee, Dong-Woo;Seo, Ho Jun
    • Anxiety and mood
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    • v.10 no.2
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    • pp.176-181
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    • 2014
  • Objective : Despite high prevalence and effective treatments of panic disorder, lots of patients are not properly treated due to lack of awareness of the disorder. This study summarizes and presents the results from Public Awareness Survey of Panic Disorder during the Mental Health Exposition held in Seoul in April, 2014. Methods : A total of 401 participants who visited the booth of the Korean Academy of Anxiety Disorder agreed and completed the survey. The questionnaires comprised of three sections; first, after given a case of patient with panic disorder, participants were asked to choose a diagnosis and treatment options. Second, participants were asked to differentiate the symptoms of panic disorder from those of other mental disorders and answer where they acquired the knowledge of the disorder. Third, visual analogue scales were used to get more detailed information for several issues about panic disorder. The incidence and ratio for each question were provided and compared. Results : Among the participants, 78% reported a patient within the case need treatment, and 30% accurately recognized it was panic disorder. As for treatment needed, 40% selected psychotherapy by psychiatrists, 28% chose counseling by psychologist, 23% said that they can overcome it by self-care. Only 2% of participants selected the pharmacotherapy as treatment needed. Approximately 40% of participants have encountered information about the disorder from gossips of celebrities, 32% from mass-media, and merely 6% from medical professionals. About 80% of participants could discriminate the symptom of panic disorder from those of depression, schizophrenia, or generalized anxiety disorder. Conclusion : Our results suggest that substantial proportions of participants have the awareness of panic disorder, while as for treatment they were strongly biased against pharmacologic treatments. Most of their source of the awareness was not relied upon professional information. Efforts for giving correct information and increasing public awareness of panic disorder are needed to bridge a gap between professionals and general public.

A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System (미국 임상영양치료(MNT)의 법제화 과정 및 수가 체계)

  • 박은철;김현아;이해영;이영은;양일선
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.852-862
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    • 2002
  • The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

Factors Influent on Treatment Decision for the Need of Dental Implant (치과임플란트 대상환자의 치료결정에 영향을 미치는 요인)

  • Kim, Su-Gwan;Son, Soon-Yong;Jeong, Seon-A;Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.264-273
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    • 2011
  • This study subject is to provide appropriately basic information about annually increased implant treatment by their lost teeth base on increasing old people and also analyze factors influencing implant treatment decisions for patient. For about 3 month from July on the 2010, This survey was carried out at 13 dental clinic as target of 217 patients on categorized into implant treatment-group and non-treatment-group in Seoul and Gyeonggi-do. Implant treatment-group showed highest portion at 50(30.3%), non- Implant treatment-group showed highest portion at 20's(35.7%), And The patients of implant treatment-group are good oral condition, and they showed a positive attitude. Result of analysis by multiple logistic analysis(regression), Factors of influencing implant treatment decision are age, gender, period of education, monthly income, condition of periodontal tissue, regular checkup, counseling attitude, trust in hospital. Therefore, proactive management about the necessity of regular dental check-up is needed the education and promotion. And medical team should have efforts to Improving technique of medical consultations and Improving the trust of the hospital's for implant treatment decision. Also, The patient's subjective determine rather than it is important to preparing to facilitate decision of specific clinical basis. And The government's financial support and policy alternatives are certainly required in order to be implant treatment without cost burden.

Effects of Burnout on Job Stress and Ego-Resilience of Fire Officials (소방공무원의 직무스트레스와 자아탄력성에서 소진의 영향)

  • Lee, Hae-Young;Kim, Yeob-Rae
    • Fire Science and Engineering
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    • v.31 no.2
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    • pp.106-112
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    • 2017
  • This study examined the burnout intermediates between Fire officials' job stress and Ego-resilience. The objective of this study is to suggest a policy that improves Fire officials' Ego-resilience. This survey was given to 365 fire officials in northern Gyeonggi-do region and the data was analyzed by correlation analysis and regression analysis using SPPS 22.0. The hypothesis is the Fire officials' burnout would be related to Ego-resilience and the effect on Fire officials' job stress regarding Ego-resilience is associated with burnout. The results of the study are that unstable work and inadequate reward affect the measure of burnout, which manifests as sarcasm and job efficacy and reduces the Fire officials' Ego-resilience that results in a positive pointing of the future, emotion control and interest. The meaning of policy is as follows: First, Fire officials need to be given confidence in their work stability. Second, they have to receive social or financial rewards. Third, they require a continuous supporting policy that solves their tension, physical and mental fatigue. Finally, developing diverse educational programs will be needed to promote their Ego-resilience.

A Study on Actual Conditions and Needs of Breastfeeding Education for Pregnant Women in Health Centers (보건소에서의 모유수유 교육 프로그램 운영 실태와 요구도 조사)

  • Kim, Jie-Eun;Park, Dong-Yean
    • Korean Journal of Community Nutrition
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    • v.13 no.6
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    • pp.818-828
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    • 2008
  • This study was conducted to investigate actual conditions and needs on breastfeeding education for pregnant women in health centers for the development of a breastfeeding educational program. The questionnaires were mailed to 245 health centers and 148 (60.4%) questionnaires were returned. 91% of the health centers had breastfeeding education for pregnant women. 66% of them operated breastfeeding education as one part of other health programs. About 76% of supervisors and 64% of educators were the nurses. The teaching methods frequently used were lectures (30.5%), giving out booklets and leaflets (22.6%), demonstration and practice (21.5%), personal counseling (13.3%), and others. The teaching materials used were materials of outside speakers (39.7%), materials of development oneself (19.0%), materials of academic association or institute (14.8%), and others. The subjects which educators taught were the benefits of breastfeeding (16.7%), breastfeeding techniques (15.8%), caring for breasts before and after delivery (15.1%), nutritional management for lactating women (14.2%), coping strategies for the difficult situation of breastfeeding (13.3%), and others. Those were different from each other according to the educators' general characteristics. Success factors of education were increased motivation for breastfeeding (52.8%), practice (22.6%), professional's lecture (11.3%) and others. The failure factors of education were the ineffectiveness of the lecture method (69.2%), lack of education for supporters (15.4%) and lack of standardized education (15.4%). The most important barrier of education was the lack of a standardized breastfeeding educational programs (43.9%). The most effective teaching methods that educators thought were demonstration and practice (24.0%). The educators thought they need the tools and space for practice (28.2%), a standardized breastfeeding educational program (26.9%), and the human resources (24.4%) for effective education. Subjects that educators thought important for education were the breastfeeding techniques, benefits of breastfeeding, caring for breasts before and after delivery, nutritional management for lactating women, coping strategies for the difficult situation of breastfeeding, rooming system after delivery, ways to assess mother's milk quantity, introducing successful cases of breastfeeding in rank order. To promote the effectiveness of breastfeeding education, standardized breastfeeding educational programs, diverse teaching materials, space and tools, and human resources are needed.

The Study of ABEEK Accreditation Assessment Draft Statement in 2006 (2006년 공학교육 프로그램 인증평가 예비논평서 분석 연구)

  • Kang, So-Yeon;Kim, Mee-Kyoung;Kim, Myoung-Lang;Choi, Keum-Jin
    • Journal of Engineering Education Research
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    • v.10 no.1
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    • pp.77-85
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    • 2007
  • Though accreditation demands considerable ongoing effort on the part of the college, about 10 percent of Korean engineering colleges has been accredited for 5years by ABEEK. It is true that engineering accreditation contributed the Korean engineering education to improve. Many engineering colleges which had prepared the engineering accreditation developed the integrating system for the engineering education, and over 50 engineering education research centers which assisted to programs in accreditation were founded. Also the faculty commitment to quality programs and excellence in teaching, continuous counseling for students, portfolio guiding and continuous quality improvement(CQI) etc. were performed for accreditation preparation. The engineering colleges preparing accreditation has made efforts for satisfying accreditation criteria, but it is difficult of modifying education systems which have been maintained by now. In addition, engineering colleges need guideline how to satisfy standards. The purpose of this study is to analyze draft statement of 4 universities which were evaluated in 2006 and to suggest the minimal resources for engineering colleges to prepare accreditation.

Categorization of Nursing Diagnosis and Nursing Interventions Used in Home Care (가정간호에서 사용된 간호진단과 간호중재 분류)

  • Suh, Mi-Hae;Hur, Hae-Kung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.5
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    • pp.47-60
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    • 1998
  • This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.

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