• The Korean Nurse
• /
• v.35 no.2
• /
• pp.71-91
• /
• 1996

The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

• Journal of Korean Academy of Nursing
• /
• v.24 no.2
• /
• pp.190-205
• /
• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• Health Policy and Management
• /
• v.9 no.1
• /
• pp.30-71
• /
• 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.

• Journal of Korean Academy of Nursing
• /
• v.13 no.2
• /
• pp.22-43
• /
• 1983

1. Need for and Purpose of the Study. There is an increasing demand for curriculum improvement of the Korean Army Nursing Academy (KANA), since it was upgraded into 4-year institution of higher learning from 3-year one. In particular, it is strongly advocated that the KANA needs the outside expertise for its curriculum improvement-namely not only from the internal military view of points but also from the viewpoints of professional educational society, In line with such a necessity for the study, this study was aimed at 1) analyzing the current actual practices of KANA'S curriculum, 2) investigating the desired practices of KANA'S curriculum, and 3) identifying the discrepancy between the actual and desired practices of curriculum. 2. Problems for the Study This study had 4 problems to be answeared as follows: 1) What are the actual curriculum practices of KANA? 2) What are the desired curriculum practices of KANA? 3) How are the extents of perception of actual and desired curriculum different in four groups (student, faculty & administrator, nurse, and medical doctor in militay hospital) ? 4) What are the restraining forces that impede the change from actual to desired curriculum practices? 5) What are the relationships of curriculum component,』 in actual and desired curriculum practices? 3. Methods and Procedures This study was conducted by means of document analysis in addition to literature review and by means of needs assessment questionnaire which was developed by the researcher. The questionnaire included 62 statments with 7 questions for demographic data collection. The needs assessment questionnaire was managed to a total of 243 subjects (100 students, 46 faculty & administrators, 55 nurses, and 42 medical doctors), The collected data were treated using SPSS computer system so as to calculate mean scores, standard deviations, and correlation coefficients. The significance test was made through t-test and one-way ANOVA. The statistical significance level was set at both .05 and .01 level. 4. Major findings The major findings in this study are as follows: 1) The score of desired practices was significantly greater than that of actual practices, representing a strong need for curriculum betterment. 2) There were significant differences in the perceptions of actual practices as well as desired practices among four groups (student, faculty & administrater, nurse, and medical doctor). 3) The most frequently selected restraining forces were army's inherent character, economical limitation, and educational expertise limitations. 4) Such variables as sex, position attachment to the KANA and grade made a statistically significant effect on the perception of desired curriculum practice, while the variables like marrige, position, and military class made it on the perception of actual curriculum practice. 5) The coefficients among the curriculum components were lower in perception of the actual curriculum practices than those in the desired practices. 5. Conclusions The conclusions based on the major findings of this study are as follows: 1) The current curriculum development procedure of the KANA is not consistent with the theoretical frame of systematic development sarategy of curriculum. 2) There are wide conflicts among the groups who are supposed to participate in curriculnm development, concerning the actual and desired practices of KANN'S curriculum. 3) A great deal of need for curriculum improvement for the KANA is clearly felt, and in particular, in the process of teaching and learning. 4) Each component of curriculum is not intergrated into a whole development procedure, being segregated each other. 5) For better curriculum improvement, such restraining forces as financial and professional limitations should be eliminated. 6. Recommendations 1) For Further Research a. There is a need to replicate this study after in-depth statistical analysis of each item of need assessment questionnaire, and with more representative subjects. b. A study should be conducted which. has its focus on the analysis of restraining forces for the change from actual to desired curriculum practices of the KANA. 2) For KANA'S Curriculum Improvement a. There is a need to promote the professional expertise of the participants in curriculum development and the communication among them. b. It is desirable to establish an institution or section of administration, which is soley in charge of curriculum development. c. To better develop KANA's curriculum not only faculty and administrators but also students should be encouraged to participate in development process, while the military medical doctors' participation should be carefully considered.

• The Korean Journal of Emergency Medical Services
• /
• v.12 no.1
• /
• pp.27-41
• /
• 2008

Purpose : With increasing number of school accidents, it is crucial to find out necessity of first aid training among school health educator. This study has been conducted to have an clear idea on the demands and necessity for first aid training and what kind of training is most required from school health educator. Method : In this study, questionnaires from 87 school health educator in elementary, middle and high school health educator in the city D were analyzed. The survey was carned out from May 26, 2008 to June 7, 2008 and from the collected data, frequency, independent two samples t-test, paired T-test, one way ANOVA and pearson's correlation were conducted with SPSS 14.0. Result: 1. 51.61 % of nurse-teachers experienced emergency situations and the relations between the necessity they felt from experiencing those situations and demands for first aid training were not statistically meaningful(t=1.87, p= .175). 2. Necessity and demands for the first-aid training were checked with three point scale and there were statistical significance between the two with $2.44{\pm}.47$ and $2.24{\pm}.47$ respectively(t=3.275, p= .000). 3. 86.20%(75 persons) of the respondents have had received first aid training and the training they received were CPR 82.75%(72 persons), primary survey 81.60%(7l persons), contact to 911 79.30%(69 persons) and wounds treatment(lacerated wounds, bum and chilblains) 75.86%( 66 persons) in order. 4. As for the questions that ask on confidence of first-aid treatment, 80% answered they are confident on some limited kinds of treatments, 16% said they are confident and 4% answered they lack confidence. As for the treatment that they can show the highest confidence, wounds treatment topped the list with 93.24%, nose bleeding and removing foreign substance, and stanching followed the list with 82.43% and 81.08% respectively. 5. 97.67% of respondents said they were willing to take training and 89.62% answered to take the training to deal with emergency situations that are taking place in their schools. As for the question that asks for the most wanted treatments, CPR topped the list with 32.18%(28 persons) and treatment for obstruction of airway and shock followed the list with 35.63%(31 persons) and 27.59%(24 persons). Conclusion : Currently, first aid treatment has been centered on CPR, primary survey, contact to 119 and wounds treatment. However, since most of school health educator are fairly confident with wounds treatment, stanching and other first aids, in future training it will be more desirable to focus on CPR and treatment for obstruction of airway and shock that were shown to be most wanted by school health educator.

• Research in Community and Public Health Nursing
• /
• v.10 no.1
• /
• pp.5-18
• /
• 1999

The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

• Journal of Korean Academy of Nursing
• /
• v.23 no.1
• /
• pp.68-89
• /
• 1993

This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6％ of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6％) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

• Quality Improvement in Health Care
• /
• v.20 no.1
• /
• pp.76-88
• /
• 2014

Objectives: Parents of a premature baby feel a pressure on their baby's growth and they are highly in need for proper education. However, the lack of proper education can cause the difficulty of follow-up care and rehospitalization. Currently, methods of education among each nurse are based on verbal explanation and can be often different. Therfore, it is true that the psychological burden is great during education. Hence, by enforcing discharge education activities, we intend to provide information; induce participation of parents; promote the level of performance; standardize education program; and increase the job satisfaction of nurses. Methods: NICU conducted a questionnaire survey of the demand and satisfaction for discharge education among mothers that left hospital. And before and after the improvement activity, the satisfaction level of mothers and nurses were studied, and rehospitalization rate were analyzed. Results 1)The survey results of the satisfaction level of mothers towards education program as followes: The level of understanding of content, general babysitting, special situation, education method, and educator attitude showed statistically significant increase. 2)The survey results of the satisfaction level of nurses towards education program as followes: While, the need for education program decreased, the adequacy of education content and method, consistency of education, understanding of learner, and learner's performance increased. All the factors except for the need for education program and the adequacy of education content showed statistically significant difference. 3)Rehospitalization rate of premature babies decreased. According to analysis of the cause of rehospitalization, breast-feeding related apnea turned out to be the highest. Conclusion: Through QI, satisfaction of mothers and nurses improved more than 10%. And rehospitalization rate of premature babies decreased by the same amount as well. Therefore, with the help of the standardized discharge education program, mothers who is not easy to take care of after leaving hospital can be seen to significantly affect their healthy growth and development.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.14 no.4
• /
• pp.1781-1791
• /
• 2013

The present study was intended to measure the level of psychosocial stress and fatigue symptom according to the various characteristics such as sociodemographic, health-related, job-related, job stress factors, and psychosocial factors among nurses working at ward and operating room in university hospitals, and to reveal the relation between these factors and psychosocial stress and fatigue symptom. The self-administered questionnaires were given to 220 nurses working at ward, and 147 nurses working at operating room in 4 participating hospitals located in Daejeon City during the period from July 1st to Aug 31st, 2012. As a results, the factors related to the psychosocial stress of nurses working at ward were age, subjective health status, job career, satisfaction of work, fit to the job, job demand, job control, coworker support, self-esteem, locus of control, type A behavior pattern. In operating room, there were age, sleep hours, subjective health status, job career, physical burden of work, satisfaction of work, fit to the job, consider quitting the job, job demand, job control, type A behavior pattern. The factors related to the fatigue symptoms of nurses working at ward were age, leisure time, subjective health status, satisfaction of work, consider quitting the job, job demand, locus of control, type A behavior pattern. In operating room, there were age, subjective health status, physical burden of work, supervisor support, coworker support, locus of control. Based on the study results, we suggest that the factors related to psychosocial stress and fatigue symptom of nurses were different from working station. We need development and application of programs to keep under management psychosocial stress and fatigue symptom.

• Journal of East-West Nursing Research
• /
• v.7 no.1
• /
• pp.32-47
• /
• 2002

This study is a descriptive comparative investigated one to analyze nursing education system and curriculum of Korea and China trans-culturally. 1) Education System The basic level of nursing education in Korea consisted of 65 3-year- junior college of nursing (7379 students) and 48 4-year-bachelor of nursing college (2345 students) in 2000 showing more 3-year-junior college of nursing and its students. In China, western nursing as well as Chinese nursing education system were operating. In 2000, 501 western school of middle technical nursing, 29 school of middle technical nursing of middle level education, and 89 3-year western and 24 Chinese junior college of nursing, and 42 4-year western bachelor of nursing college and 10 Chinese of high level education have been established. The presence of Chinese school of middle technical nursing system seemed to be in slower development in nursing than Korea, but that of Chinese nursing education seemed to be advanced with its national identification prior to Korea. Post graduate continuous education for RN-Diploma and RN-BSN program has been opened as in Korea. The Hosa(護士) system in school of middle technical nursing in China reflects lower level of education than Korea. But it can be a merit, other than in Korea, without nurses aids, when they are acting under supervision of nurses and led by them, and there presents a special course for promotion up to high level education. Graduate school in Korea is divided into general type opening a curriculum for MS in 1960 and as of 2000, 21 general types for majoring in nursing. The PhD course in Korea was established in 1978, and after that the PhD courses have been opening in 14 universities at present. China established master degree course in 1991 and as of 7 colleges are ongoing, and the doctoral course is now under planning, resulting slower development than Korea. 2) Education of theory and clinical practice in Korea and Chine (1) Korea's 3-year junior nursing college have 51 subjects, 49 subjects in China, which was not different. China was following education of ideology and medical. 4-year Bachelor of Science College has 92 subjects in Korea with cultural subjects and essential major studies/elective in theory education in Korea, while 63 subjects in China, showed wider selection in Korea's education. (2) Korea's 3-year and 4-year nursing colleges performed clinical practice education parallel with theoretical education for a certain period, block or theory/practice system. While China's 3-year and 4 or 5-year-colleges educated the theory first and then practice for one year in the last grade, integrating each situation of the departments and the theory. (3) Korea's oriental nursing theory in nursing education was performed in 28 colleges of 65 nationwide ones of 3-year junior nursing colleges, but only one school was educating clinical practice. In 4-year bachelor of nursing colleges, the oriental nursing theory was done in 14 among 48 investigated. And 1-4 subjects of them were doing, and 4 schools performed of clinical practice, showing more reinforced than the junior colleges. China's 3-year and 4-5-year western nursing colleges taught two subjects of Chinese medicine nursing. China's 3-year & 4-5-year College of Chinese medicine nursing, theory of Chines medicine nursing education taught eight subjects. (4) 5-year colleges of Chinese medicine western integrated nursing, theory of Chinese medicine nursing education consisted of twelve Chinese medicine nursing subjects and two of Chinese medicine western integrated nursing subjects. China was tempting a new development of a pattern of Chinese medicine nursing subjects reinforced. 3) The verification of Korean and Chinese nurse's license. The verification test of Chinese nurses license is differentiated at the level of education other than in Korea. Expire date is 2 years and a qualified test must be done to a renewal. And the continuing education hours are 72 per year, which is more enforced than Korean nurses (10 hours a year). In accordance with WTO regulations, we should prepare for opening foreign hospital, educating oriental nursing subjects. And on this, it is recommendable to settle a basic frame research to run the oriental nursing practice ongoing. 1. It is desirable to develop the oriental nursing subjects to apply its idea to the western nursing and differentiate Korean nursing. 2. It is desirable to certify oriental nurse's characters, to expand and develop the nursing areas to practice it, and to establish the oriental nursing system. 3. It is expectable to promote Korean nursing specialization to develop the oriental nursing as a professional and to create its demand.