• 보건행정학회지
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• 제28권3호
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• pp.197-201
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• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• Child Health Nursing Research
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• 제28권1호
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• pp.9-22
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• 2022

Purpose: The purpose of this study was to identify the gaps in research related to developmentally supportive care in the neonatal intensive care unit (NICU). The ultimate goal was to explore directions of further research on developmentally supportive care for premature patients. Methods: The Arksey and O'Malley scoping review method was used. Articles on developmentally supportive care for preterm infants in the NICU, written in English or Korean, were identified through electronic search engines. A total of 279 papers were identified in the initial search, of which 22 full-text papers were included in this review. Results: Several nursing studies have been published in the past 5 years. The important elements of developmentally supportive care were family-centered care and management of the NICU environment. The primary developmentally supportive care interventions were training programs to promote the care competency of NICU nurses. Conclusion: It is necessary to actively develop comprehensive developmental support interventions that consider the various elements of developmentally supportive care for preterm infants. Additional studies should be done to develop programs that provide direct intervention for premature infant and their families.

• 지역사회간호학회지
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• 제27권1호
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• pp.21-30
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• 2016

Purpose: This research was conducted to identify long-term care service needs in the baby boom generation. Methods: Data were collected from September 3 to October 9, 2012 targeting 196 baby boomers residing in Seoul and Gyeonggi-do with the measurement of long-term care service needs having five domains. Collected data were analyzed using the SPSS 20.0 program. Results: Demand for long term care service in those who preferred nursing homes was highest as $4.40{\pm}0.69$ in the safe environment domain. In case of those preferring home care services, demand was highest as $4.37{\pm}0.56$ in the social interaction domain. People who preferred nursing homes had higher needs in personal health care and improvement of the service quality domains. Those who preferred home care services showed diverse needs according to their characteristics. Conclusion: The baby boom generation had high needs in all the domains of long-term care services and such needs were diverse according to their characteristics. However, long-term care services had limitations that they provided standardized and uniformed services only. Therefore, health care services and improved quality services should be provided in a way of meeting the users' needs, and tailored services should be provided in consideration of the users' characteristics.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제6권10호
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• pp.77-94
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• 2000

The purpose of this thesis is to lay groundwork for the development of emergency care system in metropolitan area. It compares the performance and outcome of the current system with foreign counterparts and investigates the changing aspects of future medical environment. Emergency medical system can be divided into two parts of both pre-hospital care, which refers to the emergency measures taken before arriving at a hospital, and hospital care that is given within a hospital. Pre-hospital care includes on-the-spot expedients, information system and delivery system, whereas hospital care is related to the classification and specialization of medical care facilities. This research focuses on the evaluation of the performance of a rescue party, which is part of pre-historical care system. As a result, it provides valuable material for the development of the emergency medical system in Seoul.

• Acute and Critical Care
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• 제33권4호
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• pp.238-245
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• 2018

Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권1호
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• pp.9-22
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• 2013

Purpose: The aging population is the quickly increasing in Korea. Since 2008, the National Long term Care Insurance, a number of long term care facilities have established during short time in Korea. Especially, the environmental assessment tool is important for managing healing environment in a long term care facility for the elderly. Alzheimer's Garden Audit Tool (AGAT) is used to assess whether a garden incorporates those elements and qualities as healing outdoor space. In this paper, we discuss the benefits, limitations, and future directions of the assessment tool for long-term care facilities. Methods : The AGAT audit was done through content analysis by 5 experts from diverse discipline as post occupancy evaluation of a long term care facility located in suburban area. The expert group was asked to describe their comments for modification and improvement in application of AGAT. Results : The results of this study show that it is necessary to refine the instrument's items to better meet the needs of the criteria and items for Korean culture-friendly tool. Especially, greenhouse elements (various plants, birds etc.), multisensory experiences, users-oriented space, programmed activities in garden, and hazards on pathway has somewhat limitation as measurement to assess outdoor of long-term care facilities in Korea. Implications : Consequently, AGAT could be applicable to evaluate the outdoor space of long term care facility in Korea with culturally sensitive revision.

• 한국응급구조학회지
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• 제7권1호
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• pp.5-28
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• 2003

The purpose of this study which was conducted by framing of standardized advanced emergency care instructor qualification course outline and training competent instructor Course development based on following educational principle and it would be expected more improved aspect. Advanced Emergency care Instructor Qualification Course Development (1) based on advanced emergency care instructor job analysis and paramedic job description. (2) Learning of emergency care instructor qualification course is continuous. It is important to begin at the learner's level of knowledge and to relate new learning to information the learner needs. (3) Learning of emergency care instructor qualification course is purposeful and must make sense to the learner. Progress in learning must make sense to the learner. Progress in learning must be constantly appraised through feedback. The purpose of learning BLS information and skills must be kept in sharp focus. (4) Learning involves as many senses as possible. The more stimulating a learner activity is to the senses, the longer the information will be retained. Conservative figures indicate that 75% of what is heard is for-gotten after 2 days. It has been said that learners remember (5) Learning activities must be appropriate for the emergency situation through the PBL educational method. In BLS lecture skill learning, the greatest proportion of class time should be spent in manikin practice, using performance sheets as a learning tool or guide. (6) Learning must be stimulating. Instructors can motivate learners by helping them achieve higher levels of proficiency and encouraging other levels of course completion, such as instructor and instructor trainer. (7) Learning is affected by the physical and social environment. The physical environment should be conducive to both the kind of learning taking place and the activities used for learning. Advanced emergency care instructor qualification course organized educational psychology, educational methodology I,II,III, educational material making skill, lecture & conversational skill, BLS theory & pratice lecture skill, minic lecture designed PBL module. test of minic lecture & pratice lecture skill. Advanced emergency care instructor qualification course continued to active instructor training and motivated to active EMS system.

• 대한가정학회지
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• 제39권3호
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• pp.67-81
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• 2001

The purpose of this investigation was to examine whether early child-care experience, alone or in combination with mother/child factors, was associated with emotion regulation. Participants were forty 12-18 month-old infants, their mothers and their caregivers. Infants were observed in the Strange Situation to assess the pattern of emotion regulation. Mothers were interviewed, given Questionnaires, and observed in play. Caregivers were observed in child care to assess the caregiving environment. There were significant main effects of good quality child care on open emotion expression and heightening emotion expression. Significant interaction effects revealed that infants were more likely to be open emotion expression when high maternal sensitivity /responsiveness was combined with good quality child care, or nonmaterial care initiated prior to six month of age. Infants were more likely to be minimizing emotion expression when low maternal sensitivity/responsiveness was combined with nonmaternal care initiated after six month of age, or more than one care arrangement. Difficult temperament infants received nonrelative care were somewhat more likely to be minimizing emotion expression. Infants were more Likely to be heightening emotion expression when high maternal sensitivity/responsiveness was combined with relative care. Boys experiencing nonrelative care were more Likely to be heightening emotion expression.

• 한국실내디자인학회:학술대회논문집
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• 한국실내디자인학회 2006년도 추계학술발표대회 논문집
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• pp.170-173
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• 2006

Escalating rate of working women is increasing the necessity for day-care centers. Moreover, insufficient child-care system is known as one of many factors that relate to the seriously low birth-rate of our society. Therefore providing more adequate day-care centers can not be regarded as a mere personal necessity but a social need to be considered at corporate and governmental level. The current study analyzes 'Reggio-emilia teaching method' which is a type of early childhood educational program and its relationship to the built environment. It also examines current interior spaces of Reggio-emilia day-care centers and suggests designs for an day-care center appropriate for educating children in Korea.

• Architectural research
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• 제9권1호
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• pp.9-18
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• 2007

The objective of this research study was twofold; 1) to explore and identify health supportive design factors in Swedish elderly care homes and 2) to understand their usefulness and suggest implication in Korean elderly care settings. A descriptive and explorative method was applied using a combination of field studies and semi-structured interviews. Three study trips were carried out during Sept. $14^{th}$ and Oct. $12^{th}$ 2005; two facilities situated in Stockholm suburbs and one in the south of Sweden. According to this research, the valuable factors to support health and well-being for the elderly are as follows; 1) Community integration: These elderly care homes are generally places close to a residential area center or a city center. Services are often shared between residents and community members at large, consequently there is a flow of "visitors" of all ages connecting with the facility on a daily basis. 2) Homelike environment: A noteworthy aspect of Swedish elderly care homes is keeping the facility appearance as homelike as possible. The associations with home may be explored through the appearance and configuration of both the exterior and interior of the building. These homes seemed to be designed with a conscious aim to create a homelike setting. 3) Small scale approach: Clustering of resident rooms is one method through which the small scale approach can be achieved in larger facilities. With unit clusters, the facility can foster opportunities for social interactions among resident. 4) Accessibility to garden and nature: The courtyard is a well developed concept in planning elderly care homes in Sweden. They are generally safe and easily accessible to the residents. Studying Swedish models may provide practical knowledge of how the physical setting may improve resident's health in Korean elderly care homes.