• 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.

• The Southeast Asian review
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• v.27 no.2
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• pp.37-76
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• 2017

$Nguy{\tilde{\hat{e}}}n$ Cư Trinh has two faces in the history of territorial expansion of Vietnam into the Mekong delta. One is his heroic contribution to the $Nguy{\tilde{\hat{e}}}n$ family gaining control over the large part of the Mekong delta. The other is his role to make the eyes of readers of Vietnamese history be fixed only to the present territory of Vietnam. To the readers, $Nguy{\tilde{\hat{e}}}n$ Cư Trinh's achievement of territorial expansion was the final stage of the nam $ti{\acute{\hat{e}}n$ of Vietnam. In fact, however, his achievement was partial. This study pays attention to the King $V{\tilde{o}}$ instead of $Nguy{\tilde{\hat{e}}}n$ Cư Trinh in the history of the territorial expansion in the Mekong delta. King's goal was more ambitious. And the ambition was propelled by his dream to build a new world, and its order, in which his new capital, $Ph{\acute{u}}$ $Xu{\hat{a}}n$ was to be the center with his status as an emperor. To improve my assertion, three elements were examined in this article. First is the nature of $V{\tilde{o}}$ Vương's new kingship. Second is the preparation and the background of the military operation in the Mekong Delta. The nature of the new territory is the third element of the discussion. In 1744, six years after this ascending to the throne, $V{\tilde{o}}$ Vương declared he was a king. Author points out this event as the departure of the southern kingdom from the traditional dynasties based on the Red River delta. Besides, the government system, northern custom and way of dressings were abandoned and new southern modes were adopted. $V{\tilde{o}}$ Vương had enough tributary kingdoms such as Cambodia, Champa, Thủy $X{\tilde{a}}$, Hoả $X{\tilde{a}}$, Vạn Tượng, and Nam Chưởng. Compared with the $L{\hat{e}}$ empire, the number of the tributary kingdoms was higher and the number was equivalent to that of the Đại Nam empire of the 19th century. In reality, author claims, the King $V{\tilde{o}}^{\prime}s$ real intention was to become an emperor. Though he failed in using the title of emperor, he distinguished himself by claiming himself as the Heaven King, $Thi{\hat{e}}n$ Vương. Cambodian king's attack on the thousands of Cham ethnics in Cambodian territory was an enough reason to the King $V{\tilde{o}}^{\prime}s$ military intervention. He considered these Cham men and women as his amicable subjects, and he saw them a branch of the Cham communities in his realm. He declared war against Cambodia in 1750. At the same time he sent a lengthy letter to the Siamese king claiming that the Cambodia was his exclusive tributary kingdom. Before he launched a fatal strike on the Mekong delta which had been the southern part of Cambodia, $V{\tilde{o}}$ Vương renovated his capital $Ph{\acute{u}}$ $Xu{\hat{a}}n$ to the level of the new center of power equivalent to that of empire for his sake. Inflation, famine, economic distortion were also the features of this time. But this study pays attention more to the active policy of the King $V{\tilde{o}}$ as an empire builder than to the economic situation that has been told as the main reason for King $V{\tilde{o}}^{\prime}s$ annexation of the large part of the Mekong delta. From the year of 1754, by the initiative of $Nguy{\tilde{\hat{e}}}n$ Cư Trinh, almost whole region of the Mekong delta within the current border line was incorporated into the territory of $V{\tilde{o}}$ Vương within three years, though the intention of the king was to extend his land to the right side of the Mekong Basin beyond the current border such as Kampong Cham, Prey Vieng, and Svai Rieng. The main reason was $V{\tilde{o}}$ Vương's need to expand his territory to be matched with that of his potential empire with the large number of the tributary kingdoms. King $V{\tilde{o}}^{\prime}s$ strategy was the variation of 'silkworm nibbling' and 'to strike barbarians by barbarians.' He ate the land of Lower Cambodia, the region of the Mekong delta step by step as silkworm nibbles mulberry leave(general meaning of $t{\acute{a}}m$ thực), but his final goal was to eat all(another meaning of $t{\acute{a}}m$ thực) the part of the Mekong delta including the three provinces of Cambodia mentioned above. He used Cham to strike Cambodian in the process of getting land from Long An area to $Ch{\hat{a}}u$ Đốc. This is a faithful application of the Dĩ Man $C{\hat{o}}ng$ Man (to strike barbarians by barbarians). In addition he used Chinese refugees led by the Mạc family or their quasi kingdom to gain land in the region of $H{\grave{a}}$ $Ti{\hat{e}}n$ and its environs from the hand of Cambodian king. This is another application of Dĩ Man $C{\hat{o}}ng$ Man. In sum, author claims a new way of looking at the origin of the imperial world order which emerged during the first half of the 19th century. It was not the result of the long history of Đại Việt empires based on the Red River delta, but the succession of the King $V{\tilde{o}}^{\prime}s$ new world based on $Ph{\acute{u}}$ $Xu{\hat{a}}n$. The same ways of Dĩ Man $C{\hat{o}}ng$ Man and $T{\acute{a}}m$ Thực Chi $K{\acute{\hat{e}}}$ were still used by $V{\tilde{o}}^{\prime}s$ descendents. His grandson Gia Long used man such as Thai, Khmer, Lao, Chinese, and European to win another man the '$T{\hat{a}}y$ Sơn bandits' that included many of Chinese pirates, Cham, and other mountain peoples. His great grand son Minh Mạng constructed a splendid empire. At the same time, however, Minh Mạng kept expanding the size of his empire by eating all the part of Cambodia and Cham territories.