• 성인간호학회지
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• 제28권4호
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• pp.470-481
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• 2016

Purpose: The purpose of this study was to explore self-management support experiences among breast cancer survivors. Methods: Individual in-depth interviews were performed for survivors who had treated breast cancer after completion of chemotherapy and radiation therapy. Data were collected from April 2014 to July 2014 and analyzed using phenomenological method by Colaizzi. Results: Five essential themes were found as follows: 1) Need for continuous help and support to maintain self-management, 2) Need for professional resources to carry out regular exercise, 3) Overcoming psychological difficulties through others rather than health care professionals, 4) Disappointment with time with and circumstances of health care consultation, 5) Dependence on means of media for health related information. Conclusion: The results might contribute to an understanding of self-management support experienced by breast cancer survivors in Korea. It is suggested that evidence-based program for self-management support should be developed and applied to nursing intervention for breast cancer survivors.

• 대한간호학회지
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• 제24권4호
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• pp.568-583
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• 1994

In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

• 보건교육건강증진학회지
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• 제16권1호
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• pp.137-148
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• 1999

The necessity of school health promoting projects is well known to many researchers, however, there is a lack of research on the development of strategies for school health programs and the evaluation of the effectiveness of the programs. The results of our previous study in 1996 identified poor eyesight as one of the several health problems among elementary school children in urban areas. The main objective of this study is to develop, implement, and evaluate vision care for elementary school children. The research method utilized a quasi experimental design using non-equivalent group, pre-post comparison. The sample consisted of all second grade children in two elementary schools in Kyung-giProvince. In order to prevent a contamination effect of the vision care program, one school was selected as a control and the other school was selected as a treatment group. The experimental school had 467 children and the control school had 402 children. The visual acuity of children in both group was measured and a survey questionnaire was sent out to parents on the knowledge, attitude, and behavior related to vision care before the program was implemented. The children of the experimental school received the following programs; separate education on proper nutrition and care of eyesight for children and parents, daily eye exercises using video tape, and an essay and poster contest on healthy eyesight. The eye exercise program lasted from March, 1997 to November, 1997. On November, 1997, visual acuity was measured again from children in both schools. The data was analyzed by using SAS statistical package. The results indicate that the children in the experimental group had significantly (p〈0.001) better eyesight than the children in the control group. Also, some of the behavior highly related to the poor eyesight are poor maternal eyesight and watching TV from a short distance. In conclusion, one of the significance of this project is that the vision care program was developed after the need assessment. It will be encouraged in the future that more school health program should be developed after a need assessment. Also, inclusion of family members was important in health promoting projects within a school setting since healthy behavior needs to be reinforced at horne as well as at school.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.42-50
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• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.143-153
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• 2002

경상북도 일개면 지역에 거주하는 65세 이상 재가노인 355명을 대상으로 방문보건의료 요구도를 알아봄으로써 향후 보건기관의 효율적이고 효과적인 방문보건의료서비스 제공방안의 기초자료를 제시하고자 하였다. 주관적 건강상태는 64.5%가 허약하다고 하였고, 저ADL과 저IADL이 각각 14.1%, 14.9%였다. 의료인의 도움을 받아야할 건강문제가 있다고 응답한 노인이 73.5%이었는데, 성, 연령, 결혼상태, 의료보장상태, 직업유무, 경제적 상태, 치료여건, 주관적 건강상태, 일상생활수행정도, 수단적 일상생활수행정도에 따라 차이가 있었다(p<0.05). 의료인의 도움을 받아야 할 건강문제가 있다고 느끼는 노인의 주관적인 방문보건의료 요구도는 19.5%였다. 방문보건의료 요구도는 75세 이상인 경우(p<0.05), 직업이 없는 경우(p<0.01) 유의하게 높았고, 가족이 화목하지 않을수록, 주관적 건강상태가 허약한 경우, 저 IADL인 경우 유의하게 높았다(p<0.01). 방문보건의료를 받기를 원하는 경우 이유는 돌봐줄 사람이 없어서가 64.7%로 가장 높았고, 거리가 너무 멀어서(지역적 문제)가 23.5%로 그 다음이었다. 제일원하는 방문보건의료서비스는 투약이 82.3%로 가장 높았다. 방문보건의료를 원하지 않는 경우 이유는 거동이 가능하므로 60.0%, 의사와 직접 만나기를 원하므로 25.7%의 순이었다. 방문보건의료 요구여부를 종속변수로 한 다중 로지스틱 회귀분석 결과, 가족이 화목하지 않을수록, 주관적 건강상태가 허약할수록 방문요구도가 높았다(p<0.05).

• 보건행정학회지
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• 제17권2호
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• 보건행정학회지
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• 제28권3호
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• pp.315-319
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• 2018

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

• 대한간호학회지
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• 제24권3호
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• pp.484-498
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• 1994

The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1％ of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.

• 성인간호학회지
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• 제23권6호
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• pp.554-563
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• 2011

Purpose: The purpose of this study was to investigate factors associated with drug misuse behaviors among polypharmacy elderly. Methods: This was a cross-sectional survey. Participants consisted of 116 polypharmacy elderly who were taking 5 or more medications each day. Data were collected via face to face interviews. Data were analyzed using the PASW 18.0 program. Data concerning predisposing factor (knowledge, benefit), enabling factor (communication with health care provider), and need factor (perceived health status, number of disease) were collected. Results: The total mean score of drug misuse behaviors among polypharmacy elderly was 3.04 out of 10 points. Communication with health care provider, perceived health status, and knowledge were found to be significantly correlated with drug misuse behaviors. In stepwise multiple regression analysis, a total of 42% of the variance in drug misuse behaviors was accounted for communication with health care provider, perceived health status, and knowledge. Conclusion: Therefore, education program for improving communication with health care provider, and knowledge should be designed and provided for polypharmacy elderly.

• 종양간호연구
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• 제9권1호
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• pp.1-6
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• 2009

Purpose: The purpose of this study was to identify the needs of hospice care in families of the hospitalized patients with terminal cancer. Method: The data were collected from April to July, 2008. The participants were 100 family caregivers of hospitalized terminal patients with cancer recruited from two general hospitals in 2 cities in Korea. Needs of hospice care were measured using the 'Needs Assessment Instrument for Hospice Care in Families of the Patients with Cancer'. Results: The mean of needs score was 76.6, which meant degree of the needs was very high. Among the categories of the needs, the mean of category 'emotional care' was the highest. There were significant differences in the needs of hospice care according to sex and type of present therapy. Conclusion: Health care providers in hospital and hospice facilities must assess the needs of families as well as the patients in order to meet their specific needs. Additionally, they need to have deeper understanding of the need of emotional care and to apply emotional care to hopice patients and their families.