• Journal of Korean Academy of Nursing Administration
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• v.9 no.4
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• pp.541-557
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• 2003

Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

• Health Policy and Management
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• v.20 no.4
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.731-742
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• 2018

Purpose: The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory. Methods: Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0. Results: The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients. Conclusion: It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.

• Journal of Korean Public Health Nursing
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• v.29 no.2
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• pp.325-343
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• 2015

Purpose: This study was conducted in order to identify and describe the experiences of health care during pregnancy, birthing, and postpartum period for Vietnamese marriage immigrants. Methods: The participants were 15 Vietnamese married immigrant women who became pregnant and gave birth within the last five years. Data were collected by in-depth interview with Vietnamese women. Data were analyzed using Colaizzi's method of phenomenology. Results: Six theme clusters were extracted as follows: 'being left with no other option in loneliness and longing filled in a limited life', 'continued trials and errors amidst frustration and fear', 'silently following orders despite the quality of medical services that change with each medical care provider', 'compromise by selecting amidst confusion between the Korean way and the way at home', 'depending on family, who is the communication channel, but becoming disappointed', and 'finding the reason for existence and struggling by herself to become a mother amidst doubled confusion'. Conclusion: A program for effective empowerment of Vietnamese immigrant women should be developed. In addition multicultural family centered programs should be developed with emphasis on acceptance of women's culture, respect for her culture, and supports. Medical staffs and nurses should also improve culturally sensitive competence in order to provide care for immigrant women.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.242-259
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• 1997

This study describes associated factors of readmission of 213 inpatients from an university hospital in Seoul. This retrospective study reviewed medical records of patients who discharged from a hospital stay for general diseases between 1 August 1995 and 31 October 1995, Cases were 68 discharge patients with an unplanned readmission within 30 days of discharge from an index stay. And the other cases are 145 patients who had more than two discharges and didn't have an unplanned readmission within 30 days. Logistic regression model was analyzed and the results were as follows; 1. duration of readmission, rate of unpayed, room, path, and risk of disease were more likely to be readmitted unexpectedly than the expected readmission patients. 2. early readmission, low risk condition group, and inadquateness of discharge plann for patients had unplanned radmissions rather than planned readmissions. Therefore, discharge planning education to health care provider is required and assessement of discharge planning should be evaluated. Readmissions are usually for related problems that arose during the original hopitaliztion and caused cost problems. Especially the unplanned readmissions are frequently preventable. Ultimately, models for readmissions can serve as a valuable clinical tool for target high-risk patients and older patients and with this kind of tools we can reduce hospital readmissions and maintain high-quality of inpatient care.

• Korean Journal of Occupational Health Nursing
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• v.20 no.3
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• pp.299-307
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• 2011

Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

• Health Policy and Management
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• v.30 no.4
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• pp.433-437
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• 2020

Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor's quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor's quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.

• Korean Journal of Adult Nursing
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• v.26 no.3
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• pp.287-299
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• 2014

Purpose: The aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB). Methods: A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0. Results: Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL ($R^2$=.03~.22, p=.041~<.001). Conclusion: CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.

• Journal of Preventive Medicine and Public Health
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• v.52 no.2
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• pp.115-122
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• 2019

Objectives: The aim of this study was to assess knowledge, attitudes, and practices regarding tuberculosis (TB) in the general population in Timor-Leste. Methods: In the nationally representative cross-sectional 2016 Timor-Leste Demographic and Health Survey, 4622 men (aged 15-59 years) and 12 607 women (aged 15-49 years) were randomly selected using stratified multistage sampling and interviewed. Results: Overall, 66.9% of men and 62.8% of women were aware of TB, 4.4% of men and 12.6% of women had TB courtesy stigma, and 83.3% of men and 88.6% of women reported intention to receive TB treatment. The $mean{\pm}standard$ deviation overall TB knowledge score was $3.9{\pm}2.0$ (out of 8) among men and $3.0{\pm}1.8$ among women. In a multivariable linear regression analysis, among both men and women, older age, higher education, rural residence, and sources of TB information (family/friends, school/workplace, health care provider, Internet, television, and newspaper) were associated with higher TB knowledge scores. In addition, among women, higher wealth status and having heard about TB from the radio were associated with higher TB knowledge scores. Negative associations with TB courtesy stigma were found for urban residence and having heard about TB from family or friends among men, and for older age, higher TB knowledge, and TB information sources (family/friends and school/workplace) among women. Among both men and women, higher TB knowledge scores and having heard of TB from a health care provider were associated with intention to receive TB treatment. Conclusions: This study identified socio-demographic risk factors for deficiences in population-based TB knowledge in Timor-Leste; these findings should be considered when designing TB communication, prevention, and control strategies.

• Health Policy and Management
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• v.18 no.1
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• pp.85-107
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• 2008

This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.