• 대한임상검사과학회지
• /
• 제44권4호
• /
• pp.178-183
• /
• 2012

We investigated the latest trend of u-Health and relations with clinical technologist. Since 2000, Korea has become an aging society. Korea will become an aged society by 2018, and it is expected to enter the ultra-high aged society by 2026. Increase in over 65 years population means that the desire of medical service and care demand for the elderly is greatly required. In addition, many predicted Korean national health insurance would falter financially. Medical suppression policies and regulations are also amended continuously. U-Health based on the IT industry and development of related technologies and industries contains the variety concepts of telemedicine, telehealth, e-health, u-healthcare and POCT. Especially, the use of POCT supplied quick clinical examination is extending steadily in medical center and hospital, which will generate the field friction between nurses and medical technologists. In the transition situation from provider-centric service to consumer-driven health care system, this study recommended the principal role and correspondence of clinical laboratory workers and offered information about changes in healthcare market and the basic concept of expert system, measurement and the diagnosis principle to clinical technicians throughout the investigation of the recent research and government policy trends.

• 대한간호학회지
• /
• 제37권5호
• /
• pp.790-800
• /
• 2007

Purpose: This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area. Methods: A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record. Results: Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up. Conclusion: Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.

• 보건행정학회지
• /
• 제16권1호
• /
• pp.17-40
• /
• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

• 대한간호학회지
• /
• 제25권3호
• /
• pp.562-580
• /
• 1995

This research was an attempt to make it possible to provide nursing care and health education meet- ing the need not of care givers but of patients by identifying the nature of patients' self regulation experiences. The specific objective of this study was : 1) to explore self regulation experiences of patients with adult disease. The phenomenological approach in qualitative studies is used to serve this purpose. Colaizzi's method is used for the phenomenological analysis of the data in this study, which were collected from 25 patients hospitalized in the internal medical ward and oriental medical ward of a Seoul hospital, suffering from adult disease such as hypertension, arteriosclerosis and diabetes mellitus. The research was conducted over a period of March to September, 1994. The investigator conducted participated observations and in-depth unstructured interviews which were audiotaped under the permission of patients. The investigator read the data repeatedly to identify and categorize significant statements, formulating meanings, themes and theme clusters. The result is categorized as follows : Self regulation activities, their barriers and predisposing factors of a disease. Thirteen theme clusters of self regulation activities related to health identified were. “maintaining diet regimen”, “maintaining exercise regimen”, “maintaining medication regimen”, “maintaining oriental medical regimen”, “maintaining health monitoring regimen”, “maintaining self effort”, “maintaining religious life”, “maintaining social sup-port systems”, “maintaining peaceful mind”, “maintaining moderation in life”, “maintaining sincere attitude in life”, “maintaining natural life”, and “maintaining folk remedy” This findings confirm the fact that self regulation is complicatedly and diversely influenced by oriental medicine and folk remedy, and Korean traditional ideas melted in Confucianism, Buddhism, Taoism and Shamanism, and modern medical care and western culture. Seven theme clusters of self regulation barriers identified were : "lack of knowledge and self aware-ness", "lack of social supports", "lack of awareness of need in continuous regimen and treatment", "dissatisfaction with hospital and health care provider", "lack of self management ", "lack of will to combat illness", and "overconfidence in folk remedy" Four theme clusters of predisposing factors of a disease were : "cumulation of stressors", "fatalism", "careless life style", and "family history". In conclusion, this. study will prove helpful not only in understanding clients in light of our traditional culture but also in providing them with the kind of nursing care and health education satisfying their demands and particularly cultural needs.

• 지역사회간호학회지
• /
• 제25권3호
• /
• pp.187-197
• /
• 2014

Purpose: The aim of this study was to identify the roles, duties and tasks of elementary health teachers. Required knowledge, skills, and worker behaviors were also examined. Methods: Elementary health teachers' jobs were analyzed by DACUM workshop. First, the health teachers' roles and related jobs were described, and then the jobs were divided into duties and subordinate tasks. The identified roles, duties and tasks were reviewed and refined, and then were organized in a DACUM chart. DACUM committee members discussed not only general knowledge, skills and work behaviors but also future trends and concerns. Results: The DACUM chart for elementary health teachers consisted of 8 duties and 52 tasks. Required knowledge, skills and worker behaviors were also listed. Conclusion: Elementary health teachers play roles as health manager, health care provider, and teacher in school. Their roles, duties and tasks are being changed. Thus, their jobs need to be redefined legally, politically, and institutionally.

• 한국직업건강간호학회지
• /
• 제10권1호
• /
• pp.110-119
• /
• 2001

This study was performed to review applying the case management to the occupational health nursing as a cost-effective way for injured workers. The case management for injured workers is a comprehensive management system, which is composed of planning and implementing in cooperation with employee, employee' family, medical service provider team, employer and case manager, to provide high quality health services to employee and their family. The case management process for injured workers is similar to the nursing process. It thus appears that the occupational health nurse is best personnel to perform the role of case manager for injured workers in workplace. As a case manager in workplace. the occupational health nurse would be expected to get both knowledge and experiences, to get trusted from the employee and employer, and to expand professional domain in changing health care environment.

• 보건행정학회지
• /
• 제31권2호
• /
• pp.173-179
• /
• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• 문화기술의 융합
• /
• 제10권2호
• /
• pp.225-236
• /
• 2024

본 연구는 국내 지역사회 통합돌봄 제도에 관한 연구 동향을 파악하고 향후 연구 방향을 제시하고자 수행되었다. 주제 범위 문헌고찰방법으로 JBI방법론적 지침에 따라 진행하였다. 문헌검색은 5개의 DB(RISS, DBpia, NDSL, KISS, NAL)에서 실시하여 최종분석에는 34편의 논문이 선정되었다. 지역사회 통합돌봄과 관련된 이용자와 제공자 측면으로 분류하여 분석하였으며 이용자 측면 결과는 서비스 만족도, 신체적 건강상태와 관련된 변수가 가장 많이 사용되었고 긍정적인 결과가 나타났다. 제공자 측면 결과는 서비스 제공으로 인한 문제점과 개선점을 주로 연구하였으며 기관 간 협업체계 활성화의 필요성과 서비스 수행 인력 부족이 많은 연구에서 나타났다. 본 연구결과를 토대로 향후 지역사회 통합돌봄 제도의 확장에 있어 대상자 선정기준 확립 뿐 아니라 서비스 제공자의 전문성 확보, 지역 간 및 기관 간 협업체계 및 서비스 편차해소를 위한 대책마련이 필요할 것이다.

• 대한간호학회지
• /
• 제17권3호
• /
• pp.204-217
• /
• 1987

It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t＝-5.29, df＝62, p＝.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t＝2.72, df＝62, p＝.009, for diastolic blood pressure t＝1.95, df＝62, p＝.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r＝-.2981, p＝.008, for diastolic pressure r＝-.1720, p＝.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

• Child Health Nursing Research
• /
• 제21권4호
• /
• pp.311-319
• /
• 2015

Purpose: To reilluminate academic fundamentals and missions of child health nursing (CHN). Methods: Critical review of literature. Results & Conclusion: The academic fundamentals of CHN were analyzed for three different basis; philosophical, theoretical, and legal & ethical basis. The philosophical basis of CHN was summarized as six beliefs; A child is an important human resource and a valuable asset for future society; A child should be respected as a unique and dignified human being; A child has his/her own unique developmental needs; A child is a vulnerable client and should be advocated for; Atraumatic care should be provided to each child; Child health care should be family-centered. The essence of the theoretical basis were reilluminated into caring theory and client advocacy theory. The legal basis of CHN was stated as pertaining to the various child-related laws and international conventions, such as UN Convention on the Rights of the Child. The ethical basis were stated as 4 principles of biomedical ethics and The UNESCO Universal Declaration on Bioethics and Human Rights. The mission of the CHN was stated and the role of CHN was described as one who is a child rights advocator, professional caring service provider, policy maker, health educator, researcher.