OECD회원국 가운데 10여년 넘게 지속적으로 합계출산율이 1.3명 미만을 기록한 국가는 한국이 유일하다. 2006년부터 정부는 인구정책을 본격적으로 추진하고 있으나, 한번 떨어진 출산율은 도무지 회복될 기미를 보이지 않고 있어서 '저출산의 덫'에 빠져있다고 볼 수 있다. 이러한 저출산이 지속되는 경우에는 국가경쟁력은 물론이고 국가의 존속 자체를 위협할 수 있는 심각한 문제가 발생할 수 있다. 한국 사회에서는 학업과 취업으로 인해 여성의 출산이 점점 늦어지고 있으며, 열악한 근로환경에 의해 임신에 부적절한 건강상태를 초래하기도 하므로 가임기 여성과 임산부에 대한 건강관리는 매우 중요하다고 할 수 있다. 따라서 본 연구에서는 저출산 시대에 있어 주요 국제기구와 국가가 추진하는 모성 중심의 건강증진 전략을 살펴보고, 이를 토대로 한국 사회에서의 모성 건강증진 정책에 대한 문제점을 분석하여 그들을 위한 보다 효과적인 건강증진 방안을 몇 가지 제시하였다.
Penberthy, Jennifer K.;Chhabra, Dinesh;Ducar, Dallas M.;Avitabile, Nina;Lynch, Morgan;Khanna, Surbhi;Xu, Yiqin;Ait-Daoud, Nassima;Schorling, John
Safety and Health at Work
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제9권4호
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pp.381-387
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2018
Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.
Background : The purpose of this study was to investigate the understanding and the attitude of Korean hospital CEOs toward the healthcare quality improvement. Methods : A mailed questionnaire survey to the CEOs of hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for the study, 58 participated, yielding a response rate of 54 percent. Result : The hospital CEOs have expressed that their hospital management was arduous job, and they had been pressured by increasing competitions among healthcare providers. They indicated that the low fees of health insurance made their hospital management difficult. The results also indicated that there was general consensus that the improvement of service quality was important in encouraging their organizations, but the investment of manpower and equipment ranked higher than the improvement of service quality. The majority of the CEOs have good understanding about quality improvement activities. However the facts that in general QI must be focused at the process of services and customer satisfaction, meanwhile quality improvement activities are helpful for the organizational productivity embarrassed them. The hospital CEOs responded that there were successful changes in terms of quality of care, patient satisfaction, and process efficiency after QI activities, but no increase in patient number and profit. Lack of understanding to QI activities and limited budget seem to attribute unsatisfactory outcomes. Conclusion : The majority of Korean hospital CEOs have a good understanding and attitude about QI activities. As mentioned in the result, despite of several limitations, several facts regarding the CEOs of hospital in Korean can be elucidated. (1) The general cognition of the QI project is relatively high, and it is accepted with positive concern, (2) the priority of the QI project, however, is not set higher than other projects and (3) the specific concepts of the actual QI project such as customer (patient)-focused work driving, the recognition of the work accomplishment, and the importance of rewards have not sufficiently understood.
Objectives: This study aims to identify gaps between knowledge regarding migration and the spread of HIV/AIDS, to improve understanding of migrants with HIV/AIDS and their human rights, and to make suggestions for Korean policy makers to reform laws and policies towards granting migrants with HIV/AIDS more human rights and access to treatment and care. Methods: This study is based on an extensive literature review, questionnaire surveys and in-depth interviews from randomly selected 8 countries from 5 different continents: Japan from Asia; Australia from Oceania; Finland, Germany, Ireland and United Kingdom(UK) from Europe; and Canada and United States of America(USA) in North America. Results: This study has found that Korea has a discriminating policy regarding HIV/AIDS and foreigners. Classifying HIV/AIDS into a legal communicable disease, it requires a presentation of HIV/AIDS test results from foreigners wanting a long-term stay before entering. In principle, foreigners with HIV/AIDS cannot either enter or stay in Korea. If they are known infected with HIV/AIDS by any reason, they became to face an immediate deportation regardless of their sojourn statuses and purposes. Conclusion: With the results, this study suggests three reasons why Korean government needs to change the current HIV/AIDS policy on foreigners: 1) HIV-related travel restrictions have no public health justification, 2) its strict HIV/AIDS policy on foreigners could result in restriction on the mobility and migration of its people by the other countries, inversely, and 3) it needs to meet international guidelines and to observe conventions that international organizations suggest to maintain its status as a member of the international society.
Purposes: This research is an empirical research to analyze the effect of self-leadership on the job satisfaction and organizational citizenship behavior and the mediating effect of psychological capital. Methods: This research investigates the effect of self-leadership and psychological capital on job satisfaction and organizational citizenship behavior of public health workers. The analysis was carried out to 4 local medical staffs in Chungcheongnam-do province, which distributed 330 copies and recovered 313 copies (94.8% recovery) and analyzed 304 copies (effective response rate 92.1%). Findings: First, causality was found in self-leadership and psychological capital. Second, it was found to have a significant effect on psychological capital and job satisfaction. Third, psychological capital was found to have a significant effect on organizational citizenship behavior. Fourth, psychological capital has a positive effect on both Self-leadership's behavior-oriented strategy, natural reward strategy, and strategic thinking pattern strategy. In the job satisfaction relationship, there was a partial mediating effect. Fifth, psychological capital has a positive effect on both self-leadership and organizational citizenship behavioral behavior-oriented strategy, natural reward strategy, and strategic thinking pattern strategy. The organizational citizenship behavioral relationship was found to have a partial mediating effect. Practical Implications: Taken together, the results indicate that the members of the four public health care organizations run by Chungcheongnam-do have a high weight on the natural reward strategy of achieving job satisfaction through the pleasures of doing their favorite activities or jobs.
The purpose of this study was to analyze the information about the disaster temporary shelter space planning guidance described in the U.S. shelter guidelines in terms of the habitability for disaster victims and to address the implications and potential impacts of its findings for the improvement of the shelter design standards and guidelines in Korea. The researchers reviewed four federal and non-governmental organization shelter field and design guidelines and attributes regarding the shelter space planning were classified in accordance with four habitability categories: Safety, Health, Convenience, and Comfort. Three major findings emerged from this study: 1)A total of 72 items about the shelter space planning were extracted from guidelines, and the majority of items are concerned with dormitory areas and sanitary spaces. Other items were about accessibility, children respite care area, signage, health service areas, food preparation and serving areas, parking and drop-off areas, registration and waiting areas, shelter manager and staff areas, lounge and storage areas, and household pets area. 2)Most of these items are strongly related to the convenience category(66.7%), followed by comfort(40.3%), safety(30.6%), and health(25.0%). 3)The habitability of the disaster temporary shelter can be established with considerations on the needs of disaster victims and vulnerable people, minimum occupancy space per person, separate sanitary spaces for the privacy, safe and convenient access routes to the shelter, and the provision of children areas for safety and comfort. The study findings will contribute to the development of the disaster shelter guidelines in Korea by suggesting shelter space planning indicators related to the habitability for the governmental and non-governmental organizations' immediate and systematic responses to the disaster.
Objectives : The purpose of the study is to investigate the education, certification system, and extent of duty of dental hygienist between Korea and five developed countries including United States, Canada, England, Australia, and Japan. Methods : Internet based access to five developed countries was made and the analysis was done for the definition of occupation, main duties, similar occupations, education policy, job descriptions, license certification system, standards of duty, Q & A management, current status of obtaining certification, and scope of work. Results : United States has a two-year associate degree(AS) and a four-year bachelor degree(BS). Canada has two to three years degree and a two-year course is accepted in england and Australia. In the meanwhile, Korea and Japan have two-year and four-year educational courses. The duty of dental hygienists includes the prevention education for dental health and continuing dental health care. Most of the dental hygienists in Korea and Japan play the assistant roles for the dental surgeons. United States has national board examinations including written examinations, practical examinations, and computer assisted examination. Written and practical examinations are also conducted in Korea. England and Australia have the recognized educational organizations for qualification. Conclusions : Problem based and problem solving skills are the most important in dental hygienist education in Korea. The training of highly competent dental hygienists must be done for the improvement of dental hygiene in Korea in the near future.
Background: Instrument players are exposed to occupational musculoskeletal symptoms due to constant movement and strain to meet the needs of their audience. This can cause dissonance between the player and the instrument and can cause medical problems in the musculoskeletal system such as pain, tendinitis, muscle spasms, and joint hyperextension from overuse of body parts. Objective: The purpose of this study is to comparatively analyze the characteristics and occurrence of musculoskeletal symptoms in professional and student players, and to find out the awareness of the need for health care professionals and special exercise programs for orchestra players. Methods: The subjects were professional orchestral musicians 191 from the three symphony orchestras and music students 209 from the four universities volunteered to participate in this study; 393 subjects (98.25%) completed the questionnaire. symptom prevalence and related factors of playing-related musculoskeletal disorders (PRMDs) were surveyed with a self-administered questionnaire. Standardized Nordic Questionnaire was complemented by adding a visual-among scale and used to diagnose PRMD. Results: High prevalence of musculoskeletal complaints in both professional musicians (85.30%) and student musicians (82.30%). Professional musicians and student musicians also suffered the highest problem in shoulder and neck complaints. Significant differences were found between groups that recognized of necessity for specialized health professionals, professional organizations, and special programs for musicians. Conclusions: Professional musicians and student musicians, like orchestra players, are already exposed to overuse syndrome. However, student musicians lack awareness of the risk of injury compared to orchestra players. We suggest that an appropriate treatment management program for the prevention and early treatment of musculoskeletal system damage should be provided to performers at an early stage.
Objective: This study investigated the awareness of occupational therapy in the community in occupational therapy majors through a survey. This purpose is to investigate the awareness of occupational therapy in the community among occupational therapy majors and establish a theoretical foundation. Methods: The research subjects were surveyed among occupational therapy majors at M University living in Gyeongsangnam-do, and analyzed 141 questionnaires from September 2023 to December 2023. Results: The results of this study that education and awareness improvement are needed to increase awareness of occupational therapy in the community, and it was found that continuing education and case sharing are effective. Activation of home rehabilitation and continuous health management. This institutional development can induce employment activity through community rehabilitation, and activate programs in connection with adult day care centers. For the development of community occupational therapy, participation in education and development of customized treatment are necessary, and patient It should be developed to help with movement and movement, and it has been shown that it can also affect the quality of life of patients. In addition, cutting-edge technologies such as artificial intelligence are expected to be applied to remote support, telemedicine, etc., and are applied to dementia, cognitive patients, and central nervous system patients. In order to institutionalize occupational therapy in the community, it is helpful in daily life, nursing, and management. It was said that this would be helpful for community participation. Conclusion: This study investigated the awareness of occupational therapy in the community among occupational therapy majors. Education and awareness improvement are needed to increase awareness of occupational therapy in the community. Education to improve the professionalism of occupational therapists, strengthening connectivity with other majors, and local organizations. It is believed that collaboration with the local community and institutional supplementation tailored to the needs of the local community were necessary.
Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.
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