• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

• Journal of Nutrition and Health
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• v.13 no.1
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• pp.15-26
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• 1980

The main purposes of the nutrition and clinical surveys were to provide baseline information on the nutritional status of pre-school children in rural health demonstration project areas of the Korea Health Development Institute (KHDI) for nutrition guidance services for the MCH target group. The survey covered a total of 222 pre-school children and 135 mothers in Okgu Gun, Cholla Pukto Province from August 10 to August 17, 1979. The survey results are summarized as follows: 1) Family Environment Seventy percent of the households had more than three children, and the mean family sire was 6. Sixty-nine percent of the mothers and 47% of the fathers of the surveyed households were educated at or below the primary school level. The majority, 70% of the mothers, were aged between 20 years and 35 years. 2) Anthropometric Measurements and Hemoglobin Value 4.5% of the children were lower than 80% weight for age of the Korean standard, and 5.4% were lower than 85% arm circumference for age of the Jelliffe's standard resectively, and those were suffering from protein-energy malnutrition. Angular stomatitis were observed on 66.2% of the subjects. Mean hemoglobin value was 11.1g/100m1, and 44.2% of the subjects were categorized as anaemia. 3) Food and Nutrient Intake of animal foods was very low, ranging from 2.9 to 17%. Consumption of eggs was less than 2% of total food intake, and intake of legumes was also very scanty, between 0.8 to 3.7%. These data present evidence of very poor protein intake, quality as well as quantity. Energy intake of children was 60.0 to 64.4% of the recommended allowance, and mean protein intake only met 47.4% of the recommendation. Low intake of vitamins except thiamin were also found. 4) Mother's Nutrition Knowledge Eighty-five percent of the mothers were entirely ignorant regarding the 'five basic food group' which is most important fact on food and nutrition guidance. Mean knowledge score from 14 basic questions about food and nutrition was as low as 5.1. There was a significant positive correlation between mother's educational level and nutrition knowledge score. 5) Family Planning Variable There were significant correlation among maternal, family planning variables, and some of the nutritional and physical measurements. The study revealed that the mother's educational level and nutrition knowledge score are more crucial factors than the family planning variables on effecting food intakes on children. Recommendation : According to the results of the surveys, there were high incident rates of nutritional anaemia and angular stomatitis among pre-school children, and most of rural women had very limited knowledge about food and nutrition. As a main part of the health education activities, the community health workers should provide nutrition education to the village mothers to improve the nutrional status of young children in rural areas. Nutrional promotion at the primary health care level should be mainly based on appropriate nutrition education.

• Journal of KIISE:Computing Practices and Letters
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• v.15 no.4
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• pp.244-254
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• 2009

This paper describes a remote system to monitor the circadian behavioral patterns of elders who live alone. The proposed system was designed and implemented to provide more conveniently and reliably the required functionalities of a remote monitoring system for elders based on the development of first phase prototype[2]. The developed system is composed of an in-house sensing system and a server system. The in-house sensing system is a set of wireless sensor nodes which have pyroelectric infrared (PIR) sensor to detect a motion of elder. Each sensing node sends its detection signal to a home gateway via wireless link. The home gateway stores the received signals into a remote database. The server system is composed of a database server and a web server, which provides web-based monitoring system to caregivers (friends, family and social workers) for more cost effective intelligent care service. The improved second phase system can provide 'automatic diagnosis', 'going out detection', and enhanced user interface functionalities. We have evaluated the first and second phase monitoring systems from real field experiments of 3/4 months continuous operation with installation of 9/15 elders' houses, respectively. The experimental results show the promising possibilities to estimate the behavioral patterns and the current status of elder even though the simplicity of sensing capability.

• Women's Studies Review
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• v.31 no.1
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• pp.93-116
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• 2014

This thesis discussed the status of women workers as wage laborers and home laborers and the valid of a documentary movie for representing women laborers through a documentary movie, Weabak that revolved around Home-ever occupation strike leaded E-Land labor union at 30th June, 2007. Jobs for women labors got covered by the flow of flexibility with the policy of labor flexibility in South Korea during 1990s. The reasons that justify this trend are their position in the households, and their roles in working places are not very important because there are not required difficult skills. The mass dismissal which caused the E-Land strike also shared these ideologies. In Weabak, since women laborers were always expected to care for their family, they were need strikes in their home as well as their working place. However, a household is a basement for them to get the identity as a women laborer. It has two ambivalent meanings, as a protected area and disorder for them to pursue their life at the same time. Identity of Women laborers, domestic laborers as well as wage laborers, are very difficult to identify as a general noun, a laborer. Weabak is an important example to show us the possibility of a documentary as searching new realism for representing women laborers' story using their own perspective.

• Korean Journal of Community Nutrition
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• v.20 no.3
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• pp.165-177
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• 2015

Objectives: Based on individual and environmental characteristics of low-income children, we developed a nutrition education program for school-aged children from low-income families according to effective use in social welfare centers. Methods: We conducted in-depth group interviews to assess program needs in 28 participants, 10 low-income school-aged children and 9 of their care givers, 9 social workers and 9 care-givers. Theoretical backgrounds of our program were heath belief model and social cognitive theory considering motivation, action and environment characteristics. Results: Based on the findings of this qualitative study, we developed major program themes and contents. Five selected key themes were 'balanced diet', 'processed food', 'food hygiene and safety', 'Korean healthy traditional diet', and 'family cooking' to induce changes in dietary behaviors. Main findings of in-depth group interviews included 'child's active participation', 'simple and easy to understand messages', and 'environmental constraints' such as a lack of child care at home, limited budget of social welfare centers, and less qualified educators for nutrition and health. Each lesson was constructed as a 1-hour program particularly emphasizing activity-based programs, including cooking and teamwork exercises. Program contents in each session consisted of activities that could induce outcome and value expectations, self-efficacy, perceived benefits, and barriers and cues to actions regarding diet behavior. Conclusions: We developed a nutrition education programthat is rarely available for low-income children in Korea, considering theoretical bases. Further studies are needed to validate our program.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.231-241
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• 1996

The estimation of medical care status and the planning of health service program should be done according to each community resident's socio-medical background and public health service. In this point, it is most necessary to be set the exact and new socio-economic statistics data in Nepal, one of the worst countries in national health status. We surveyed 668 house, 3,425 residents in Dolka area, Nepal from January 25th to February 1st, 1995. 1. In personal characteristics, the ratio of men and women was similar, the person who were below 19 years old were 28.1% and the single were 52.4%. The illeterate person were 50.3% and the lower group in economic status which had been estimated by interviewers were 46.9%. 2. In sanitational characteristics, the person who used stream water or rainwater to drink were 42.2% and the person who always boiled water to drink were only 8.3%. The person who had not toilet in their house were 67.3% and the lower group in sanitational status which had been estimated by interviewers were 61.8%. 3. The prevalence rate of illness during the last one month were 8.6% and the chronic were 26.1% and the acute were 72.5%. The distribution of sickness symptom were headache, fever and joint pain in order and the person who took no medical treatment among the sick were 37.0%. The patterns of medical utilization were public health center, hospital and pharmacy in order. 4. Illness prevalence was significantly related to sex, age, merital status and educational experience. The residents who were women, 40 years old or more, married and had not educational experience were apt to take illness. 5. Medical utilization was significantly related to educational experience, job, distance from home to medical facilities and economic status. The person who had educational experience, were officer workers or merchants, lived near by medical facilities and had higher economic status took medical treatment very well.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.473-486
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• 2021

The purpose of this study is to investigate the mediating effect on self-efficacy in the effect of the compensation system of caregivers on job satisfaction. The research method was analyzed with SPSS V22.0 on the data of 367 people surveyed of caregivers working at home welfare facilities and elderly care facilities in the metropolitan area. The result is as follows. First, it was found that the average monthly salary, satisfaction of compensation treatment, and fairness of compensation had a positive effect on job satisfaction in the compensation system of caregivers. Second, in the compensation system for care givers, it was found that monthly average salary, satisfaction with compensation treatment, and compensation process had a positive effect on self-efficacy. Third, it was found that the self-efficacy of caregivers had a positive effect on job satisfaction. Fourth, in the compensation system of caregivers, it was found that the monthly average salary, compensation treatment satisfaction, and compensation process had an effect on job satisfaction, whereas self-efficacy had a positive mediating effect. It revealed that the higher the average monthly salary, compensation treatment satisfaction, and compensation process in the caregiver's compensation system, the more positively the self-efficacy had, and this self-efficacy had a positive effect on the job satisfaction of the caregiver.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.4-17
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• 2000

Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.353-377
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• 2000

This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

• The Journal of the Korea Contents Association
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• v.11 no.9
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• pp.414-428
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• 2011

The purpose of this study was to investigate the effects of the elderly long-term care workers' job stress on psychological burnout and organizational effectiveness and the moderating role of social support. For this study, data were collected from 290 long-term caregivers from 50 in-home visitation care facilities in Seoul using structured questionnaires. Collected data were analyzed using hierarchical regression techniques. Results showed that role three job stress variables had positive effects on caregivers' psychological burnout; that two job stress variables(role ambiguity and role conflict) and psycholigcal burnout had negaive effects on caregivers' job satisfaction whereas they had positive effects on caregivers' intent to leave; that workload negatively impacted caregivers' job satisfaction but no effect on their intent to leave; and that two social support variables played moderating roles in the relationship between job stress and psychological burnout and the relationship between job stress and organizational effectiveness.