• Title/Summary/Keyword: Home Care Workers

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Development of an Efficient Management Program for the Home-based Cancer Patient Management Project of Public Health Centers (보건소 재가 암환자 관리사업의 효율적 관리 방안 개발)

  • Cho, Hyun;Son, Joo-Young;Heo, Jeom-Do;Jin, Eun-Hee
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.128-136
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    • 2007
  • Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.

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Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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A Study on the Maternal and Child Health Status in a Rural Area (일부농촌지역(一部農村地域)의 모자보건실태(母子保健實態)에 관(關)한 연구(硏究))

  • Nam, Sang-Duk
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.333-342
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    • 1974
  • In September 1974, a survey was conducted towards 900 women respondents, each representing a household, residing in 18 selected Myuns(townships) of 18 Guns(counties) in Kyunggi-Do. Fifty households were selected randomly in each Myun and the sample Myuns were also randomly selected from the 18 Guns home-visiting interviews were carried out by Myun level maternal and child health workers with questionnair forms designed to measure the maternal and child health status at each household. Major findings obtained from this survey can be summarized as follows: 1. Of the women responents who were investigated in this survey, 13.1% of them were comprised in the illiterates, indicating no difference in literacy rate from that in most urban areas. 2. Most(93.8%) of the respondents were found to have married at ages of 20-24 years old. 3. Most(85.8%) of the respondents were found to have delivered their first babies at ages of 20-24, while only 13.4% had their first babies at 25-29. 4. About 22% of the respondents had 2 children, while 19% and another 19% had 2 and 4 children, respectively. 5. A great majority of the respondents (78%) experienced not a single death of a child within the family, while about 17% experienced death of one child. 0.7% of the women experienced deaths of 4 or more children. 6. 18% and 17% of the women experienced 4 and 3 pregnancies, respectively, and 12% of them experienced 7 or more pregnancies. 7. About 29% of the women experienced an induced abortion at least once. Nearly 2% of them were found to have experience of 4 or more induced abortions. 8. One half (51%) of the women were found to have received prenatal guidances in the latest pregnancies by (Ub(town) and Myun (township) level maternal and child health workers at least once or more times. 9. 52% women received professional prenatal care in the latest pregnancies: 24% at hospitals or clinics and 20% at health centers. 10. Most (89%) of the last-born children were delivered at home, while only 8.7% were delivered at hospital or clinics. 11. Materials used at delivery comprise vinyl (40%), cement bags (32%) ana gauzed or absorbent cottons (19%). 12. The largest preportion of the attendants at delivery comprises mothers in-law (48). Only 24% were found to be attended by either doctors, midwives or maternal and child health workers. 13. In most (90%) of the deliveries scissors were used to cut the umbilicus. But most (7%) of them used unsterilized scissors, 6 while only 20% of them used sterilized ones. 14. About 68% of the last-born babies were breast-fed for 12 months or more. Those who weaned during 6-12 months were 21%. 15. During 12 months after birth, 65% of the last-born babies were breast-fed, while 24% were given a combination of breast milk and cooked rice. 16. About nine out of the 10 births were found to be registered. 17. 71% of babies received BCG vaccination, while 79% and 56% received samllpox and DPT vaccinations, respectively within a year after birth. Those who were vaccinated against poliomyelitis were about 50%. 18. About 87% of the respondents recogninized the existence of government-sponsored maternal and child health guidance program.

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The Analysis of Need with Homebound Disabled Persons in a Country Area (일부 농촌지역 재가 장애인의 요구도 분석)

  • Jung, Byeong-Ok;Lee, Cu-Rie;Kim, Keun-Jo;Park, Heung-Ki;Kim, Bonn-Won
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.43-62
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    • 2006
  • The survey was conducted with participation of the 289 handicapped persons residing at the rural area OOeup-gun in Kyungbook for the period of March 2 - May 31, 2006, to study the nature in general of the handicapped and the boundaries of their need. For the nature in general of the handicapped, the study was done by gender iscrimination, age, marital status, religion, educational level, occupation, monthly income, disability cause, disabled duration, disability type, disability level. For the boundaries of their need, the study was done by demand of financial support, educational demand, demand of voluntary workers, need of rehabilitation and medical treatment, job training, improvement of living conditions, or so. Using the Win.SPSS program, we made a frequency analysis and conclusions on the nature in general of the handicapped and the boundaries of their need on a 2-test. Conclusions are : 1. Nature in general of the handicapped The existence of the handicapped shows high at the age over 51 (71.6%), male-handicapped (65.1%), primary school graduates (62.9%), farming engaging (65.2%), monthly income less than one million Won (80.5%), cause by disease (53.8%), duration more than 10 years (61.6%), disability at level 3 (39.8%), extremity disability (66.4%). 2. Correlation of nature in general with demand of the handicapped a. In demanding the financial support, support for helper’s compensation shows high (p<0.05). In demanding the necessity of voluntary workers, the male-handicapped appears high during the absence of family assistance and the female-handicapped appears differently per week and also appears high during the absence of family assistance (p<0.05). b. In educational demand of the handicapped by their age, the age below 30 demands technical-job training and the age over 31 demands medical education for health care (p<0.01). c. In demanding the financial support by educational level, support for living cost shows high (p<0.05). d. In demanding improvement of living conditions by postnatal cause of disability, improvement of house structure shows high (p<0.05). e. In demanding assistance of voluntary workers by disabled duration, "No Need" shows high in the disabled duration more than 4 years (p<0.05). f. In demanding rehabilitation and medical treatment by disability type, home-visiting treatment, oriental medical treatment and physical therapy show high (p<0.001). g. In educational demand by disability level, medical education for health care shows high (p<0.01).

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The Incidence Rates and Risk Factor of Mild Injury for Two Weeks - Using Korea National Health and Nutrition Examination Survey 2001 - (2주간 경미손상의 발생률과 위험요인 - 2001년 국민건강영양조사자료를 이용하여 -)

  • Lee, Je-Suk;Kim, Soon-Duck;Lee, Dong-Ki;Lee, Ji-Sung
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.279-286
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    • 2008
  • Objectives: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. Methods: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. Results: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0,70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. Conclusions: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.

A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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Improvements of the Relevant Act for Working of the Marriage Immigrants' Family in Korea (결혼이민자 가족의 국내 취업활동 허용을 위한 관련법 개선방안)

  • Cho, Hyun;Ko, Zoonki
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.251-263
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    • 2013
  • To explore the device to allow the marriage immigrants' family to take jobs in our country, the social and economic environments that they face are investigated and analyzed through literature survey and field inquiry. The principal motive of the marriage to Korean is economic problem. But their actual economic conditions are inferior, and other legal problems, such as getting jobs and remitting money to their home country, drive them to unstable status. The present hiring policy is applied only to foreign workers with no domestic relations(E-9), hence the marriage immigrants are excluded from the domestic employment. To make institutional devices for giving them the employment opportunity, the modification of the existing laws are proposed. For examples, the 'Act on employment of foreign workers' can be revised to permit immigrant's relatives to get jobs, and 'Immigration control law' can be amended to guarantee legal qualification for taking jobs. It is desirable that the overall control be made by the Prime Minister's Office, and operation as well as surveillance be performed by the Ministry of Gender Equality and Family (MGEF) and the Ministry of Employment and Labor (MEL).

Task Analysis of Managers in the Customized Visiting Health Services (보건소 맞춤형 방문건강관리사업 전문인력의 직무분석)

  • Han, Young Ran;Park, Young Rye;Kim, Young Hee;Choi, Hee Chung;Chung, Mi Ja
    • Research in Community and Public Health Nursing
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    • v.23 no.2
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    • pp.165-178
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    • 2012
  • Purpose: The aim of this study was to analyze the tasks of managers who were working in the Customized Visiting Health Services (CVHS) and to prioritize analyzed tasks according to performance frequency, perceived importance, and difficulty. Methods: Job analysis method by Hartley (1999) was used for task analysis and performance frequency, perceived importance, and difficulty were used for prioritize as criteria. A total of 85 managers in the CVHS of public health centers nationwide were recruited through e-mail and mail survey. Using SPSS/WIN 15.0, descriptive statistics, such as frequency distribution, means, median, and standard deviation, were conducted to examine each subject's general characteristics, the frequency, importance, and difficulty of the tasks as well as to prioritize the each task. Results: The job description of the managers revealed 12 duties, 35 tasks, and 104 task elements. Of the 85 managers, 84.8% were classified as nurses, 40.5% were home health care specialists, and 32.9% were social workers. Their coretasks were management of client cases, budget management, and management of work performance and quality assurance. Conclusion: Considering the analyzed managers' tasks and core tasks, we need to examine each manager's role precisely and provide various educational programs for improving overall manager competence.

A Study on the Development of Korean Child Welfare between 1950s and 1970s in the Light of Children's Light - Based on the Perspective of Social History - (『동광』에 비친 1950-70년대 한국 아동복지의 전개 - 사회사 관점 중심으로 -)

  • Choi, Ok Chai
    • Korean Journal of Social Welfare
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    • v.69 no.1
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    • pp.9-32
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    • 2017
  • This study aims to figure out the development of Korean child welfare between 1950s and 1970s in the light of Children's Light as the oldest professional journal of social welfare in Korea. This journal had been published by CCF Superintendent Korea Conference from 1957. Particularly, this study has been conducted through the social historical perspective, and the collected data was analysed by three periods, institution-centered care era(1957-1961), home-centered care era(1962-1969), and expanded services era(1970-1979). Finally, the resultant themes are as follows: firstly, orphans' forster under social prejudice, social work inclined to Christianity, and institution-centered social casework based on faith; secondly, development of systematization on the whole social welfare, rising of social work professionalism, tasks for orphans and workers in orphanages, and expectations on the integration of practice; and thirdly, strengthening of children's education and health in the institution, questioning on deinstitutionalization, preparation against withdrawal of foreign aid agencies, and the government's passive correspondence. Unfortunately, this study limits to reveal the children's services by non-Christian agencies because of the data based on the services by Christian agencies.

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Study for Validation of the Korean Childcare Teacher's Job Satisfaction Scale(K-CTJSS) (한국형 보육교사 직무만족척도(K-CTJSS)의 표준화를 위한 타당화 연구)

  • Cho, Song-Yon;Baik, Eun-Joo;Kim, Hye-Gum;Kwon, Yeon-Hee;Jung, Jee-Nha
    • Journal of Families and Better Life
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    • v.29 no.2
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    • pp.1-12
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    • 2011
  • The purpose of this study was to validate the standardization of the "Korean Childcare Teacher's Job Satisfaction Scale"(K-CTJSS) that the validity and reliability was evaluated by pretest in 2009. K-CTJSS is composed by 40 items with 6 factors and is responded by 6 point Likert scale. Participants consisted of 1,276 childcare teachers in Korea except Gangwon-do and Jeju-do by purposive sampling. Results were as follows: First, exploratory factor analysis resulted in 40 items composed of 6 factors (director's childcare center management system, social recognition, working environment and welfare, workload and time management, relationship with co-workers, relationship with parents). Second, the confirmatory factor analysis supported a 6 factor structure by resulting over appropriate level of goodness of fit. Third, inter-corelation coefficients among 6 factors were significant level(r = .10~.70). Fourth, the reli ability level of 6 factors by Cronbach's ${\alpha}$ were high(.84~.95.). Finally, concurrent validity levels with Childhood Job Satisfaction Survey(Jorde-Bloom, 1989) and the Satisfaction with Life Scale(Diener et al., 1985) were r = .07~.84 and .19~.46, respectively.