• 농촌의학ㆍ지역보건
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• 제1권1호
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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.

• 가정간호학회지
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• 제6권
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• 간호행정학회지
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• 제16권2호
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• pp.162-171
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• 2010

Purpose: Nursing home quality indicators have been focused widely on result outcomes, not for the environment in that quality of service are delivered, This study aimed to examine structural factors influencing quality management activities in nursing homes. Method: Sample was 170 nursing homes responded to the survey questionnaire which was distributed to the 543 nursing homes nation-wide, Data were collected on structural characteristics, types of services, and quality management activities, Data were analyzed with the descriptive statistics, Pearson correlations, and multiple regression. Result: Most of the nursing homes were operated as free of charge by the social welfare ownership. Average number of residents was 52.1 with severe and mild dementia and bedridden status, In terms of quality management activities, 34% of the sample had CQI committee that focused their activities on services delivery process, performance appraisal, record keeping regularly. 30.6% of quality management activities were accounted for by the number of residents with dementia, the ratio of RN to residents, rehabilitation services, and social wefare services in nursing homes. Conclusion: We recommend that more comprehensive quality management activities should be developed as process quality indicators in conjunction with the outcome indicators.

• 대한가정학회지
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• 제43권12호
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• pp.97-111
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• 2005

Early Head Start (EHS) can provide services to a child and family from pre-birth until the child is three years old. Services are comprehensive, intensive, individualized and flexible according to child and family needs, and integrated with community service delivery systems. The local program designs and operations were developed and carried out within the framework of the Head Start Revised Performance Standards, which included specific provisions for services to pregnant women, infants and toddlers and emphasized prevention, early intervention, safety, and health education. As with preschool Head Start, EHS programs are required to make available 10 percent of their enrollment for infants and toddlers with disabilities as defined by Part C regulations of the state in which the program operated. Quality child care has become a priority for EHS. A majority of EHS children need child care, and the quality is important to their development. An evaluation of EHS in 17 programs selected from the first program cohorts showed that the program had significant and positive impacts on a wide range of parent and child dimensions, some with implications for children's later school success. Among the issues for policy attention identified by American EHS for the Korean system are: - The need to create a comprehensive infant/toddler care system - The need to address access of teachers for young children - The need to improve quality.

• 지역사회간호학회지
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• 제15권4호
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• 한국위성정보통신학회논문지
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• 제9권1호
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• pp.6-12
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• 2014

방송미디어 산업은 유무선 통신네트워크의 발전과 더불어 스마트 미디어로 발전하며 새로운 미디어 생태계를 구축하고 있다. 스마트 미디어 생태계에는 다양한 사업자들이 새로운 패러다임과 함께 신규서비스를 창출하고 있다. 반면에, 지상파 방송사는 강력한 콘텐츠 제작 능력과 지상파 방송망을 포함한 미디어 전송 네트워크를 보유하고 있음에도 불구하고, 치열한 경쟁 환경속에서 상대적으로 뒤처지고 있는 상황이다. 본 논문에서는 지상파 방송이 스마트 미디어 경쟁 환경과 곧 도래하는 UHD 방송 환경에서 경쟁력을 갖추기 위한 방안으로 다양한 기능을 포함한 셋톱박스 기반의 플랫폼 구축 방안을 제안하고, 상세한 전송 네트워크 구조 및 플랫폼의 구성에 대해 설명한다. 새로운 방송서비스인 UHD 방송환경에서 새로운 미디어 플랫폼의 성공적인 정착을 통해 지상파 방송서비스의 직접 수신가구 수 증가를 기대할 수 있으며, 무료 보편적 시청권 제공이라는 지상파 방송의 본연의 목적과 수익성 확보를 얻을 수 있을 것으로 기대된다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2014년도 추계학술대회
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• pp.540-542
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• 2014

UPnP(Universal Plug and Play) 규격은 홈 네트워크 환경에서 네트워크 기능이 지원되는 다양한 기기들을 발견하고 상호 서비스 연동이 가능하게 해준다. 최근 모바일 컴퓨팅, 클라우드 기반 서비스, 스마트 기기 콘텐츠 공유, 사물인터넷(IoT - Internet of Things) 등과 같은 IT 패러다임이 부각되고 있으나 이들을 지원하기에는 홈 네트워크에 국한된 UPnP는 기능적인 한계를 보여주었다. 이와 같은 새로운 IT 패러다임을 지원하기 위해 최근 UPnP 포럼은 기존 UPnP를 확장시켜 UPnP+를 발표하였다. 본 논문에서는 UPnP+의 기반이 되는 UDA 2.0(UPnP Device Architecture V2.0) 규격의 상세 기능을 소개하고, 어떻게 UDA 2.0이 홈 네트워크의 영역을 광대역 망과 비IP 기기의 영역까지 확장시킬 수 있는지 보여준다.

• 가정간호학회지
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• 제30권2호
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• pp.141-154
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• 2023

Purpose: This study aimed to explore the social perception of visiting nursing before and after coronavirus disease (COVID-19). Methods: This survey-based study used online big data for comparative analysis by classifying the keywords related to visiting nursing searched on domestic portal sites before and after COVID-19. Results: According to the results of analyzing the Intertopic Distance Map based on Latent Dirichlet Allocation in this study, four topics were extracted, two each before and after COVID-19. The first topic before the COVID-19 period was termed "the expansion of visiting nursing subjects and services visiting nursing," while the second was termed "visiting nursing," which is related to customized welfare. The first topic after the COVID-19 period was termed "the suspension and resumption of visiting nursing services," while the second was "the development of a non-face-to-face home visit healthcare system". Conclusion: The results of this study can be used as useful reference data to contribute to future medical service delivery system reform policies starting at the end of COVID-19 and the revitalization of community care for visiting nursing.

• 가정과삶의질연구
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• 제30권5호
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• pp.1-15
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• 2012

The purpose of this study is various discussion and alternatives focusing on integration of center for enhancing family policy delivery system and family support service the long term. The subject is managers who work at Healthy Family Support centers and Multicultural Family Centers. And they are responded non-structural questionnaire. The results were follows: First, 82.4% respondents of healthy support center and 50% respondents were in favor of integration. Second, reason of integration are conformance for social integration, the efficiency of center operations, the adequacy of program for various family, doing program with the goal of both centers of the similarity, complementary, and user convenience, prevent duplication and missing of services and so on, If the amount charged against the project of the center dissimilarity of institutions, including the operating direction was different. Third, the Center for the meaning of integration are name, organization, reorganization or consolidation of functions, was regarded as entrusted to corporate consolidation. Fourth, the consolidation that occurs during problem solving to ensure the succession of budgeting and human resources and program alternative for dressing up, commissioning center was the difference as problem solving.

• 한국식생활문화학회지
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• 제37권3호
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• pp.265-277
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• 2022

This study investigated alterations in the health behaviors and eating habits due to the coronavirus disease 2019 (COVID-19) pandemic. An online survey was administered to 270 university students from September 22, 2021 to October 26, 2021. While the frequency of eating at home had increased during the COVID-19 pandemic compared to before the pandemic, there was a decrease in the frequency of eating out, drinking, and eating vegetables. However, the frequency of eating delivery, takeout, and convenience foods and the utilization of online shopping and delivery apps had considerably increased. In addition, when selecting menus, considerations of health, hygiene, and convenience were more important during the COVID-19 pandemic than before the COVID-19 pandemic. Physical activity more than 3 days a week had decreased, whereas sedentary time showed a proportionate increase. The percentage of people who perceived their health status to be worsening was determined to have increased during the COVID-19 pandemic. To prepare for the era of infectious diseases, future research needs to identify health behaviors and dietary problems by administering surveys that include a large sample size and participants of various ages. Moreover, health promotion and nutrition management plans should be prepared accordingly.