• Title/Summary/Keyword: INTERVENTION

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A Study on the Frame of Reference of the Korean Welfare State Model Focusing on Esping-Anderson's Wel fare State Regime (에스핑-앤더슨의 복지국가체제를 중심으로 한국형 복지국가의 준거 틀에 관한 연구)

  • Jung, Hyun-Kyung
    • Industry Promotion Research
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    • v.7 no.2
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    • pp.43-49
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    • 2022
  • This study aims to study Esping-Anderson's theory of welfare state system, develop a model of welfare state suitable for Korea's situation, and apply it to reality. In this research method, basic research and analysis of ideology is used, focusing on Esping-Anderson's welfare state system theory, and applying it appropriately to the Korean situation. Studies on the model of the welfare state have been studied after the classification of complementary and institutional models asserted by Willensky and Lebo in 1965. In addition, Esping-Andersen asserts three things as a model of the welfare state according to ideology. First, the role of the market is central to the liberal welfare system that best fits the image of classical capitalism, and individualistic solidarity through the market. The role of the state or family, which can be a hindrance, is actually marginalized. In addition, in order to maximize individualistic solidarity through the market, de-commodification in the national domain tends to be minimized. Second, the conservative welfare system has a strong familistic element, so the source of social solidarity is the family, and the state plays a role of supporting and supplementing the characteristics of this family. In the conservative system, de-commodification appears to be high among household heads, or the welfare system takes on a corporatist and nationalistic form, it can be said that these characteristics are reflected. Third, in the social democratic welfare system, the source of social solidarity is the state. Therefore, the role of the state is large, the state has a high possibility of decommodification, and it has the characteristics of substitutes for the family and the market through universalist intervention. This study applies Esping-Anderson's three welfare state models to study a model suitable for the Korean situation. In conclusion, Esping-Anderson's three welfare state models can be classified into a market-oriented model based on a liberal welfare system, a status-oriented model based on a conservative corporatist welfare system, and a solidarity-oriented model based on a social-democratic welfare system, presented a compromise between liberalism and conservatism as a Korean model.

Nutritional Status of Intensive Care Unit Patients According to the Referral to the Nutrition Support Team and Compliance with the Recommendations (영양집중지원팀 자문 의뢰 및 순응 여부에 따른 중환자실 환자의 영양상태 비교)

  • Sohn, Yunjin;Hyun, Taisun
    • Korean Journal of Community Nutrition
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    • v.27 no.2
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    • pp.121-131
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    • 2022
  • Objectives: This study aimed to examine the effectiveness of the intervention of the nutrition support team (NST) on the nutritional status of critically ill patients. Methods: The medical records of 176 adult patients who were admitted to the intensive care unit and received enteral or parenteral nutrition for more than 7 days were retrospectively analyzed. The patients were classified into the NST and non-NST groups according to whether they were referred to the NST or not. The NST group was further classified into the compliance and non-compliance groups depending on their compliance with the NST recommendations. Results: The NST referral rate was 56.8%, and the rate of compliance with the NST recommendations was 47.0%. Significantly higher energy and protein were provided to the NST and the compliance groups than to the non-NST and the non-compliance groups. The proportion of patients who reached the target calories after the initiation of enteral nutrition was significantly higher in the NST and the compliance groups than in the non-NST and the non-compliance groups. The serum albumin and hemoglobin levels significantly decreased in every group, but the changes were significantly lower in the compliance group. The nutritional status at discharge from the intensive care unit compared to the status at admission was significantly worse in the NST, non-NST, and non-compliance groups. However, the status was maintained in the compliance group. The length of stay in the intensive care unit was significantly shorter in the compliance group. Conclusions: Compliance with the NST recommendations was found to provide more calories and protein and prevent the deterioration of the nutritional status of critically ill patients. Therefore, effective communication between medical staff and the NST from the early stages of admission to the intensive care unit is needed to improve referrals to the NST and compliance with the recommendations.

2020 Dietary Reference Intakes for Koreans: riboflavin (2020 한국인 영양소 섭취기준: 리보플라빈)

  • Lee, Jung Eun;Cho, Jin Ah;Kim, Ki Nam
    • Journal of Nutrition and Health
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    • v.55 no.3
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    • pp.321-329
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    • 2022
  • Riboflavin and its derivatives, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), are key components of mitochondrial energy metabolism and oxidation-reduction reactions. Proposed dietary reference intakes for Koreans (KDRIs), that is, estimated average requirements (EARs), for riboflavin, based on current knowledge of riboflavin and riboflavin derivative levels, and glutathione reductase activity, are 1.3 mg/d for men aged 19-64 years and 1.0 mg/d for women aged 19-64 years. By applying a coefficient of variance of 10%, reference nutrient intakes (RNIs) were set at 1.5 mg/d for men aged 19-64 years and 1.2 mg/d for women aged 19-64 years. Likewise, EARs and RNIs of riboflavin intake were proposed for all age groups and women in specific life stages such as pregnancy. Mean adult riboflavin intake for adults aged ≥ 19 years was 1.69 mg/d in Korea National Health and Nutrition Examination Survey (KNHANES) 2020, which was 124.9% of EAR according to the 2020 KDRIs. In the 2015-2017 KNHANES study, the mean riboflavin intake from foods and supplements was 2.79 mg/d for all age groups, and 32.7% of individuals consumed less riboflavin than EAR according to the 2020 KDRIs. For those that used supplements, mean intakes were 1.50 mg/d for riboflavin from foods, 10.26 mg/d from supplements, and 11.76 mg/d from food and supplements, and 5.5% of individuals consumed less riboflavin than EAR. Although the upper limit of riboflavin has not been established, the merits of increasing supplement use warrant further consideration. Also, additional epidemiologic and intervention studies are required to explore the role of riboflavin in the etiology of chronic diseases.

Qualitative Study on Experiences of Responding to COVID-19 of Therapists in Long-term Care Hospitals (요양병원 치료사의 코로나19 대응 경험에 대한 질적 연구)

  • Bae, Won-Jin;Park, Ju-Young
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.4
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    • pp.337-347
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    • 2021
  • This study is a qualitative study conducted to provide basic data for therapists working in long-term care hospitals to improve their countermeasure strategies for new infectious diseases and improvement of the treatment room infection management system, and to help therapists understand their infection management work. Colaizzi's phenomenological research method was applied as the research method. Telephone interviews were conducted with nine occupational therapists and physical therapists working in nursing hospitals. The contents of the interview were recorded with the consent of the study subjects, and additional confirmation was received by email. The recorded content was analyzed after transcription, and the meaning and nature of the experience coping with COVID-19 were described. The content was organized into 6 themes, 17 main meaning and 49 meaning units. In accordance with the COVID-19 situation, the infection control system has been strengthened by reinforcing infection control education in nursing hospitals, practicing infection control, and supervising infection control outside business hours. It was found that the treatment environment was changed due to the restriction of treatment activities by practicing distancing in the treatment room, adjusting rest and meal times during working hours, and strengthening infection control. In addition, the therapist's role has been expanded and the paradigm of treatment has changed, such as considering the untact intervention, and they have experienced cohort quarantine, pre-tested for COVID-19, vaccinations, and side effects from COVID-19. However, due to the infection work, the therapist's work burden is increased, and the person is experiencing fear, depression, and work stress from the spread of COVID-19. They were also aware of the need for nursing hospital care personnel support, such as guaranteeing rest after vaccination and providing infection control tools and equipment. The results of this study are expected to be used as basic data for human and physical support for the development of infectious disease response strategy programs in nursing hospital treatment rooms and for infection control in nursing hospitals.

The effect of the home environment on the relationship among walking limitation, disability and depression of older people (주택환경이 노년기 보행기능제한, 장애 및 우울의 관계에 미치는 영향 연구)

  • Koo, Bon Mi;Lim, Yenjung;Chai, Choul Gyun
    • 한국노년학
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    • v.40 no.3
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    • pp.543-563
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    • 2020
  • As people age and their physical functions are declined, they stay longer in the home, thus being more affected by the home environment. Many studies have shown the association between the home environment and health. However, little is known about the effect of the home environment on disability and depression of older people with functional limitation. This study, therefore, aimed to examine the moderating effect of the home environment on the pathway between walking limitation and instrumental activity of daily living(IADL) disability, and the relationship between IADL disability and depression. We performed logistic regression and multiple linear regression analyses with data on 3,027 participants from the 2018 Seoul Aging Survey. As results, first, older people who lived home with poor conditions showed a higher risk of walking limitation(OR=1.487, 95% CI: 1.250 - 1.770), IADL disability(OR=1.594, 95% CI: 1.303 - 1.949), and depression(OR=1.943, 95% CI: 1.553 - 2.430). Second, the home environment moderated the relationship between walking limitation and IADL disability. Older people with walking limitation who lived in poor housing condition experienced more IADL disability than others. Third, after controlling for walking limitation, the home environment had significant moderating effect on the relationship between IADL disability and depression. Elderly with IADL disability living in poor home experienced higher risk of depression. Based on these results, the study suggests the necessity of home modification intervention targeting functional limitation of older adults as strategy for preventing disability and depression, and enabling aging in place.

The Impact of Care Workers' Employment Characteristics and Perception of Facility Directors' Transformational Leadership on Quality of Service (요양보호사의 고용특성과 시설장에 대한 변혁적 리더십 인식이 서비스 질에 미치는 영향에 관한 연구)

  • Kim, Hye Ji;Park, Sang Hee;Kim, Bum Jung
    • 한국노년학
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    • v.41 no.2
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    • pp.217-240
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    • 2021
  • The purpose of this study is to examine the effect of care workers' employment characteristics and perception of facility directors' transformational leadership on quality of service through a hierarchical linear model. For this aim, survey data were collected amongst 240 older adults and 200 care workers who are affiliated within 45 long-term care facilities in Seoul, and analyzed using SPSS 26.0 and HLM 8.0. As a result, one's perception of transformational leadership had a positive effect, whereas, among employment characteristics, employment type and working hours had negative effects on quality of service. Regular workers with fewer working hours and higher awareness of transformational leadership toward the director provided higher quality of service. But wage, total experience and tenure didn't meaningfully affect it. Therefore, the following suggestions were presented. First, it is necessary to reorganize incentive, salary systems and budgets, changing the status of temporary workers' hourly wage system into that of regular workers' monthly one in order to strengthen employment security with acknowledging fundamental professional values through reinforcement of expertise. Reinforcement of long-term care's publicness and establishment of base facilities are also suggested. Second, maintaining appropriate hours of work and rest including annual leave under the Labor Standards Act is needed. Also, increasing the salary of and decreasing working hours for night shift workers are required. Third, education and intervention for inspiring transformational leadership of directors and strengthening qualification standards of them are required.

Factors for Survival and Complications of Malignant Bone Tumor Patients with a Total Femoral Replacement (대퇴골 전치환술 받은 악성 골종양 환자의 생존인자와 합병증)

  • Cho, Wan Hyeong;Jeon, Dae-Geun;Song, Won Seok;Park, Hwan Seong;Nam, Hee Seung;Kim, Kyung Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.244-252
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    • 2020
  • Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

Efficacy of Preliminary Magnetic Resonance Imaging Measurement in Ultrasonography-Guided L4 Selective Nerve Root Block (초음파 유도하 요추 4번 선택적 신경근 차단술 시 자기공명영상 계측의 유용성)

  • Shim, Dae Moo;Kweon, Seok Hyun;Cho, Hyung Gyu;Yu, Hyun Kyu;Lim, Kyeong Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.229-236
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    • 2020
  • Purpose: This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. Materials and Methods: As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. Results: At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). Conclusion: A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure.

The effect of the mother's modeling and feeding practices on the eating behavior of young children (어머니의 모델링과 식사 지도가 유아의 식행동에 미치는 영향)

  • Sim, Hyeonmi;Han, Youngshin;Lee, Kyung A
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.296-308
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    • 2022
  • Purpose: To investigate the effect of a mother's modeling and feeding practices on the eating behavior of the children. Methods: From April to June 2018, 1,036 young children aged 2 to 6 years and their mothers in Gyeongsan, Gyeongsangbuk-do, were examined for their eating behavior and feeding practices using a verified dietary behavior test (DBT). The children's dietary behavior was classified into four categories: "access evasiveness", "sensory acuity", "hyperactivity", and "irregularity". The mother's eating behavior was classified into three categories: "pickiness", "negligence", and "irregularity", and feeding practice types were classified into two categories: "responsibility/monitoring", and "restriction/pressure". The differences between the groups were tested using the t-test, ANOVA, and Duncan's multiple range test. The influence of feeding practices on the children's eating behavior was analyzed by hierarchical regression analysis while controlling for the mother's modeling. Results: The problem rates of irregularity, negligence and pickiness in the mother's modeling were 33.7%, 22.8%, and 20.7%, respectively. An analysis of the mother's feeding practices revealed that responsibility/monitoring had a middle, high and low significance in 74.2%, 17.3%, and 8.5% of respondents, respectively and the risk rate of restriction/pressure when guiding children to eat was 15.3%. The problem rates for sensory acuity, access evasiveness, irregularity, and hyperactivity in children were 27.9%, 26.1%, 24.8%, and 22.0%, respectively. Among the four eating behavior characteristics of children, the child's access evasiveness and sensory acuity were more affected by their pickiness rather than the mother's feeding practices, and the child's hyperactivity was more influenced by feeding practices than the mother's eating behavior. The child's irregularity was similarly affected by the mother's eating behavior and feeding practices. Conclusion: Since the mother's eating behavior and feeding practices affect the children's eating behavior, a diet improvement program for children should consider not only the nutrition education of children but also the mother's eating behavior and provide the necessary intervention for feeding practices.

Development and Validation of the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC) (한국형 긍정적 행동지원 3차 실행충실도 척도(KT3-FC)의 개발과 타당화)

  • Won, Sung-Doo;Chang, Eun Jin;Cho Blair, Kwang-Sun;Song, Wonyoung;Nam, Dong Mi
    • Korean Journal of School Psychology
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    • v.17 no.2
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    • pp.165-180
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    • 2020
  • As a tiered system of supports, School-Wide Positive Behavior Support (SWPBS) is an evidence-based practice in the educational system of Korea. An important aspect of SWPBS is the ongoing progress monitoring and evaluation of implementation fidelity. This study aimed to develop and validate the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC). The preliminary KT3-FC consisted of a 37-item, 6-factor checklist. In the first phase of the study, 10 experts reported that the range of content validity of the KT3-FC was adequate. In the second phase of the study, 185 teachers (52 men and 133 women) who implemented SWPBS completed the KT3-FC, Individualized Supports Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and PBS Effectiveness Scale. An exploratory factor analysis resulted in a 5-factor structure, with 20 items, instead of 37 items, consisting of: (a) progress monitoring and evaluation of the individualized supports, (b) provision of supports by aligning and integrating mental health and SWPBS, (c) crisis management planning, (d) problem behavior assessment, and (e) establishment of individualized support team. The internal consistency of the KT3-FC was good (full scale α = .950, sub-factor α = .888 ~ .954). In addition, the KT3-FC showed good convergent validity, having statistically significant correlations with the Individualized Support Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and the PBS Effectiveness Scale. Finally, the confirmatory factor analysis showed that the 5-factor model of the KT3-FC had some good model fits, indicating that the newly developed fidelity measure could be a reliable and valid tool to assess the implementation of Tier 3 supports in Korean schools. Accordingly, the KT3-FC could contribute to implement SWPBS as an evidence-based behavioral intervention for Korean students.