• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.531-548
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• 1991

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.139-148
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• 1987

The community health practitioners (CHP) play an important role in primary health care services to the underserved population in rural area. Time and motion study of 26 CHPs in Kyungpook Province was conducted through work diary method for 6 consecutive days from the time they arrived until they left the primary health post(PHP) during the past 3 weeks from November 16 to December 5, 1987. The allocation of activity time by working category, service category, location of activity and CHP's function was analyzed according to the characteristics of CHPs i. e., age, marital status and experience as CHP. The major findings are as follows : The mean activity time per CHP in a week was 2,918 minutes. The length of their working hours was longer for older, married and more experienced CHPs than others. About 80% of the CHP's activities took place within the PHP and only about 20% occured outside of the PHP. Working hours for the outdoor activities were longer for younger, single and less experienced CHPs than others. The allocation of activity time by working category showed 46.3% in the technical work and 18.7% in the administrative work. Working hours for the technical activities were longer for younger, single and less experienced CHPs than others. The percentage of activity time revealed greatest as much as 63.1% for direct patient care in technical work and 61.6% for record keeping in administrative work. Of the total working hours in a week, direct patient care and public health activities accounted for 29.2% and 16.2%, respectively. Of the indoor activities, working hours for direct patient care were longer than those for public health activities. However, of the outdoor activities, working hours for public health activities were longer than those for direct patient care. The allocation of activity time by CHP's function showed 49.7% in management of common disease, 31.8% in management of PHP and technical supervision of village health workers, 9.5% in MCH and family planning, 6.6% in community health management and 2.4% in community approach. Based on these findings, it was found that CHPs were mainly working in the PHP with a majority of their time being spent for direct patient care rather than preventive and promotive health cares. To enhance the preventive and promotive health services of the CHPs and to involve the activities for community development, refresher course for CHPs should be reinforced and supervision mechanism of the CHPs should be established and operated in Gun- and province-level.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.86-92
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• 2006

Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.

• Journal of dental hygiene science
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• v.2 no.1
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• pp.21-24
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• 2002

It is important to practice preventive method to control oral disease. Dental caries tendency has been decreased in developed countries, but early childhood caries(ECC, BBTD) became serious dental problems in many countries. To slove these problems, more positive and definite prenatal programs on infants and child are needed. Mostly the control of oral health was affected by a mother's knowledge and behavior in this stage. According to many studies, prenatal education is the most effective method to promote oral health in children. But in Korea, there is little oral health education programs for pregnant women, nursing mothers, infants and children. The purpose of this study was to access the knowledge and opinions of caries prevention among gravid women. 330 pregnant women(primiparae=181, multiparae=149), aged 23 to 39 years were randomly selected at prenatal health education courses in Seoul, Korea, 2000. Face-to-Face interviews were conducted by a trained interviewer using questionnaires included demographics, attitude toward children's dental cares, knowledge of early childhood caries, knowledge concerning pregnancy and oral health. The obtained results were as follows; (1) Most respondents were very concerned about their children's oral health. (2) 58% of the respondents were unaware of early childhood caries and the proportion was significantly higher among primipara (p<0.05). (3) Only 43% of the respondents believed that improper breast feeding could develop ECC, the proportion was significantly higher among primipara(p<0.05). (4) 82% of the respondents reportedly believed that the fetus takes away calcium from the mother's teeth during pregnancy. (5) 71% of the respondents believed that dental treatment during pregnancy was unsafe. There is a relatively low level of accurate knowledge regarding infant nutritions, maternal need for oral health and dental caries prevention among pregnant women. Oral health education and promotion programs that are science-based are needed for gravid women.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.133-143
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• 1996

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongju-City Health Center, Seongju-Gun Health Center and Koryong-Gun Health Center in Kyongsangbuk-Do, from June 10 to October 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6%), easy to get referral permission in health centers(27.1%), and very difficult to get referral permission in local clinics(16.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% of patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested specialty is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.

• Proceedings of the KSEEG Conference
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• 2001.05b
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• pp.42-63
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• 2001

The detail survey on the Songsanri tomb site including the Muryong royal tomb was carried out during the period from May 1 , 1996 to April 30, 1997. A quantitative analysis was tried to find changes of tomb itself since the excavation. Main subjects of the survey are to find out the cause of infiltration of rain water and groundwater into the tomb and the tomb site, monitoring of the movement of tomb structure and safety, removal method of the algae inside the tomb, and air controlling system to solve high humidity condition and dew inside the tomb. For these purposes, detail survery inside and outside the tombs using a electronic distance meter and small airplane, monitoring of temperature and humidity, geophysical exploration including electrical resistivity, geomagnetic, gravity and georadar methods, drilling, measurement of physical and chemical properties of drill core and measurement of groundwater permeability were conducted. We found that the center of the subsurface tomb and the center of soil mound on ground are different 4.5 meter and 5 meter for the 5th tomb and 7th tomb, respectively. The fact has caused unequal stress on the tomb structure. In the 7th tomb (the Muryong royal tomb), 435 bricks were broken out of 6025 bricks in 1972, but 1072 bricks are broken in 1996. The break rate has been increased about 250% for just 24 years. The break rate increased about 290% in the 6th tomb. The situation in 1996 is the result for just 24 years while the situation in 1972 was the result for about 1450 years. Status of breaking of bircks represents that a severe problem is undergoing. The eastern wall of the Muryong royal tomb is moving toward inside the tomb with the rate of 2.95 mm/myr in rainy season and 1.52 mm/myr in dry season. The frontal wall shows biggest movement in the 7th tomb having a rate of 2.05 mm/myr toward the passage way. The 6th tomb shows biggest movement among the three tombs having the rate of 7.44mm/myr and 3.61mm/myr toward east for the high break rate of bricks in the 6th tomb. Georadar section of the shallow soil layer represents several faults in the top soil layer of the 5th tomb and 7th tomb. Raninwater flew through faults tnto the tomb and nearby ground and high water content in nearby ground resulted in low resistance and high humidity inside tombs. High humidity inside tomb made a good condition for algae living with high temperature and moderate light source. The 6th tomb is most severe situation and the 7th tomb is the second in terms of algae living. Artificial change of the tomb environment since the excavation, infiltration of rain water and groundwater into the tombsite and bad drainage system had resulted in dangerous status for the tomb structure. Main cause for many problems including breaking of bricks, movement of tomb walls and algae living is infiltration of rainwater and groundwater into the tomb site. Therefore, protection of the tomb site from high water content should be carried out at first. Waterproofing method includes a cover system over the tomvsith using geotextile, clay layer and geomembrane and a deep trench which is 2 meter down to the base of the 5th tomb at the north of the tomv site. Decrease and balancing of soil weight above the tomb are also needed for the sfety of tomb structures. For the algae living inside tombs, we recommend to spray K101 which developed in this study on the surface of wall and then, exposure to ultraviolet light sources for 24 hours. Air controlling system should be changed to a constant temperature and humidity system for the 6th tomb and the 7th tomb. It seems to much better to place the system at frontal room and to ciculate cold air inside tombs to solve dew problem. Above mentioned preservation methods are suggested to give least changes to tomb site and to solve the most fundmental problems. Repairing should be planned in order and some special cares are needed for the safety of tombs in reparing work. Finally, a monitoring system measuring tilting of tomb walls, water content, groundwater level, temperature and humidity is required to monitor and to evaluate the repairing work.