• Title/Summary/Keyword: Living Unit

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A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services (치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석)

  • 홍여신;박현애;조남옥
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Seed Production Studies in Italian Ryegrass ( Lolium multiflorum Lam. Itailcum ) I. Effect of seeding time and seed rates of Italian ryegrass, cv. Tetrone on seed production (이탈리안 라이그라스의 종자생산에 관한 연구. 제1보. 파종기와 파종량이 종자에 미치는 영향)

  • 박병훈;이남종
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.4 no.3
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    • pp.226-234
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    • 1984
  • In order ti find out the optimum seeding time(OST) and optimum seed rate(OSR) of Italian ryegrass on seed production, this studies with tetraploid cv. Tetrone were carried out on the experimental field of Livestock Experiment Station. Treatments included seed rates of 1, 2, 3 and 4 kg per 10a and combined with seeding time on 20, 30 Aug, 9, 19 and 29, September 1983. Seeds were sown in rows 50 cm apart and were spaced in a continuous line with width of 15 cm within the rows. The results are summarized as follows: 1. Autumn tillers could be classified into three groups from winter-killing point of view, namely winter-killing completely, damaged growing point only and living tillers. 2. The young inflorescence-bearing stem in Italian ryegrass which were sown earlier than 9. September were more susceptible to winter killing. Tiller buds in those stems which originated from an axillary buds at the stem base within senescent leaf-sheaths emerged lately in spring, and consequently heading was delayed, culm length shortened and seed yield reduced. 3. Tiller buds which originated from damaged growing point only and living tillers in moderate shoots emerged early in spring and those tillers became mainly spike-bearing culm. 4. The emergence-time of tillers influenced on culm-, spike- length and ripenness more than seeding time and seed rate. 5. Seed yield was mostly affected by the number of spikes per unit area. 6. For the safety of over-wintering and enough spikes on seed production, OST and OSR at Suweon were the last part of September and 2-3 kg per 10a, respectively. Especially OSR was 2 kg per 10a for early and 3 kg per 10a for late OST.

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Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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Value of Health, Multidimensonal Health Locus of Control and Level of Self-esteem in Low Income Mothers (도시빈곤여성의 건강가치, 건강통제위성격 및 자아존중감과의 관계)

  • Lee, Kwang-Ok;Yang, Soon-Ok
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.52-68
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    • 1996
  • As a product of poverty, health means the physical, mental and social instability caused by poverty. High mortality, high morbidity, and unsatisfied needs for medical care indicate the health condition of poor people. These indicators are related to the social and psychological property. This study is to develop an effective method of nursing in the poor family which is an essential unit in the nursing field of the community and to which a fundamental approach is need as a top priority. We can make such a study, though partially, by revealing the relationship among the Health-value, Health Locus of Contol, and the Level of Self esteem. We randomly sampled 243 women who are participating in the nursing department of the comnnity nursing centers in Seoul. We investigated by using questionaries and made an analysis on the result by SAS program. The result of this investigation can summarized as follows : 1. The average age of the subjects investigated is 43.4 and the participation rate in the economic activity is as high as 49.4%. Most of them are paid daily. The average members of the family are 4.28 persons, and 80.2% of which are nuclear families. The type of housing is as follows:51.4% are monthly-rent houses. Rent houses represent 23.5%. And 43.6% of the subjects graduate the high schools 2. The level of self-esteem possessed by the subjects is 37.17. The quality of task performance(3.46) and the morality(3.53) are low as compared with the other qualities. 3. In relation to the locus of control, internality is 22.39, the influence of powerrful others represents 20.24, and the effect of chance occurance is 16.41. 4. The orderings of value scale are the physical and mental health, comfortable life, happiness, mental peace, and pleasure. The lowest order is social recognition. 5. Considering in relation to the self-esteem and the locus of control, we found out that there is a negative relationship among the self-esteem, the influence of powerful others. The lower the level of self-esteem is, the higher the influence of powerful others is. There is also a negative relationship among the detailed items such as the qualities, and the positive attitude. 6. In a significant test in the general characters of the subjects and in the level of self-esteem, we can obtain the follwing results. The higher the economic level is, the higher the level of self-esteem is. And the higher the level of satisfaction with life is, the higher the level of self-esteem is. 7. In the locus of control, the higher the economic level is, the higher the internality is. 8. In the health-level, 75.72% represent the high health -level. And the group which has the low satisfaction with life represents the high level of health-value(81.6%). With these results, we can conclude that the level of self-esteem possessed by the poor women living in the city is high and that they have the multi-dimemsional health-value even though they are living in the poor condtions. Traditionally, the poverty has been recognized as an unfavorale factor in the health care. But this study shows that the poverty is no longer an unfavorale factor and, on the contrary, it has a potential power with which people can improve their health by possessing the high self-esteem and the high health value. The ultimate purpose which the nursing task of the community has is to make the patients keep and improve their own health. So, when the nurses approach the poor patients, the nurses should put an emphasis on the individual responsibilities of the patients, and respect their own health value.

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CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT (소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성)

  • Pyo, Kyung-Sik;Kang, Yun-Hyong;Bahn, Geon-Ho;Cho, Soo-Churl;Lee, Eun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.227-236
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    • 1998
  • Objectives:Conduct disorder is one of the most frequent diagnosis in outpatient and inpatient mental health facilities for children and adolescents. This study investigated the clinical characteristics of children and adolescents with conduct disorder. Methods:The study employed a retrospective review of 45 inpatients diagnosed with conduct disorder by DSM-IV criteria at SNUH Child Psychiatric Unit from 1993, March to 1998, September. Results:The results were as follows:1) The sex ratio was 2:1, male dominant. Mean age on admission was $12.8{\pm}2.4$ years old(male:$12.2{\pm}2.3$, female:$14.1{\pm}2.1$). The mean age of male subjects was significantly lower than that of female subjects(p<.05). 2) We classified all subjects according to child- or adolescent-onset type by DSM-Ⅳ. Childhoodonset type was 42.2%, and adolescent-onset, 57.8%. The onset of male subjects were significantly earlier than that of female subjects(p<.05). 3) The most common complaint was 'serious violation of rules'(77.8%) by DSM-Ⅳ dimensions, while the most common single symtom was 'run away from home overnight at least twice while living in parental or parental surrogate home'(48.9%). 4) The comorbid psychopathology of the subjects were frequently described as follows, in order of frequency:substance use(42.2%), ADHD(35.6%), depression(20.0%), tic disorder(11.1%), bipolar disorder(4.4%). 5) On MMPI, both Pd and Ma subscales got the highest scores. The mean of total IQ by KEDIWISC was $100.0{\pm}15.1$. Female subjects' IQ was higher than that of male subjects. 6) Regarding the number of visits to the OPD after discharge, many subjects(33.3%) had visited OPD fewer than four times. Conclusions:In this study, the male to female ratio of adolescent type showed a decreasing trend. An interesting finding was the fact that socio-economic circumstances, as well as the level of education among patients, were higher than those of previous studies. The subjects' problem were also principally self contered and posed no threat to others.

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Analysis of Safety Education Contents of 『Field of home life』 in Technology·Home Economics Textbook developed by the revised curriculum in 2009 (2009 개정 기술·가정 교과서 『가정생활영역』의 안전교육 내용 분석)

  • Kim, Nam Eun
    • Journal of Korean Home Economics Education Association
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    • v.29 no.2
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    • pp.23-39
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    • 2017
  • The Purpose of this study is to present the basic data for selecting and improving the safety education contents which help practically middle school students through analysis of contents of safety education in 'field of home life' of 2009 revised middle school textbooks. The subjects of analysis are 12 types of middle school textbooks: in total 24 books written by 12 publishers in terms of the revised curriculum in 2009. The analysis criteria is developed by the researcher referring to preceding studies regarding safety education based on the seventh safety education standard presented by the Ministry of Education (2015). With such analysis criteria, all words related to the contents of the safety education of analysis criteria were extracted from each textbook, such as words directly mentioned as 'safety', words mean as 'psychological safety' and 'happy life', words related to 'attention', 'note', 'stability' etc. Under the analytic frame of safety education contents according to a home economics textbook, content analysis method was used for producing the frequency and percent of those words. The textbook analysis shows that the number of pages regarding safety education is 336.3 pages, as 9.8% in total 3,412 pages of 12 types of technology and home economics textbooks. As following the analysis of each textbook volume of the proportion in the contents related to safety education, 224.9 pages are on the first volume and 111.9 pages are on the second volume. As grades increase from year one to year three, the proportion of safety education in home economics textbooks is decreased. The highest number of safety education contents unit is 'Self-management of youth' which includes three parts of safety education. In the case of a unit for emphasizing practice, experience and practical exercise such as 'Life of youth' and 'Practice of eco-living', safety education content in the area of 'life safety' are mostly contained. Safety accidents related to the most student experienced, Household accidents (1.4%) and experiment or practice accidents (0.3%) are presented in a low figure. The contents of universal housing and school violence are duplicated on first and second volume of text. The most presented safety education content in the 12 types of textbooks are proper sexual attitude, dietary problems, family conflict and food choice. The least common contents are dangerous drugs, family welfare, internet addiction and industrial accident compensation insurance. As this study is to analyze 12 textbooks developed in 2009 revision curriculum, it is necessary to compare it with the textbook written by the revised curriculum in 2015 and to clarify the contents system of safety education and to avoid duplication of contents. In addition, it is necessary to develop and distribute a safety education program that can support textbooks.

Importance of objectives of Housing unit in Home Economics by three systems of action of Home Economics teachers in middle school (중학교 가정과 교사가 인식하는 주생활 영역의 세 행동체계별 목표 중요도)

  • Lee Hee-Joon;Cho Jae-Soon
    • Journal of Korean Home Economics Education Association
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    • v.17 no.4 s.38
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    • pp.117-131
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    • 2005
  • The purpose of this research was to develop objectives of Housing contents in Technology$\cdot$Home Economics by three systems of action and to find out the importance of the objectives of the teachers have taught the class. The 303 teachers from 183 middle schools replied the mail questionnaire during September, 2003. The data were analyzed by SPSS/win. The 21 objectives for each system of action were developed based on the textbooks, teachers guides, and other related references. The importance of the objectives related to communicative system of action was the highest, respectively followed by the ones related to technical and emancipatory systems of action. Indoor Environment & Equipment was more likely to be important than Maintenance & Repairs as the objectives related to communicative system of action, while Usage of Living Space was less likely to be important than the other two sub-units. The importance of the objectives was somewhat differed by the general characteristics of the teachers. The older are the more important the objectives related to technical system of action. Female, Home Economics teachers, who learned philosophy of Home Economics were more likely to think than others objectives related to communicative and emancipatory systems of action to be important. This research showed the teachers' perspectives of the objectives of Housing contents were not the same among respondents and generally supported the previous results from other contents of Home Economics.

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Exploring Cognitive Achievement Characteristics by Group of Achievement Levels in the PISA 2018 Science Domain and Education for Cultivating Epistemic Knowledge in the National Curriculum (PISA 2015와 비교한 PISA 2018 과학 영역의 성취수준별 인지적 성취 특성과 교육과정 상 인식론적 지식 함양을 위한 교육 탐색)

  • Lee, Shinyoung
    • Journal of The Korean Association For Science Education
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    • v.41 no.5
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    • pp.401-414
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    • 2021
  • The purpose of this study is to explore the cognitive achievement characteristics by group of achievement levels in the PISA 2018 science domain compared to the results of the PISA 2015, and to compare and analyze the 'epistemic' knowledge in the revised curriculum 2009 and in the revised curriculum 2007. The average correctness rates in PISA 2015 and PISA 2018 were analyzed by sub category of the evaluation frame in the PISA scientific domain. In the competencies domain, especially, the average correct answer rates of 'evaluating and designing scientific inquiry' were the lowest in medium and lower groups, but the rates rose in all achievement groups compared to PISA 2015, which is encouraging. Although the answer rates were low for both 'living system' knowledge and 'epistemic' knowledge in the knowledge domain, the average answer rates of the upper and middle groups increased in 'epistemic' knowledge compared to PISA 2015. The changes in the curriculum experienced by students participating in PISA were analyzed in relation to the 'evaluating and designing scientific inquiry' competency and 'epistemic' knowledge, which increased in average correct answer rates. In terms of understanding science, the "What is science?" unit that explicitly presents epistemic knowledge, and nature of model in inquiry activities, were explicitly presented in the revised curriculum 2009. In terms of understanding the process of justifying scientific knowledge, the number of inquiry activities increased, scientific explanations based on experimental results strengthened, and the "Science and Human Civilization" unit was introduced to help students to understand STS while simultaneously conducting arguments. These findings confirm the educational performance of groups by achievement level in the PISA 2018 scientific domain and suggest that the direction of education relates to epistemic knowledge in Korea's Science curriculum.

Evaluation of Park Service in Neighborhood Parks based on the Analysis of Walking Accessibility - Focused on Bundang-gu, Seongnam-si - (보행접근성 분석에 기반한 근린공원의 공원서비스 평가 - 성남시 분당구를 대상으로 -)

  • Hwang, Hae-Kwon;Son, Yong-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.52 no.1
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    • pp.59-70
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    • 2024
  • As urbanization progresses, the demand for parks and green space is increasing. Park green spaces in the city are important spaces in the city because they are recognized as spaces where people can freely engage in outdoor activities. The park service area is a measure that shows the extent to which services are provided based on distance. In this process, the concept of accessibility plays an important role, and walking, in particular, as the most basic means of transportation for people and has a great influence on the use of parks. However, the current park service area analysis focuses on discovering underprivileged areas, so detailed evaluation of beneficiary areas is insufficient. This study seeks to evaluate park service areas based on the pedestrian accessibility and the pedestrian network. Park services are services that occur when users directly visit the park, and accessibility is expected to be reflected in terms of usability. To quantify the pedestrian network, this study used space syntax to analyze pedestrian accessibility based on integration values. The integration values are an indicators that quantify the level of accessibility of the pedestrian network, and in this study, the higher the integration value, the higher the possibility of park use. The results of the study are as follows. First, Bundang-gu's park service area accounts for 43%, and includes most sections with high pedestrian accessibility, but some sections with good pedestrian accessibility are excluded. This can be seen as a phenomenon that occurs when residential areas and commercial and business areas are given priority during the urban planning process, and then park and green areas are selected. Second, based on Bundang-gu, the park service area and pedestrian accessibility within the park service area were classified by neighborhood unit. Differences appear for each individual neighborhood unit, and it is expected that the availability of the park will vary accordingly. In addition, even in areas created during the same urban planning process, there were differences in the evaluation of park service areas according to pedestrian accessibility. Using this, it is possible to evaluate individual neighborhood units that can be reflected in living area plans, and it can be used as a useful indicator in park and green space policies that reflect this in the future.