• 여성건강간호학회지
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• 제4권1호
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• pp.161-178
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• 1998

In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

• 한국보건간호학회지
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• 제3권2호
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• Clinical and Experimental Pediatrics
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• 제51권7호
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• pp.671-689
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• 2008

북한의 경제난이 장기화함에 따라 북한 어린이 및 산모들에 대한 인도적 지원의 필요성이 제기되었다. 정부는 2006년 3월 세계보건기구와 북한 영유아지원 2개년 사업의 MOU를 체결함으로써 북한 영유아 및 산모지원사업(이하 영유아 지원 사업)을 시작하였다. 영유아 지원 사업은 산모와 영유아에 대한 영양개선, 질병관리, 건강관리의 세 부분으로 구성되며, 국내 민간단체와 세계보건기구, 유니세프 등과 같은 국제기구에 의해 수행되어오고 있다. 세계보건기구가 중심이 되어 진행하고 있는 영유아 지원 사업은 1기(2006-2007)를 끝내고 2기(2008-2010)를 시작하고 있다. 이에 반해 민간단체에 의해 추진되고 있는 사업은 지역선정, 사업내용 등의 조정과정 지체와 국내외 정치적 상황 등을 이유로 그 진척이 늦어지고 있다. 그러나 최근 남포산원과 어린이병원을 중심으로 일부 진전이 이루어지고 있다. 영유아 지원 사업은 그간 민간단체가 추진하는 사업에 대한 지원적 역할에 머물렀던 정부가 스스로 체계적인 검토를 통해 우선순위를 설정하고 우선 순위에 따라 지원여부를 결정하였으며, 상당한 규모의 예산을 지원함으로써 사업의 질과 효과성뿐만 아니라 대북 교섭력을 높이는 것을 목표로 시행한 사업이다. 또한 남북한 정부, 국제기구, 국내외 민간단체간의 협력네트워크의 구축도 시도하고 있다. 이러한 긍정적인 면에도 불구하고, 정치적 특수성, 남북간 이견과 이견조정기전의 미흡, 경험의 부족 등으로 인해 여러 가지 어려움 속에서 사업을 진행하고 있다. 그러나 정치적 전망의 불확실성에도 불구하고, 향후 남북한 관계개선에 있어 가장 선도적인 역할을 할 영역 중의 하나가 보건의료부문이 될 가능성이 높으며, 그 중에서도 영유아 지원 사업의 중요성은 더욱 커질 것이며 보건의료부문의 성공적인 남북교류모델을 만드는데 중요한 역할을 수행하여야 할 것이다.

• Journal of Nutrition and Health
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• 제9권4호
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• pp.36-46
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• 1976

This study was projected to provide basic data on prenatal care for future direction in maternity and child care, and also to investigate the diet of women during pregnancy and the period directly afterwards in order to offer to mothers appropriate advice for the improvement of nutritional standards. A clinical study on prenatal care was based on 1054 delivery cases. A nutritional survey was performed on 174 mothers admitted to the department of obstetrics at St. Mary's Hospital during the period of March, 1975 to February, 1976. The results obtained are summarized as follows; I. Clinical study on prenatal care 1) The age distribution showed 59.4% of the mothers were between the ages of 25 to 29 years old. 2) The gestational period was highest between the 37th and 40th gestational weeks. 33.7% of the mothers were primigravidae and 31.8% of them primiparae. 3) 41.3% of the mothers had not received prenatal care or had only received it once before. 4) Induced deliveries were 61.8% and spontantaneous deliveries 38.2%. 61.9% of the mothers had received prenatal care, while those without prenatal care accounted for 61.6% of the total induced deliveries. 5) Low birth weights were 7.7% and 5.0% of the mothers had received prenatal care, while 11.5% had no prenatal care. 6) There were 1.13% of still births, 0.32% of the mothers had prenatal care and the remainder did not have prenatal care. 7) Of those receiving prenatal care, 2.1% showed in the $0{\sim}3$ Apgar score group, 6.3% in the $4{\sim}6$ Apgar score group, and 91.6% in the $7{\sim}10$ Apgar score group. Among the non-prenatally cared for group 5.0% of the newborns were in the $0{\sim}3$ Apgar score group, 9.7% were in $4{\sim}6$ Apgar score group and 85.3% were in the $7{\sim}10$ Apgar score group. 8) Obstetrical complications were developed in 11.86% of the pregnant women when they were hospitalized. Among the group receiving the prenatal care 8.1% of the mothers had obstetrical complications. In the group without prenatal care 17.16% of the mothers had obstetrical complications. The most common obstetrical complication was malpresentation. 9) The first prenatal care was received between the 37th and 40th gestationl weeks. II. Food intake during pregnancy The following are the results from the questionnaires of the mothers concerning diets during pregnancy; 1) Main meals and snacks In 32.2% of the cases, their main meals during the diet amounted to more than was usually eaten at other times. In 67.8% of the cases, their main meals during the diet were the same as that usually eaten. In 22.4% of the cases, snacks during the diet amounted to more than usually eaten at other times. In 77.6% of the cases, snacks during the diet were the same as usually eaten. 2) Itemized list The mothers made a special effort to include certain items in their diets, the following is a breakdown of those items; a. egg, meat, fish 33.3% b. fruit, vegetables 32.2%. c. milk, fruit juice 18.4% d. cake, bread 2.9% e. nothing special 13.2% 3) Milk 44.8% of the mothers had at least one cup of milk everyday. 33.4% of the mothers had at least one cup of milk on occasion. 15.5% of the mothers did not have any milk. 4) Vitamins 39.7% of the mothers had vitamins everyday. 24.7% of the mothers had vitamins occasionally. 35.6% of the mothers did not have any vitamins. 5) Anemic symptoms 9.2% of the mothers very often had anemic symptoms during pregnancy. 39.1% of the mothers often had anemic symptoms during pregnancy. 51.7% of the mothers did not have anemic symptoms at all. 6) Taboos on food 23% of the mothers recognized 'taboos' on food during pregnancy 27% of the mothers displayed on uncertainty about the 'taboos' on food during pregnancy 50% of the mothers displayed indifference toward the taboos. III. Nutritional survey on the new mothers diet. 1) The diets for new mothers can be divided into four categories, such as general diet, low sodium diet, soft diet and liquid diet. 2) Cooked rice and seaweed soup were the main foods for the new mothers as has been the traditional diet for Korean mothers. 3) The average diet contained 1,783g. And the average consumption of the basic food groups per capita per day was 1,265g for cereals and grains, 456g for meats and legumes, 58g for fruits and vegetables, 0g for milk and fish and 4g for fats and oils. 4) In addition to the 1,783g of food in the main diet there was also 142.8g of food taken as snacks. 5) The average daily consumption of calories and nutrients was 2,697 Kcal and 123.4g for proteins, 44.9g for fats, 718.2mg for calcium, 14mg for iron, 2,101.4 I.U. for vitamin A, 0.43mg for thiamine, 1.02mg for riboflavin, 15.88mg for niacin, 5.26mg for ascorbic acid. When these figures are compared with the recommended allowances for new mothers in Korea, the calories and nutrients taken in were satisfactory. But the intake of minerals and vitamins was below the recommended allowance.

• 대한간호학회지
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• 제8권1호
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• pp.152-162
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• 1978

The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

• 대한치과기공학회지
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• 제32권4호
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• pp.417-433
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• 2010

Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.