• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.671-683
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• 2011

Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.109-119
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• 2010

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

• Journal of Legislation Research
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• no.41
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• pp.87-123
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• 2011

Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• Health Policy and Management
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• v.29 no.4
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• pp.382-393
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• 2019

The right to petition is a classical right of the people in constitutional states, and in Korea, it is a statutory right in the Constitution, the National Assembly Law, the Petition Law, and the Local Autonomy Act. The healthcare community first made a successful petition to the National Assembly when it achieved the amendment of the Government Organization Act through a petition to the National Assembly for the independence of the Ministry of Health, and this achievement served as the basis for further petitions. Since then, the healthcare community has successfully achieved the enactment and amendment of related occupational laws through National Assembly petitions, such as the amendment of Article 41, Paragraph 7 of the former Medical Insurance Act (Korean Medical Association, 14th Assembly), enactment of the Dental Health Act (Korean Dental Association, 15th Assembly), and amendment of the Health Functional Foods Act (Korea Pharmaceutical Association, 16th Assembly). Its petition accomplishment rate is higher than the total petition accomplishment rate of the Health and Welfare Committee of the National Assembly. However, along with the overall decrease in the number of National Assembly petitions, the Korean Medical Association and Korea Pharmaceutical Association have not achieved any results through petitioning since the 16th Assembly (June 2000), and the Korean Hospital Association and Korean Nurses Association have not achieved any results through petitioning since the 17th Assembly (April 2004). Furthermore, no National Assembly petitions have been made at all for 5 years (2014-2018). The Korean Medical Association and Korea Pharmaceutical Association previously showed a high petition accomplishment rate through their accumulated experience with National Assembly petitions and vigorous policy assistance from doctors/pharmacists/nurses turned lawmakers. More specifically, healthcare organizations have achieved results by actively conducting organized activities with the National Assembly, as implemented by a national assembly director and employees, and in case of petitions for legislation, each group has established infrastructure for reviewing the relevant laws by appointing a legislative director, as well as a legal advisor and advisory counsel. Although the organization that has submitted the most petitions to the National Assembly is the Korean Hospital Association, the group with the highest petition success rate is the Korean Medical Association, which may be linked to the relatively high proportion of doctors who have become lawmakers. Furthermore, the fact that other healthcare organizations were highly interested in petitioning the National Assembly has had major implications for the petition activities of healthcare organizations.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.177-187
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• 2017

Purpose: From August 2017, hospice-palliative care (HPC) will be provided to patients with acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), and liver cirrhosis in Korea. To contribute to building a non-cancer (NC) hospice-palliative care model, NC specialists were interviewed regarding the goals, details, and provision methods of the model. Methods: Four physicians specializing in HPC of cancer patients formulated a semi-structured interview with questions extracted from literature review of 85 articles on NC HPC. Eleven NC disease specialists were interviewed, and their answers were analyzed according to the qualitative content analysis process. Results: The interviewees said as follows: It is difficult to define end-stage NC patients. HPC for cancer patients and that for NC patients share similar goals and content. However, emphasis should be placed on alleviating other physical symptoms and emotional care rather than pain control. Timing of the care provision should be when patients are diagnosed as "end stage". Special issues should be considered for each NC disease (e.g., use of anti-retroviral drugs for AIDS patients, oxygen supply for COPD patients suffering from dyspnea, liver transplantation for patients with liver cirrhosis) and education should be provided to healthcare professionals. NC patients tend to negatively perceive HPC, and the government's financial assistance is insufficient. Conclusion: It is necessary to define end-stage NC patients through in-depth discussion to minimize issues that will likely accompany the expansion of care recipients. This requires cooperation between medical staff caring for NC patients and HPC givers for cancer patients.

• Journal of Korean Academy of Nursing
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• v.7 no.2
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• pp.1-10
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• 1977

Personalized Patient centered nursing care is increasingly difficult to achieve despite the fact that it remains one of our consistent goals. So, we must find away to individualized nursing care. One means, to achieve this is by use of the nursing history form, which has been developed to help the nurse make maximum use of her limited time with the patient, by obtaining systematically the information needed to plan his nursing care. The nursing history form can be used to collect data about individual nursing needs but also it lends itself to the collection of epidemiological data relevant to the needs of patient population. So this study was undertaken in an attempt to describe the general characteristics of the population studied, to find out their perceptions and expectations related to their illness and hospitalization, to find out specific basic needs and to examine the relationship between the patients nursing needs and demographic characteristics through the responses to the nursing history questions. The study population defined and selected was all the patients (70) who were admitted to Yonsei University Hospital from October 1 - 15, 1975. The direct interview method was used and the data were categorized by the investigator, according to the nature of responses to each question and were subjected to the percentile and the chi- square tests. The findings can be summarized as follows 11. General characteristics of the study population ; The population was made up mainly of urban patients who were highly educated. The age was equally distributed. 2. Patients, perceptions and expectations related to illness and hospitalization ; 88.6% of the patients knew about the reason for hospitalization but 64. 5% could state symptoms only. 37.5% recognized the cause of illness. Approximately three fourth of the patients expressed on expectation for early recovery. 60.0% of the patient responses indicated, that they expected less than 10 days of hospitalization. Of the total responses regarding hospitalization, 45.7% were negative about the post -hospitalization expectation, 45.7% expected to return to work. As a result of these findings, we can see that there is a great educational need, a psychological need and environmental need for adaptation to the hospital and a socio- economic need for the post - hospitalization period. 3. Specific basic needs : The physical needs include the problem of getting sufficient sleep (50.0%), difficulty in food intake(47.1%), problems with hospital diet (47.0%), abnormal condition of the skin(44.3%), problems with bowel elimination(35.7%), assistance with bathing(35.7%), pain(30.0%), difficulty in walking(30.0%) , difficulty in seeing(30.0%) problems in urinary elimination(20.0%) , and difficulty in hearing(10.0%), 4. Nursing needs and epidemiological characteristics ; Age distribution was related to the rendition of the mouth but no significant differences were observed statistically with the patients responses to the other nursing history questions according to the epidemiological variables of age, sex, education and residence.