• 대한간호
• /
• 제37권3호
• /
• pp.62-77
• /
• 1998

지역 사회 서비스는 노인들이 질적으로 보다나은 삶을 영위할 수 있도록 돕는 기능을 해야 한다. 적절한 서비스의 공급을 위해서는 지역사회 서비스 욕구 사정의 과정이 우선적으로 요구되어지며, 이에 본 연구는 호주 NSW주 Illawarra지역내의 retirement village에 거주하는 자가 돌봄이 가능한 노인들의 지역사회 서비스에 대한 욕구를 평가하는데 그 목적을 두었다. Illawarra지역내의 여덟개 retirement village에 거주하는 98명의 자가 돌봄이 가능한 노인들을 대상으로 그들의 1) functional status; 2) 지역 사회 서비스에 대한 지식정도; 3) 지역 사회 서비스 사용정도; 4) 지역 사회 서비스 만족도; 5) 잠재적인 지역 사회 서비스 욕구 등에 대한 자가 보고형 설문조사가 이루어졌다. 수집된 자료들은 JMP(for Mackitosh) program으로 통계 처리되었고, computed frequencies가 본 연구의 목표 달성을 위해 주로 사용되었다. 연구 결과를 요약하면 아래와 같다. 1. 평균 연령 76세인 대상자들의 80%이상이 그들의 일상 생활 운영에 다른 사람의 도움을 필요로 하지 않으며 건강상태 또한 양호하다고 자각했다. 2. 90%이상의 대상자들이 지역 사회 서비스를 이용하지 않았다. 3. 70%이상의 대상자가 지역 사회 서비스의 존재에 대해 지각하고 있었다. 4. 60%이상의 대상자가 필요시에는 지역 사회 서비스에 관한 정보를 어렵지 않게 얻을 수 있다고 생각했다. 5. 40%의 대상자가 기존의 지역 사회 서비스에 대한 양과 질에 만족을 나타냈고, 그 외의 대상자들 (60%)은 그 지역 사회 서비스에 대한구체적인 지식이 없다고 보고했다. 6. 25%의 대상자들이 여러 지역 사회 서비스에 관한 관심을 보였다. 결론적으로 대다수의 대상자들은 대부분의 지역 사회 서비스들을 필요로 하지 않았고, 이러한 결과는 현재 자가간호가 가능한 retirement village 거주 노인들에게 당연한 것으로 보여진다. 그러나, 자존감이 강한 노인들에게 서비스 욕구는 자가 돌봄이 건강에 대한 포기정도로 왜곡되어 자각될 가능성이 있는 만큼, 본 연구를 통해 보고된 대상자들의 지역 사회 서비스에 대한 관심도는 고려해 볼만한 가치가 있다고 여겨지며, 이에 노인들의 자존감이 서비스 욕구에 미치는 영향에 대한 연구를 제언하는 바이다.

• 보건행정학회지
• /
• 제9권1호
• /
• pp.156-177
• /
• 1999

The current method of rate adjustment for inflation is based on the evaluation of the financial performance of hospitals. The method has the disadvantage such as too complicated, expensive process as well as low reliability. This study, therefore, develops the 'Korean Medical Insurance Economic Index(MIEI)' as a new model for the rate adjustment with the use of the macro economic indices. In addition, we calculate the 1992∼1998 rate adjustment with the MIEI, and examines the validity of the MIEI by comparing with the conventional method. Medical costs are classified into nine categories : physician salaries, nurse·pharmacist·medical technician salaries, assistants & others salaries, material cost(by imports), material cost(by domestics), depreciation & rent paid(by imports), depreciation & rent paid(by domestics), power utilities, other administrative costs. Then the category weight which is the ratio of category in the total cost is calculated. Macro economic indices are selected for each cost category in order to reflect the concept of the each cost category and inflation during the year of 1992∼1998. Finally MIEI which integrate all category according to the category weight and selected macro indices is calculated. The mean of hospital MIEI which weighting by amount paid by insurers was cacluated. The result from the application of empirical data to the MIEI model is very similar to that of the current method. Furthermore, this method is very simple and also easy to get social consensus. This MIEI model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권23호
• /
• pp.10367-10374
• /
• 2015

Background: Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. Aim: The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. Materials and Methods: An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Results: Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. Conclusions: The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

• 대한간호
• /
• 제33권4호
• /
• pp.86-98
• /
• 1994

We have examined the development and conceptual definition of shamanism and divination through significant characteristics of various illnesses. However, the terrminology has been inconsistent and its real conceptual meaning is not well defined. Divination is a historically dominant religious practice which represents the core of Korean folk culture. Despite prevalent prejudice toward its primitive nature, we cannot deny its profound relationship to our unconscious, especially our reliance on its religious role whenever we face crisis or conflict. It is therefore appropriate to use the term divination in this context. Shamanism originated as humanity's oldest mode of communication with divine - a religion, The shaman is not a sorceress but a priestess, a healer, a spritual guide, a leader, a mystic, traditionally having a different significance from that of the contemporary diviner or "shaman". The traditional concept of illness has been profoundly altered to serve new functions: while the shamanistic view is based upon spiritual abduction, divination on the other hand invokes concepts of spiritual invasion phenomena such as spirit intrusion, taboo violations, soul loss, object instrusion, deviations from the appropriate spiritual path besiegement, and curess or predestination (the idea that the sufferer is born with his fate), We should therefore try to understand divination from a more holistic point of view, rather than attempting to fit it into the standrd medical illness. We must recognize divination as a phenomenon within our culture, since most people have a mixed conception of illness arising from a combination of divinational and modem concepts, Since divination's humanistic approach is ingrained in our people, to irresponsibly ignore the spiritual aspects of treatment would exert a negative influence on our culture, Especially now, while attraction is focused on Korean culture and its influence on every aspect of our livies, it is important for nurses to expand our horizons in order to create a way of nursing more suitable to Korean culture. Increased importance is now being given to the opinions of patients themselves about their own illness and health, so nurses should seek to understand how patients accept their illness and what particular kinds of help they expect to receive. Consequently, an understanding of traditional divinations will enable us to utilize these characteristics on the job in order to enhance nursing care.

• 대한간호학회지
• /
• 제45권5호
• /
• pp.742-751
• /
• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• 한국간호교육학회지
• /
• 제6권1호
• /
• pp.64-76
• /
• 2000

The purpose of this study is to identify the difference in learning styles, learning stages, and preferred nursing specialties between two groups of nursing programs, regular BSN and RN-BSN. The survey instrument was a simplified version of the Kolb's Learning-Style Instrument which was developed by the researcher, a self- reported learning style questionnaire with twelve questions related to the four learning stages. The sample of the study was the 218 nursing students in a university in Korea which consisted of 58 junior and 67 senior students in the regular BSN program, and 58 junior and 35 senior students in the RN-BSN program. Main findings of the study were as the following. 1) Over all, the major learning style was either the diverger or the accomodator; the most preferred learning stage was the concrete experience and the leastly preferred learning stage was the abstractive conceptualization learning stage; and the most preferred nursing specialty in the future was the clinical nursing. 2) Students in the BSN program preferred four learning stages with rather equal proportion, whereas the students in the RN-BSN program preferred the concrete experience learning stage as high as 60.3% and the abstractive conceptualization learning stage as low as 9.5%. 3)For the future career, the junior students of both programs preferred clinical and educational nursing areas, and the senior students of both programs preferred clinical and research areas. The main reason of the difference seemed to result from the different courses such as Health Education or Teaching Method for the juniors and the Nursing Research for the seniors of both groups. Because the sample of the study was limited to a university, it is difficult to generalize the study results for the entire nursing students in Korea. Continuous studies with larger numbers of nursing students and nurse educators, and experimental studies measuring the effects of new curricula are needed for the future.

• Journal of the Korean Data and Information Science Society
• /
• 제26권3호
• /
• pp.715-727
• /
• 2015

본 연구는 우리나라 요양병원의 간호인력 확보수준과 간호결과의 관련성을 파악하고 간호에 민감한 환자 결과를 알아봄으로써 요양병원의 적정 간호인력 확보에 대한 근거를 제공하기 위해 시행되었다. 자료는 건강보험심사평가원의 2012년 '요양병원 병원평가정보'를 바탕으로 분석하였다. 연구결과, 간호사 1인당 환자 수가 평균보다 많은 그룹에서 유치도뇨관 비율 (고위험군/저위험군)이 통계적으로 유의하게 높았다. 간호인력 1인당 환자 수가 평균보다 많은 그룹에서 일상생활수행능력이 감퇴한 환자비율 (치매환자군/비치매환자군), 요실금, 욕창이 새로 발생한 환자 (고위험군)비율이 통계적으로 유의하게 더 높았다. 그리고 요양병원의 등급이 향상될수록 입원환자의 간호결과가 더 좋아지는 것으로 나타났다. 이는 간호인력 확보수준이 높을수록 그리고 요양등급이 높을수록 환자의 간호결과에 긍정적인 영향이 나타난다는 결과이다. 따라서 요양병원에서 간호인력 수를 적정화시킬 수 있는 보다 강력한 정책적 접근이 필요하다는 것을 제안하는 바이다.

• 근관절건강학회지
• /
• 제26권3호
• /
• pp.290-306
• /
• 2019

Purpose: This study aimed to describe the experiences of health-care providers about advanced practice nurses (APNs) focusing on the perspectives of physicians and APNs in Korea. Methods: Qualitative data were collected with snowball sampling. Six physicians and 13 APNs participated in this study through in-depth interviews or a focus-group interview. Qualitative content analysis was employed. Results: Three themes and seven categories were emerged. Three themes were 1) challenging start and attempts to settle down on unfamiliar system, 2) being positioned as an APN at clinical settings, 3) long journey for social recognition and legal institutionalization of APNs' role. Seven categories were 1) challenges to new area, 2) introduction and conflict of APN system, 3) driving force for stepping toward becoming APNs, 4) dedication and commitment to role development, 5) efforts to prove APNs' competency, 6) approaches to guarantee legal APNs' activities, and 7) filling the gap in health-care service. Conclusion: The findings suggest that health-care providers who have collaborated with APNs are aware of the needs to operate APN system more stably through the legislation of APNs' scope of practices. Further research is needed to provide the evidences of APNs' practice outcomes such as health care quality, patient safety, reduction of medical expenses, etc.

• 성인간호학회지
• /
• 제15권4호
• /
• pp.531-541
• /
• 2003

Purpose: The purpose of the study was to explore how hospital nurses decide to quit working as professional nurses using the grounded theory method. Method: The data was collected by individual in-depth interviews with 12 hospital nurses who recently resigned from work and it was analyzed using 'constant comparative analysis.' Result: The core category that emerged was "in search of new balance with self, work, and family". Three stages were identified: 1) "unconditionally accepting the working situation of itself," 2) "weighing advantages and disadvantages of working as a hospital nurse", and 3) "redesigning a future". Each stage contains three major strategies. The major strategies of the first stage are "maintaining a learning attitude", "enduring physical burnout," and "enduring unfair interpersonal relationships". The second stage contains "identifying advantages of working", "identifying disadvantages of working", and "comparing the advantages with the disadvantages". Lastly, the third stage includes "reassessing the aim of life", "beginning to construct an alternative life", and "deciding to quit working at a certain point". Conclusion: The results of the study will help nursing administrators in designing and implementing an effective turnover prevention program for nurses by understanding more deeply the process of turnover phenomenon among hospital nurses.

• International Journal of Internet, Broadcasting and Communication
• /
• 제10권1호
• /
• pp.31-39
• /
• 2018

The purpose of this study was to examine the meaning and structure of nurses' computer using experience. To do this, we conducted a total of three interviews with 11 nurses working between the ages of 26 and 48. Interview data were interpreted using Giori method (1985) and Lincoln & Guba method (1985). As a result, 112 semantic units were derived, and then 18 sub-components were divided into 5 final components. As a result of the analysis, the computer experience that the nurses used in the hospital consisted of 'used for almost every task', 'usefulness', 'important', 'convenience', 'burden', 'anxiety', desire', simple work level', 'no problems', 'eye, muscle and movement discomfort', 'depends on task', 'more complex', 'accuracy', 'organize contents', 'simple', 'incomparable', and 'easy'. Based on the above conclusions, the nurses' experiences of using the computer in the hospital could be concluded as follows. Currently, almost all nursing jobs in hospitals are using computers. However, most of the tasks related to simple computer tasks related to the ability to use the computer was low, and because of this, the computer did not work properly, or when new programs were introduced to feel the burden and anxiety, want more systematic computer education Found. Especially, according to the career, the difference between computer and hand work was different, Nurses over 20 years said that computers can handle simple tasks that are a bit more complicated than manual tasks, whereas emotional tasks were handicapped, in the 10 to 20 years of experience, computer work was more accurate and appropriate to organize content, Nurses under 10 years were not only easy to work with computers but also have no experience in manual work, they could not compare the computer and the hand work. This study suggests that the use of computers in nurses' work is essential and that more systematic computer-based education should be provided. In addition, due to the nature of the nursing service, the professional opinions of the nurses should be reflected in the development of programs for the emotional nursing work.