• Title/Summary/Keyword: Nurse aides

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Problems in the field of maternal and child health care and its improvement in rural Korea (우리나라 농촌(農村)의 모자보건(母子保健)의 문제점(問題點)과 개선방안(改善方案))

  • Lee, Sung-Kwan
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.29-36
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    • 1976
  • Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

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A Study on the Working Environment Recognition and the Caracter Disposition of Nurse Aides (간호조무사의 근무환경인식과 성격성향에 관한 연구)

  • Lee Sun Yi
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.57-74
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    • 1990
  • As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

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Comparison of Major and Job Satisfaction of Students and Graduates in Dental Hygiene and Nursing (대전 일부 치위생학과와 간호학과 재학생 및 졸업생의 전공과 업무 만족도 비교)

  • Baek, Seong-Min;Song, Da-Hye;Park, Jin-Seul;Bae, Jeong-Yeon;Jeong, Won-Seok;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.378-385
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    • 2013
  • Although dental hygiene has haven a special domain of knowledge and its own business territory, people have misunderstandings about dental hygienists as nurses or nirses' aides in Korea. Inadequate knowledge could make negative results for university applicants to choose department of dental hygiene. This study was aimed to compare major and job satisfaction of students and graduates in dental hygiene and nursing for objective comparison and suggestion for dental hygiene. The subjects were 98 dental hygiene students, 113 nursing students, 53 dental hygienists, and 53 nurses by convenience sampling in Daejeon. The questionnaire consisted of satisfaction of college life, social identity, career path and job. ANOVA with Tukey post-hoc analysis was used with SPSS 20.0 program. Although dental hygiene students scored lower than nursing students in satisfaction of college life, social identity, career path and job, dental hygienists, nurse and dental hygiene students didn't have different satisfaction of job. Dental hygienists scored the lowest in relation with clinical work and major curriculum, and sexual discrimination. Nurses scored the lowest in working condition and salary. Dental hygienists and dental hygiene students had lower scores in information and advice of career path, entrance to graduate school, stable work, family's pride of my major, social position and so on. We suggested the community of dental hygiene should try to promote dental hygienists to public, the community of dentists should give the stable working condition, and the department of dental hygiene should improve the major curriculum to relate with clinical work.