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Re-interpretation of Aging: Gerotranscendence & Erikson & Erikson's Nineth Stage (노화에 대한 재해석: 노년초월 이론과 9단계이론을 중심으로)

  • Yoon, Min-Suk
    • 한국노년학
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    • v.32 no.2
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    • pp.431-446
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    • 2012
  • The objective of this study is to introduce the theory of Gerotranscendence and the ninth stage of Erikson & Erikson(1997)'s psycho-social development theory in order to enable the academic Korean field to have a more positive and fresher point of view on aging. In order to meet this objective, this study will first take a look at Erikson's 9th stage expansion theory on human development. Then we will study Gerotranscendence as the most representing phenomena among the 9 stage theory so that the Korean Gerontology field can utilize it for future plans. The definition of Gerotranscendence was first introduced by Tornstam(1994) and has been applied as Erikson & Erikson's 9 stage theory ever since. Gerotranscendence can be described as an individual that has entered his golden years after middle age, which transforms one's point of view on life from a materialistic and logical one to a more universal and transcending one. Gerotranscendence is a voluntary and overcoming process of oneself that is displayed in many seniors which leads to a lesser focus on oneself in the eyes of the society, but increases the inter-relational bonding between past and future generations. The following is a summary of the theorhetical evaluation on Gerotranscendence which was analyzed in this study. First, this study introduces the Gerotranscendence theory, which is recognized as the most representative phenomena among Erikson's 9th stage theory that has hence expanded the application of Gerontology theories in the academic field of Gerontology. Second, this study has provided a new point of view towards the elderly in the practical field of senior citizen social welfare. With this understanding, practical levels of services from various points of view can be provided to acknowledge the needs of the elderly. Third, a much wider field of research can be exchanged and provided along with other fields of studies by applying and extending this Gerotranscendence theory in Korea. It would also be especially beneficial to exchange researches within related fields of study such as psychology, sociology, nursing science, family science and the study of religion. Not to mention also lending support to hospitals for the elderly(nursing homes) and institutions related to senior welfare, or practical fields where there is an active exchange of research using Gerotranscendence theory.

A Study of the Ethical Values of EMT students (응급구조과 학생의 윤리적 가치관에 관한 연구)

  • Kim, Mi-Seon
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.37-51
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    • 2001
  • This study is aimed at examining the ethical values of EMT students. The results below are based on the revised questionnaires, which can be applicable to EMT from the original questionnaires developed by Lee(1990), with a sample of 124 students consisting of 63 first and 61 second year students, conducted November 2-8, 2001. Data were analyzed using SPSS in terms of means, standard deviations, t-test, ANOVA, Pearson's correlation coefficient. The results are as follows: 1. In the area of Human life, all subjects showed utilitarian disposition. All respondents perceived the item "When patients recognizing there is no hope for survival ask for euthanasia, it is ethically right to accommodate their opinions." as the most utilitarian item, whereas they perceived the item "When an hopeless patient is on cardiac arrest, it is ethically right to do CPR as the most deontoogical item. 2. In the area of patient relationship, all students of two groups took on deontoogical characteristics, but there were no statistically significant differences between two groups. All students perceived an item "EMT have to keep it secret if patients disclose their suicide intentions and ask for absolute secrecy" the most utilitarian item, whereas they perceived an item "Even though patients act and speak in a very rude manner, EMT people should do their best to provide care for patients." as the most deontoogical item. 3. In the area of task relationship, first year students perceived an item "Given time limitations, it is ethically right to give priority to the patients who can be rehabilitated over the patients who can't be fully recovered." as the most utilitarian item, whereas second year students perceived an item "Under no circumstances should any placebo be administered to patients." as the most utilitarian item. All students perceived an item "When EMT students see an unconscious person lying in the street, they have to give him/her emergency treatment." as the most deontoogical item. 4. In the area of coworker relationship, all students of two groups took on deontoogical disposition, but there were no significant differences between two groups. All students of two groups perceived an item "Suppose you are regarded as the person who would be promoted. However, you think that your coworker is more competent than you. In that case you should tell your supervisor about your coworker." as the most utilitarian item. First year students perceived an item, whereas second year students perceived an item "When you observe coworkers' misconduct at work, it is ethically right to ignore their misdeeds." as the most deontoogical item. 5. This study demonstrated that for the first year students, there is a correlational relationship between areas of human life and task relationship, and between areas of task relationship and coworker relationship, whereas for the second year students, there is a correlational relationship between areas of human life and task relationship. 6. In areas of human life and task relationship, there are significant differences according to attitudes toward EMT and attendance at ethics training sessions. In the area of coworker relationship, there are significant differences according to religion, attendance at ethics training sessions, and a code of ethics. Recommendations for future research, 1. Sample items to measure ethical values and the instrument tailored to the needs of EMT should be developed. 2. A longitudinal study to track ethical value changes according to the amount of work experience is needed. 3. A code of ethics and/or ethics training, which could apply in actual situations, should be implemented.

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Birth and Infant Death Reporting System via Computer Network (출생 및 영아사망 신고체계 및 전산정보체계 개발)

  • Park, Jung-Han;Lee, Young-Sook;Rhee, Jung-Ae;Cho, Hyun;Chung, Young-Hae;Park, Soon-Woo;Jun, Hae-Ri
    • Health Policy and Management
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    • v.8 no.2
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    • pp.125-148
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    • 1998
  • Accurate vital statistics are essential for a national health planning and evaluation. Among various vital statistics, birth and death rates, and infant and matemal mortality rates together with the causes of death are the very basic ones for above purposes as well as for the maternal and child health management. These statistics are based on the birth and death reports. It is required by law to report every birth and death within one month after its occurrence. However, in case of a neonatal death occurring prior to the birth report, most of the birth and death are not reported. Thus accurate infant and maternal mortality rates are not available yet in Korea. The main objective of this study is to develop a birth and infant death reporting system via computer network. We designed a new birth report form based on the current form and data from the analysis of medical record forms of 14 hospitals. A new form is basically addition of essential medical information to the current birth report form. Since a revision of the rules and regulations related wtih the birth report is necessary to use a new form, we kept the current from intact to make it acceptable to the government office for a field trial. We also developed computer programs for data input for birth and death reports at a medical faciltiy, data processing for production of maternal and child health indices at a health center, and management of maternal and child health services including immunization and postantal care at health center. The birth certificate and birth report can be printed out at a medical facility. The computer packages were programmed by Borland Delphi 3.0 and can be run under Windows 95 system. We proposed a new birth and death reporting system via computer network after a field trial for data input, transmission, and processing. The medical and demographic data o birth and death at medical facilities will be sent to health centers directly via computer network. The health center will retain the medical data for analysis and forward only the data for birth and death reports required by current regulations to the Dong, Up, or Myun Office. Once the birth or death is reported via computer network to the Dong Office, then the Dong Office will notify the baby's mother of the birth report and request to submit the baby's name by mail. When the baby's name its submitted. the Dong Office will forward the birth reports to the Common Court and Statistics Agency in the same way as the current system, Upon the completion of birth registration of the Common Court, the court will issue the birth certificate to mother which will be used in lieu of the family record. The advantages of proposed birth and death reporting system via computer network ar as follows ; I) The accuracy, timing, and completeness of reporting will be improved and more accurate maternal and child health indices can be obtained, ii) The maternal and child health services of health center will be obtained, iii) Epidemiologic data for pregnancy and birth can be obtained, iv) Manpower for birth and death reporting will be saved.

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The Experience and Competence of Physicians Who Provide Emergency Health Care at Public Health Sub-Centers on Remote Islands in Korea (도서지역 보건지소 공중보건의사의 응급의료 경험 및 대처능력 고찰)

  • Seo, Je-Hyun;Lee, Su-Jin;Ha, Jeong-Hoon;Kwon, Duck-Geun;Kim, Jung-Ho;Lee, Jae-Hyuk;Na, Baeg-Ju;Kang, Yoon-Hwa
    • Journal of agricultural medicine and community health
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    • v.36 no.1
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    • pp.36-46
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    • 2011
  • Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.

Need Assessment for Enlargement of Oriental Medical Care Service Room in Rural Community Health Center (농촌지역 보건소 한방진료실 확대설치 요구도 및 관련요인 - 일개 군 보건소 한방진료실 내소자를 대상으로 -)

  • Kim, Dae-Feel;Song, Mi-Sook;Song, Hyun-Jong
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.39-51
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    • 2003
  • Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.

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A Study on a Prevention of Long-term Care self-reliance Support for the Elderly in Home: Proposal of an Prevention and Support for Self-reliance Support Model (재가노인의 장기요양예방과 자립지원에 관한 연구: 예방·자립지원 모형설계 방안제언)

  • Kim, Hyun-Sil;Hwang, Sung-Ja
    • 한국노년학
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    • v.30 no.4
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    • pp.1359-1375
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    • 2010
  • Expecting the expansion of the elderly population under long-term home care with the coming of the aged society, this study purposed to propose a prevention and self-reliance support model and to get practical implications for minimizing dependency on care benefits and enhancing the effectiveness of prevention and self-reliance support. Research methods employed for this study were: first, reviewing theoretical literature for clarifying the concept of prevention and self-reliance support in providing long-term care benefits for the elderly; second, identifying factors hindering prevention and self-reliance support through analyzing standard long-term care use plans and documents related to long-term care benefits at elderly welfare centers to which the research subjects belonged; and third, surveying care benefit users on factors hindering their use of prevention and self-reliance support and their needs in the use of care benefits. Based on the results of the three types of qualitative research, we proposed directions for prevention and self-reliance support modeling and suggested practical implications for enhancing the effectiveness of prevention and self-reliance support. For this study, we collected documentary materials and conducted in-depth interviews with the participants with the consents and cooperation of managers and professional social workers at day care centers and elderly welfare centers in D City. According to the results of this study, literature review suggested that long-term care prevention and self-reliance support should be provided in a way of 'strengthening user-centered support systems,' which support elderly long-term care beneficiaries' right to lead a life as the subject of their own life. Document analysis found the absence of benefits related to health and medicine and lack of social support systems for prevention and self-reliance support, and the results of in-depth interviews suggested the necessity to strengthen services related to elderly long-term care beneficiaries' prevention and self-reliance, and the keen needs of the long-term care elders for prevention and self-reliance included: ① loneliness, anxiety, fear; ② missing for and worry about children and people; ③ moving, outing; ④ health and medical services, rehabilitation programs; ⑤ desire to use day care; ⑥ inconvenience of house structure; ⑦desire for meal menus; and ⑧ the occurrence of disuse syndrome. Based on these results, we suggested the base of prevention and self-reliance support modeling with three axes: ① strengthening user-centered support systems; ② strengthening support systems connected to health and medicine; and ③ strengthening social support systems.

Improvement of Knowledge, Self-Efficacy and Self-Care Behaviors among Diabetic Patients participated in the Education Program of Sejong Center for Hypertension and Diabetes Management (당뇨병 환자 교육에 따른 지식, 자기효능감 및 자기관리행위의 변화: 세종특별자치시 고혈압·당뇨병 등록교육센터 등록자를 중심으로)

  • Jung, Jin-Gyu;Chung, Eun-Young;Kim, A-Ryeon;Park, Hyun-Jin;Kim, Yun-Jung;Ban, Young-Hwa;Kim, Jong-Sung;Yoon, Seok-Joon;Kim, Soon-Young;Ahn, Soon-Ki;Nam, Hae-Sung
    • Journal of agricultural medicine and community health
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    • v.42 no.4
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    • pp.234-243
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    • 2017
  • Objective: This study was aimed to evaluate the effectiveness of the diabetes education program implemented in a community hypertension and diabetes education center. Methods: Participants were thirty nine diabetic patients who received the education program in the center from May 2014 through May 2015. The education program consisted of two sessions for 2 days (45 minutes per session) regarding clinical information, nutrition and exercise for type 2 diabetes patients. Initially, they were assessed for general characteristics, knowledge on diabetes, self-efficacy and self-care behaviors. Reassessment was performed on their knowledge and self-efficacy directly after the program, and on self-care behaviors at 12 weeks after the program. Results: The mean score of diabetes knowledge was significantly increased from $5.27{\pm}2.10$ to $8.21{\pm}1.20$ (p<0.001) between before and after the program. The self-efficacy score was also significantly increased from $6.88{\pm}1.72$ to $8.16{\pm}1.47$ (p<0.001). The self-care behavior score was significantly increased from $3.59{\pm}1.89$ before the program to $4.35{\pm}1.29$ (p<0.001) at 12 weeks after the program. Conclusion: The diabetes education program may be effective on the improvement of knowledge, self-efficacy and self-care behaviors in type 2 diabetic patients.

Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Factors Affecting to the Instrumental Ability of Daily Living(IADL) in the Urban Elderly (도시지역 노인들의 도구적 일상생활 수행능력(IADL)에 영향을 미치는 요인)

  • Lee in hak;Moon Seng ki;Kim kun joo;Park Jae-Young
    • The Journal of Korean Physical Therapy
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    • v.14 no.3
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    • pp.238-272
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    • 2002
  • This study was intended to find out the factors affecting to the IADL, allowing objective assessment of physical function status of increasing elderly populations. The subjects of 635 elderly persons aged over 65 years old who live in Taejon metropolitan city were interviewed during the two-month period from June to July of 2000. The IADL of Older American Resources and Services(OARS), developed in Duke medical college of USA, was interpreted for use. The study results were statistically processed using SPSSWIN(ver 10.0) and conferred the following results: 1. Among the seven items of IADL, the women showed higher rates of 'yes' in items about using the telephone, getting to the places out of walking distance, going shopping for groceries, taking their own medicine while outnumbered by the men only in the item about managing their own money, without significant differences between them in items about preparing their own meals and doing their own housework. 2. In terms of IADL scores, $82.0\%$ of subjects showed the normal range of scores and $18.0\%$ were under the normal range, meaning dysfunction IADL. Specifications of general characteristics revealed that more dysfunctional were the male subjects, the higher age groups who are more than 75 years old, the higher educated groups, the groups who live in nursing homes, the groups without a spouse. 3. Based on daily activities, lower scores of IADL were found in the subjects who don't go out, who don't have recreational activities, who don't attend elderly gatherings in their neighborhood, who don't hold social meetings. Specifications of psychological traits revealed that more dysfunctional were IADL in the subjects who don't feel satisfied with their lives of the past or the present, who have a deep feeling of isolation, and who don't have the will to live. 4. Among 7 items of health habits, only the subjects who don't regular exercise had lower scores of IADL than those who do. According to HPI, the lower HPI, the more dysfunctional. 5. Based on the factors associated with IADL, the odds ratio of the subjects who don't live together with their families were 1.53 times that of the ones who do, who are educated 3.22 times that of the ones who are not, who don't have spouses 2.09 times that of the ones who do, who don't go out 4.35 times that of the ones who frequently go out, who don't recreational activities for an interest 2.64 times that of the ones who do, who don't attend elderly gatherings in their neighborhood 1.47 times that of the ones who do, who don't hold social meetings 2.23 times that of the ones who do, who don't feel satisfied with their present living 1.43 times that of the ones who do, who have a feeling of isolation 1.53times that of the ones who don'1, who have the weak will to live 3.21 times that of the ones who have the strong one, and who don't regular exercise 2.45 times that of the ones who do. 6. Logistic regression analysis of the study results found that such factors are significantly related as the degree of education, with/without spouse, social meetings, the will to live, and regular exercise, and that higher rates of dysfunctional subjects were in the more educated group, in the group without spouse, in the group who don't frequently go out, who don't have social meetings, who have the weak will to live, and who don't exercise.

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Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.