• Title/Summary/Keyword: Nursing approach

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A Study on Role Development for Social Workers Providing Health Center-based Health and Welfare Services for the Elderly in Community (사회복지사의 보건소 노인보건복지사업 참여를 위한 사회복지사 역할개발연구)

  • Cho So-Young
    • Journal of Korean Public Health Nursing
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    • v.11 no.1
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    • pp.138-162
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    • 1997
  • This study was conducted to, develop the social workers role participating health and welfare services production of health centers The sharp increase rate on the elderly population in Korea lead the social issues as that health and social services are not developed enough to cope with the increase on the elderly's hearth care needs. The priority in the elderly's care service development should be put on public sectors. so that could prevent financial catastrophy of the elderly's care. The pulbic sector was concerned with health center services : as health center in Korea provide :mainly medical-oriented services. this study focused on to combine the existing health center's services into social services. The study method was based on needs survey with 322 patients aged over than 55 in rural area. "The needs survey include general health and disease care needs and daily life caring needs. The latter was applied with ADL and IADL with modificiation for the use of Korea environment. The findings were as follows : Social workers should be able to care diseases of muscular and skeletal. circulatory, digestive and general chronic disease in social service needs. aspect. Mostly the chronic pateints quit their care services because of shortage of finanical support$(18.3\%)$ and transportation problem$(19.5\%)$, but still prefer to be cured and cared from general hospitals. and at least clinic and health centers in community. The univisible dramatic effect. of health. care services also should be concerned and cared by xocial workers. The ADL and! IADL shown the most needs on transportation needs and problems caused by weaken legs. Mostly daily activities were supported by family members $(53.3\%\;spousers\;and\;35.0\%\;children)$, and the most demands were shown on helps for transportation visiting hospitals$(37\%)$ and getting similar care services for health care needs $(31.2\%)$ and daily hygeieal needs$(11.2\%)$ Social workers' role should include health care participation with social and health promotion approach as well as socio-economic supports: during health care receiving. Social workers also should provide social services for the elderly's daily needs solving for these are not in available family supporters.

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Hospice Medicine and Nursing Ethics (호스피스의료와 간호윤리)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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A Research Study on Sexual Awareness of Parents in the Area of City (학부모들의 성의식, 성교육 태도 조사 연구)

  • Lim, Mi-Lm;Byun, Young-Soon
    • Journal of the Korean Society of School Health
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    • v.15 no.1
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    • pp.123-139
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    • 2002
  • This study was conducted to identify the level of sexual awareness and the demand for sex education, to investigate the attitude toward and acceptance of heterosexual friendship, and to identify the experience and direction of sex education of parents. The data were collected from 119 parents with high school students by the structured questionnaire from June 1, 2001 to August 31, 2001. Parents and teachers showed a similar attitude on sexual awareness, but teenagers showed a different attitude. In terms of the level of feeling of and interest in 'sex', teenagers, parents and teachers were comfortably accepting it. As for sexual curiosity in puberty, 84.8% of the parents and 95.5% of the teachers responded that it was natural, whereas only 14.7% of teenagers responded that it was natural. But As for the item that 'sex is natural as one of human needs', 3.6% of the teenagers, 16.8% of the parents and only 1.2% of the teachers responded that it was not. As for the item that 'Man have a stronger sexual impulse than woman", 6.1% of the teenagers, 16.8% of the parents and 17.3% of the teachers responded that it was not. This indicates that teenagers have a far stronger sexist awareness, which also reflect that the sex culture of Korean society that regards sex as man's sexual monopoly. 64.2% of the teenagers and 90.2% of the teachers responded that it was impossible to overcome the sexual impulse, whereas only 8.4% of the parents responded that it was possible. As for the item of masturbation, 64.5% of the teenagers responded that it was possible for male students and not possible for female students. 67.2 of the parents and 91.1% of the teachers responded that it was possible regardless of sex. In case of pregnancy in adolescence, most of the responding teenagers, parents and teachers chose abortion. This indicates that respondents have a poor basic understanding of the life-despising climate, responsible sexual intercourse and motherhood protection. As for the item of 'female refusal on male sexual approach', respondents accepted female refusal as it was in orders of teachers, parents and adolescents. As for item of 'An assaulter is entirely to blame for sexual assault', all of three groups responded in the affirmative.

CQI Activities for the Reduction of Clostridium difficile Associated Diarrhea in NCU of a University Hospital (일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동)

  • Park, Eun Suk;Chang, Kyung Hee;Youn, Young Ok;Lee, Jung Sin;Kim, Tae Gon;Yea, Han Seung;Kim, Sun Ho;Shin, Jeong Won;Lee, Kyungwon;Kim, June Myung
    • Quality Improvement in Health Care
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    • v.8 no.1
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    • pp.10-21
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    • 2001
  • Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

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Experiences of Public Visiting Nurses on the Linkage Cooperation of public case management: Focus Group Interview (방문건강관리사업 담당자의 공공부문 사례관리 연계협력 경험: 포커스 그룹 인터뷰)

  • Kim, Hyung-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.160-169
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    • 2020
  • This study was conducted to identify the linkage and cooperation experiences in public case-management services of visiting health care practitioners. Focus group interviews were conducted with three people in charge of providing visiting healthcare services in public health centers. A semi-structured interview questionnaire was developed in advance through discussions among researchers In response to the interview questions, study participants described in detail the success and failure factors associated with linkage and cooperation that they experienced while providing visiting healthcare services. The interview data were analyzed qualitatively to identify the main themes and sub-themes reflecting visiting nurses' experiences with linkage and cooperation. The three main themes were: 'Guidelines act as positive performance factors for community-based linkage and cooperation', 'Unstable employment and lack of an integrated system act as barriers to linkage and cooperation', and 'Necessary for multidimensional approach to promoting linkage and cooperation'. Based on these results, the authors propose the development of clear linkage and cooperation standards and procedures, thereby ensuring job security for visiting nurses. Moreover, an integrated information system should be developed and implemented.

Structural Equation Model for the Subjective Happiness of Adolescents : Focused on Perceived Stress, Activities and Practices (청소년의 주관적 행복감 구조모형 : 스트레스 인지와 의도적 활동중심으로)

  • Wi, Ok-Youn;Lee, Ji-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.585-596
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    • 2016
  • This study was designed to examine the relationships among the levels of perceived stress, dietary behaviors, physical exercise, drinking, smoking, and relief from fatigue through sleep which affect the subjective happiness in adolescents. Based on the study findings, this paper proposes the basic data required for offering practical solutions to improve the subjective happiness of adolescents. IBM SPSS 20 and AMOS 23 were used to conduct frequency and descriptive analyses, in conjunction with Pearson's correlation coefficients, the AMOS bootstrapping method and phantom variables, for the raw data obtained from the 9,599 participants included in the 11th Korea Youth Risk Behavior Web-based Survey. Those factors having a direct effect on the subjective happiness of the adolescents were the level of perceived stress, relief from fatigue through sleep, physical exercise, dietary behavior and smoking. Perceived stress had an indirect effect on subjective happiness, and the analysis of the indirect effect and significance level of multiple mediators by means of phantom variables showed that, as well as perceived stress, relief from fatigue through sleep, physical exercise, dietary behaviors, and smoking also had indirect effects on subjective happiness. Consequently, a multidisciplinary approach is needed to optimize the subjective happiness in adolescents and financial support for environmental improvements is particularly necessary.

A Study on the Analysis of the Related Factors to Distinguish High Risk Group of Female Suicidal Attempts (여성의 자살시도 고위험군 선별을 위한 관련요인 분석)

  • Choi, Hyang Suk;Heo, Myoung-Lyun;Kim, Eun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.308-317
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    • 2017
  • This study aims to determine the current status of experiences of suicidal attempts of Korean women and to evaluate related factors and provide basic sources for distinguishing high risk group. The primary data of the 6th period of national health and nutrition survey by KCDC, between 2013 and 2015,wereutilized in this study.Women were selected;general characteristics, psychological characteristics, and relevant information of daily activities were collected. The collected data wereanalyzed by applying the complex sample analysis method,using the SPSS 20.0 program with an application of weighted values. The resultsof this study revealed that 1% of the study population had previously attempted suicide; the suicidal attempts in subjects with prior psychological counselling within 1 year was 5.25 times higher than those without prior counselling.Subjectswith too much stress were 14.92 times more likely to attempt suicide than those without stress. Moreover, subjects with higher-intensity work in daily lives was 4.85 times more likely to attempt suicide than those with less intense work. In addition, subjects who sat for longer period of time was 3.76 times more likely to attempt suicide. All of these were statistically significant. Therefore, these subjects should be considered as high risk for suicidal attempt.In order to prevent female suicide, guidelines that considers the psychological health status and daily activities are required. In addition, it is necessary to approach this issuewith individualized prevention programs as part of social policies.

A Phenomenological Study on Pregnancy Experience of Unmarried Korean Mothers (한국 미혼모의 임신 체험 연구)

  • Han, Jin-Sook;Moon, Young-Sook
    • Korean Parent-Child Health Journal
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    • v.5 no.2
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    • pp.206-223
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    • 2002
  • The purpose of this study was to discuss the nature of pregnancy experience among unwed Korean mothers and to figure out what it meant for them, by asking some of them to reflect on themselves in a written form from interpretative and phenomenological perspective, based on van Manen's research method of the same approach. The subjects in this study were seven unmarried mothers in Korea. The data were collected from July through December 2000 through in- depth interview and observation. The statements of the participants were taped, recorded, analyzed and select essential themes. To have a phenomenological understanding of the pregnancy unmarried mothers, literary works, including essays and novels, were reviewed. The findings of this study were as below: The selected substantial themes about the pregnancy and birth experiences of the single mothers included 'hatred for boy friend,' 'hatred for the fetus,' and 'hatred for myself.' The unmarried mothers met their boy friends through the introduction of friends. At first, they were good friends, but they soon went on a date and had sexual relation with no common knowledge about sex. Most of them were aware of their pregnancy after they felt fetal movement, but they put off taking the test because they didn't want to accept the fact and feared it. Such an attitude was rare among married pregnant women, and being pregnant with no prior preparation or sexual knowledge is not common in Western countries. They felt guilty and informed their boy friends of the fact, but the boy friends didn't admit their responsibility and rejected the babies. This made the poor girls hate them, and it turned into severe abhorrence. They thought their lives were ruined by the babies, and wished they would disappear. They reproached the babies, hitting their own bellies or making a kick. They considered themselves to be abandoned and didn't want to live any more. Giving themselves up to despair, some attempted to commit a suicide. They hoped to die, thinking their death would solve the problem. When they lost a chance of abortion and were about to have the babies adopted, they felt sorry for them. The unwanted pregnancy gave them a pain, but they keenly felt they were loved by their mothers, and learned the value of family. It's attempted in this study to clearly show how much unmarried Korean mothers suffered from pregnancy, and this effort paved the way for seeing unwed mothers in a new light and having a better understanding of them, instead of sticking to general perception.

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A Study of the Use of Oral Contraceptive Among Women Rescinding in the Yonhee Dong Blum Area (연희 영세지역 주민의 먹는 피임약 복용상태에 관한 조사연구)

  • 최인숙
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.121-134
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    • 1974
  • This study is an attempt to evaluate the use of an oral contraceptive by: 1. Deforming the acceptance rate of the oral contraceptive according to socio-demographic characteristics 5. Estimating the duration of the use of the contraceptive f. Discovering reasons why the contraceptive was discontinued 4. Computing the cumulative continuation and discontinuation rate according to socio-demographic characteristics, history of pregnancies, and attitude of husband at the time of selection of the contraceptive. One hundred sixty-eight women of child bearing age (14-49 years), residing in Yonhee Dong, Seoul, Korea and registered as oral contraceptive accepters at Yonsei Community Health Center, were interviewed during a three week period in 1973. The questionnaire was designed to determine the socio-demographic characteristics of the oral contraceptive accepters, the current status of their family planning practice, medical reactions if any, discontinuation practice, and the duration of the use of the contraceptive. The major findings of the study were as follows; 1. The acceptance rate was highest for women between 30 and 34 years of age, the mean age being 34.4 years. 2. Fifty six point five percent of all respondents said that thirty years of age was the ideal age to stop having children. 3. The average number of living children was 3.5 and fifty four point eight percent of respondents felt 2 boys and I girl was the ideal number of children. 4. The average number of pregnancies was 5.2 and the average number of induced abortion was I. 4. 5. Fifty eight point eight percent of the respondents had experience in the use of contraceptive methods in the past. 6. Forty one point seven percent of the respondents replied that they chose the oral contraceptive because, "it was not complicated to use." 7. Sixty four point eight percent of the women said their husband approved of their taking the pill. 8. The cumulative discontinuation rate was sixty point five percent of the total respondents for one year in first segment. 9. Sixty six point nine percent of the respondents had experienced side-effect while using the pill. The side effects for 68.9 percent of these women were castro-intestinal upsets. Twenty point eight percent of the women who had side effects consulted with medical personnel about them. Women who had more education had more side effects. 10. Seventy three point two percent of the women who discontinued the pill did so because of medical reasons. Women who were younger discontinued the pill for personal reasons more-often than older women. Among personal reasons listed for discontinuing the pill was the attitude of the husband. 11. The average duration of continuance of the contraceptive was 5.3 cycles under 29 years of age; 7.4 cycles between 30 and 34 years of age; and 8.4 cycles over 40 years of age. 12. The discontinuation rate was seem to increase sharply in the early cycle and increase more slowly in later cycle. Conclusions and suggestions: Since the attitude of the husband was shown to be important, the current family planning program should be expended to include approach to husband. For women who must use the oral contraceptive, education and support must be enhanced so that the discontinuation rate due to side effects will be decreased.

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The Effect of Reminiscence with Audio-Visual Stimulation on Senile Dementia (치매노인에게 시청각 자극을 병행한 회상요법의 적용효과)

  • 김남초;유양숙;한숙원
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.98-109
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    • 2000
  • The purpose of this study was to identify the effect on improvement of the Activity of Daily Living (ADL) and decrease the cognitive function and agitation behaviors by reminiscence with audio-visual stimulation for senile dementia. The quasi-experimental design was used in this study. Subjects were 26 with mild senile dementia who were cared for at a Day Care Center for Dementia in Seoul. The data were collected from March to July, 1999. Subjects were divided into three groups : Control Igroup with 10 subjects, reminiscence group(Control II group with 8 subjects), and reminiscence with audio-visual stimulation group(experimental group with 8 subjects). The Control I group got routine care as usual. Control II group participated in reminiscence sessions for one hour a day, five times a week , for a period of 4 weeks. The experimental group participated in reminiscence with audio-visual stimulation sessions for one hour a day, five times a week, for a period of 4 weeks. Instruments of this study were color photography with sound that was developed through an open questionnaire about events, objects, humans in action and animals that 100 Korean elderly over 60 would like to memorize. This was referred from the Sensory Stimuli Package by Namazi and Haynes(1994). The effects of treatment was evaluated through MMSE-K by Kwon & Park(1989). Also the Brief Cognitive Rating Scale(BCRS) by Reisberg et al(1983) for the cognitive function, through Agitation Inventory by Cohen- Mansfield and Colleague(1989) for behavioral response and through the Rapid Disability Rating Scale-2(RDRS-2) by Linn & Linn(1982) for the activity of daily living respectively. Data analysis was done using SPSS for $\chi$2- test, ANOVA, repeated measures ANOVA. The results were as follows : 1. Reminiscence with audio-visual stimulation did not improve cognitive function for senile dementia, but significantly improved verbal expression, the subscale of cognitive function. 2. Reminiscence with audio-visual stimulation reduced agitation behavior of experimental group significantly, but there was no significant difference between groups. 3. Reminiscence with audio-visual stimulation did not significantly effect the activity of daily living after treatment. In conclusion, it was shown that the reminiscence with audio-visual stimulation was an effective therapy to improve verbal expression and to reduce agitation behaviors of senile dementia. Further research with more indepth approach is needed, considering characteristic and level individualized for each senile dementia.

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