• Title/Summary/Keyword: Out-of-home care service

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The evaluation of active daily living after patients had stroke - focus on active daily living habit & physical therapy - (뇌졸중 환자의 퇴원 후 일상생활에 대한 고찰 - 일상생활 습관 및 물리치료 중심으로 -)

  • Kim, Hye-Seun;Lee, Chang-Hyun
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.30-37
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    • 2003
  • Purpose : The purpose of this study is giving the healthy promotion and it's related data base for out-patients who had stroke via evaluating the general characters of their active daily living and physical therapy Method : This study researched 81 patients who had received physical therapy service in 6 general hospitals located Pusan city responded to the self-assessment questionnaires from July 2002 to August 2002. Conclusion : In this study, patients were composed of 61.7% of male, 65.4% of 50's-60's in the age, 56.8% of cerebral infarction, and 60.5% of right hemiplegia. 74.1% of patients received physical therapy after 6 months from an attack, only 62.9% used orthosis & gait aids, and 59.2% received medical care 2 or 3 times per week. 40.7% of patients had over 9 hours sleeping time and 22% had reduced $1{\sim}2hours$ before hospitalization. 90% did not have drinking and smoking. 91.4% had 3 times eating per day, and 67.7% did not have good nutrition. The reasons of that were their eating habit, 542% of eating-giver, 3.7% of economic problem. 46.9% of patients used healthy food. In active daily living, patients can't do drinking by cup, voiding & defication by themselves, however patients can't do wearing/take off, etiquette for dressing, bathing, stepping by themselves. 40.7% of patients don't wear orthosis, 55.6% of patients don't use W/C. Part of physical therapy that patients concerned importantly exercise for prevention of joint distortion, management of affected side, and 80% of patients was also concerned other's part, significantly. 71.8% of patients & care-givers want to receive physical therapy at home, and 74% of patients do physical therapy by themselves at home along teached hospitalization.

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Current Status and Challenge of Hospice.Palliative Care in Korea (한국 호스피스.완화의료 기관 현황 및 과제)

  • Lee, Kun-Sei;Joo, Ji-Soo;Kim, Jung-Hoe;Kim, Keon-Yeop
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.196-205
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    • 2008
  • Purpose: The purpose of this study was to evaluate the current status of hospice palliative care facilities, and to identify problems and improve hospice palliative care in Korea. Methods: The questionnaire survey was implemented from October to December, 2007. It was consisted of general characteristics of organization, health manpower, facilities & equipments, service programs, and so on. Sixty two (79.5%) out of 78 hospice palliative care facilities returned the questionnaires. Results: They were 42 hospital-based hospice palliative care hospitals and 9 clinics, and most of them are located at central metropolitan areas (Seoul and Gyeonggi Province). more than 80% of hospitals met with the requirements (one doctor per 10 patients and one nurse per 1.5 patients), whereas 42.9% of clinics met the requirements. Approximately 22% of them met the requirement of sick room (4 patients for 1 room). Most of them provided various hospice palliative care programs. The proportion of giving regular education programs to hospice palliative care personnels were about half (41.9%). Thirty two (51.6%) facilities provided home visiting hospice palliative care service. Conclusion: There were lack of enough health manpower, rooms, and programmes and they varied among facilities. It is necessary to increase the number of hospice palliative care facilities with consideration of regional fair distribution and standardization of programmes.

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A Survey on the Foodservice Management Practices at Child Care Centers in Gyeonggi Area (경기 지역 영유아 보육시설의 급식운영관리 실태 조사)

  • Sohn, Chun-Young;Pak, Hee-Ok
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.4
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    • pp.577-586
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    • 2011
  • This study was carried out to investigate food service management practices in various operation types of child care center in Gyeonggi area of Korea, and to provide basic information for improving food service management policies at child care centers. Self-administrated questionnaires were collected from 102 child care center directors. The statistical analysis was completed using SPSS ver. 18.0 program. Approximately 97.1% of the directors were women. The number of total children were difference in public, private and home care centers respectively (p<0.001), and time of operation was significantly (p<0.01). Only 8.9% of the centers employed a dietitian, whereas 92.5% of the centers employed cook or assistant cook, thus food service was not managed by professionals in most centers. All of the centers had been self-operated and meals were prepared in a conventional manner. In approximately 89.2% of the centers servings snacks twice a day. Menu planner of the centers which have no dietitian was the child care information center (47.5%) or the director (34.7%). In most centers, the directors was also purchasing manager and 36.0% of the center purchased food every day. These results indicated that food service management guidelines need to be established by the child care center type with the government control and financial support. We recommended that they furnish the efficient food service program for food service management.

The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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Missionary Public Health Nursing of Korea during Japanese Colonial Period (일제시대 선교회의 보건간호사업에 대한 역사적 연구)

  • Yi, Ggod-Me;Kim, Hwa-Joong
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.455-466
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    • 1999
  • Western missionary nurses practiced in Korea from 1891. and the first trial to begin missionary public health nursing service in 1909 could not put into practice for short of nursing staff and budget. The main focus of missionary medical practice was not in public health program but in the management of missionary hospitals. A few of missionary western R.N. tried district nursing in 1910s. but their activities were personal and focused on the rescue of poor and sick patients. In 1917 the North American Methodist Church dispatched R.N. Elizabeth S. Roberts to begin district nursing in Korea. Roberts began maternal and child district nursing service. Her service was focused on teaching the method of bringing up children. bathing service, and home visiting for delivery. She could not but stop district-nursing service in 1918 to serve for a hospital in Siberia. The North American Methodist Church dispatched a few of R.N. to Korea in early 1920s and the missionary public health nursing of Korea could be activated. R.N. E. T. Rosenberger began public health nursing program in Seoul with Korean graduate nurse, Shin-gwang Han, and missionary M.D. Hall. Their public health nursing program was focused on maternal and childcare. They did home visiting in the morning, and served at a well baby clinic in the afternoon. The first baby competition began in 1925. and contributed to the teaching the method of bringing up children. They expanded public health nursing activity to school health nursing and milk station. Their public health nursing program was such a success that In 1929 Severance hospital. Eastgate Hospital. Taehwa Social Evangelistic center organized Seoul Child Health Union. Maren P. Bording, another missionary R.N. and midwife dispatched by the North American Methodist Church began public health nursing program at Kongjoo in 1924. Her program was focused on the maternal and childcare and close to that of Seoul. She started the first milk station in Korea in 1926. As she was a midwife and could get M. D. license in Korea, her program was more focused on maternal care than that of Seoul. The first day nursery school in Korea and the first graduate course for public health nursing in Korea began at Kongjoo in 1930. As the city of Choongcheongnam Province moved from Kongjoo to Daejeon in 1932, missionary public health nursing service in Kongjoo extended to Daejeon. There were lots of public health nursing program in Korea in 1920s and 1930s by missionary western nurses and Korean nurses. There were 13 missionary public health-nursing center in Korea in 1932. But in the late 1930s. Japan extended colonial war and drove out western missionaries. The missionary service in Korea was daunted. and the missionary public health nursing service could not but shrink.

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A Study on Non-smoking Education status through School Health Care Services (학교보건간호를 통한 금연 교육의 실태에 관한 연구)

  • Chung, Yeon Kang;Chang, Young Mee
    • Journal of the Korean Society of School Health
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    • v.7 no.2
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    • pp.135-143
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    • 1994
  • This study is aimed at providing basic information necessary to set up education program and strategies to prevent high school students from smoking by school health care service. The main groups of study are 814 third-grade male students, 557 parents and 362 teachers, who were randomly chosen at 8 high schools in Seoul. Date analysis consisted of Chi-square test and percentage. The findings of the study are as follows: 1. The less interesting family life is, the more increasing current smoking rate is, (ex-smoking rate 53.5%, re-smoking rate 40.3%, current smoking rate 24.3%) 2. According th the results of $x^2$-test for the school life and the smoking, the students above ranking 41 showed th increase as 48.7% for continuous smoking, 18.9% for re-smoking, 67.6% for the present smoker. But it turned out that the students belonged to ranking 10 were not experienced the smoking. So it showed that there was a correlation between score and smoking. 3. It is noted that 93.3% of students, 93.3% of parents and 96.1% of teachers recognize harmful effect of smoking. But less than 70% those have recognized only half of all smoking knowledge. 4. There is a significant difference in the contends and types of education between parents and teachers. 5. For the time of home education and school health education to prevent the smoking, it turned out that 44.9% of students, 42.4% of parents, and 47.4% of teachers considered the optimal time as a high school' days. In addition it appeared that 40.5% of students, 33.4% of parents, and 54.6% of teachers recognized the necessity of the early education before the elementart school. For the optimal time to begin school health education, it showed that the middle school days were indicated from 56.6% of students, 52.7% of parents, the elementary school days were 54.6% of parents, the elementary school days were 54.6% of teachers.

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Identifying the Best Approach to Revitalize High School Culinary Education Curriculum in Korea (조리실습에 대한 인식 조사를 기반으로 한 조리교육 활성화 방안 연구)

  • Kang, Kyeoung-Shim
    • Journal of the Korean Home Economics Association
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    • v.48 no.1
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    • pp.137-161
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    • 2010
  • The aim of this study was to identify the most effective methods with which to revitalize Korean high school culinary education. To achieve this aim, a culinary recognition questionnaire survey of 616 students from 9 culinary high schools was carried out. The 9 surveyed schools represented the following of 7 regions: Chungnam, Busan, Incheon, Daegue, Jeonbuk, Gyeongbuk, and Gwangju. Collected data were subjected to descriptive analysis, $x^2$-test, t-test, and one-way ANOVA using SPSS(version 14.0). The results of this study are as follows. Culinary practice interest and learning demand of most students were high. 6.8% of students indicated that initial theory learning, followed by video education, and finally live demonstration is an effective teaching methodology. They preferred practicing on actual ingredients as the primary teaching and learning method, nominating technician cooking as the most favorite. As for areas needing improvement in culinary practice education, difficulties with material preparation and insufficient learning hours were identified as prominent factors by 66.8% of respondents. There was unanimous agreement that culinary practice education can be enhanced by highly skilled teachers, while interest for the discipline itself can be fostered by initiating and encouraging cooking participation in the home. Freshmen and special high school students suggested that a cooking related website is necessary to expand the current information interface, which is currently limited to colleagues and employers. In relation to culinary education revitalization, consistent promotion of departments, or high schools that have proven student satisfaction rates and effective culinary curriculum are required. Furthermore, teachers can also aid this process by more effective student pastoral care in order to improve school life satisfaction. However, teacher job satisfaction is an important component of this process, and better employment conditions and remuneration packages reflecting extra work must be considered as part of an attractive teacher-incentive employment policy.

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 Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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