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

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The Empirical Exploration of the Conception on Nursing (간호개념에 대한 기초조사)

  • 백혜자
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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Research on the Need Assessment Tool for the Korean Elderly at Home Focused on their Desires Based (한국 재가노인의 욕구중심 사정도구 개발에 관한 연구)

  • Kirn, Young sook;Jung, Kook in;Park, So rah
    • 한국노년학
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    • v.27 no.2
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    • pp.459-472
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    • 2007
  • This research has its purpose of developing a tool to assess the needs of the Korean elderly at home population and to provide adequate services by evaluating their physical, psychological, and socio-environmental aspects. This developed tool is composed of two hundred questions and has the advantage of combined physical, psychological and social environmental situation assessment of the elderly at home. The tool also contains not only the objective view of the professionals, but also the subjective appeals of the elderly at home population so that it can reflect their substantial desires. The assessment tool was developed over 21 months from July, 2004 to March, 2006 and this period can be divided into three different stages. In the first stage, collecting of questions for the desire-focused assessment of the elderly by literature investigation and researching foreign source materials was carried out, and this ultimately developed assessment tool was applied to the long-term care insurance pilot project in the second stage. In this process, we revised some insufficiencies of this tool after we applied to elderly of 250 from the pilot project and other 200 elderly from this research team. For the last stage, the tool was completed by using inquiries of the focused group and the group of professionals to ensure its reliability and validity. In the process of developing the tool, the total of 200 questions under 13 subcategories was selected. The 13 subcategories are basic information, subjective appeals, information of the main helper, use of services, house environment, condition of health, condition of rehabilitation, daily living(ADL, IADL, defecation, assistance), social maintenance, behavioral disability, medical health, living habits, and strength. This tool is on the purpose to assess thoroughly the desires that the elderly at home population has and to provide the best service they need.

A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea (일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究))

  • Kim, Yong-Ik;Yun, Dork-Ro;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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The Factors for Food Service Satisfaction of the Elderly Welfare Center Free Lunch Program Participants in Busan (부산 일부지역 복지관 무료급식 이용노인들의 급식만족도에 영향을 미치는 요인)

  • Lee, Jeong-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.1
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    • pp.128-136
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    • 2011
  • This study was carried out to investigate the factors of food service satisfaction of the elderly in Busan. The survey was conducted from September 1 to October 15, 2009 by questionnaires and data analyzed by SPSS program. Fifty point nine percent of the subjects lived alone and the source of living expenses of 70.5% of the subjects was subsidy from government. The most important reason for the elderly to participate in meal service was 'economic difficulty' and 'to meet friend'. The subjects had various chronic degenerative diseases, such as arthritis, hypertension, diabetes, osteoporosis and cardiac disease. Sixty-six point eight percent of the subjects needed diet therapy for their diseases, but 87.1% of them don't want to pay the extra fee. Thirty six point five percent of the subjects attained information about lunch program because it was 'close to home' but 20.7% was 'from public officials'. The reasons for the use of the meal service were 'economic difficulty' (40.0%), 'to meet friends' (22.6%), and 'bother to prepare meal' (16.50%). The services provided by welfare center were health care, physical exam and haircut. The score given by the subjects on the satisfaction of meal service was 3.84 on the 5-point maximum scale. Higher satisfaction on kindness of staff, satisfaction of social support and awareness of support resulted in higher satisfaction of food service. It would be effective to provide food service models that meet specific needs of the elderly according to social welfare service and social community activities.

The Recognition about Food Wastes Treatment at Yongin Area

  • Kim, Jeong-Hyun;Kang, Hee-Joo;Kim, Kyung-Tae;Kim, Hyun-Soo;Hwang, Seong-Hee;Kim, Yong-Chul;Kim, Pan-Gyi
    • Journal of Environmental Health Sciences
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    • v.30 no.4
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    • pp.329-343
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    • 2004
  • We conducted to investigate citizen's attitude to the treatment of food waste in Yongin city. The respondent of $41.81\%$ throws the food waste eliminate from home and store less than 1l in Yongin. When they dump the food waste, they speak out the inconvenience of damaged envelope by animals in case of home and store. This caused troubles for reason of sanitary. So a local autonomous entity must carefully consider of expand use specially designed container as like apartment house. They give an answer that the collecting time of food waste is suitable form dawn till morning. This answer shows the satisfaction of the period time to collect the food waste. They prefer to be appointed the exclusive place to collect food waste. The service interval of collect is suitable 1 time a day. They want to increase the number of washing of the collecting container. This is good method for sanitary condition, but the care of the period time to collect the food waste is more efficient than the care of the number of washing the collecting container. The care of the period time minimizes to incur the enmity of the people and to pollute in environment. The major of respondent handled the food waste after keeping the basket or a kit. This fact shows to us almost citizen doesn't feel the seriousness to remove the moisture of the food waste. Recently, many solutions which can be disposal efficiently are getting magnified and improved owing to increase utilities channel to loss in quantities and dry the food waste. We expect the reduction of food waste is solved getting easily step by step. The results of the awareness about the facility of food waste show citizen prefer recycling facility to the other facilities. If recycle facility and incineration facility are constructed, they were worried about bed smell. When some facility of the food waste is constructed, they have to maintain and to handle not to incur the enmity of the people. The spread rate of specially designed container already increased, the citizen set a high value on the use of specially designed container more than amount-rate vinyl envelope that people have used for several years. In the cost treatment about food waste, the major respondent answered the use cost of specially designed container is suitable price. So we can know the use charge is proper level. The majority of citizen more prefer autonomous plan which voluntary atmosphere creation and public information by mass media than levy system and rising treatment cost which forced plan. The citizens have pretty positive thinking of incineration, so the government needs more efforts for a public notice, which includes the incineration is no more than abandoned thing. Each of local self government has to sort the food waste and make kind of resource system related to collecting and carrying, constructing a suitable facility, proper disposal of the food waste and producing harmless in our surrounding in order to solve the invisible problems. To do above mentioned things, we have to analyze referred several problems till now. Also, to minimize the side effect, the government will have to improve through enforce the system.

A Study on Comparison of Commercial Arbitration System in Korea and U.S.A. (한국과 미국의 상사중재제도에 관한 비교연구)

  • 이강빈
    • Journal of Arbitration Studies
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    • v.12 no.1
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    • pp.271-321
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    • 2002
  • Every year, many million of business transactions take place. Ocassionally, disagreements develop over these business transactions. Many of these disputes are resolved by mediation, arbitration and out-of-court settlement options. The American Arbitration Association(AAA) helps resolve a wide range of disputes through mediation, arbitration, elections and other out-of-court settlement procedures. The AAA offers a broad range of dispute resolution services to business executives, attorneys, individuals, trade associations, unions, management, consumers, families, communities, and all level of governments. The 198,491 cases composed of the 194,303 arbitration cases and the 4,188 mediation cases, were filed with the AAA in 2000. These case filings represent a full range of matters, including commercial finance, construction, labor and employment, environmental, health care, insurance, real state, securities, and technology disputes. The Korean Commercial Arbitration Board (KCAB) does more than render arbitration services. It helps facilitate settlements and guarantee implementation thereof between trading partners at home and abroad involving disputes related to such areas as the sale of commodities, construction, joint venture agreements, technical assistance, agency agreements, and maritime transport. The 643 cases composed of the the 197 arbitration cases and the 446 mediation cases, were filed with the KCAB in 2001. There are some differences between the AAA and the KCAB regarding the number and the area of mediation and arbitration case filings, the breath of service offerings, the scope of alternative dispute resolution, and the education and training. In order to apply to the proceedings of the commercial mediation and arbitration, the AAA has the Commercial Mediation Rules, the Commercial Arbitration Rules, the Expedited Procedures, the Optional Procedures for Large, Complex Commerical Dispute, and the Optional Rules for Emergency Measures of Protection as amended and effective on September 1, 2000. In order to apply to the proceedings of commercial arbitration, the KCAB has the Arbitration Rules as amended by the Supreme Court on April 27, 2000, which have been changed to incorporate the revisions of the Arbitration Act that went into effect on December 31, 1999. There are some differences between the AAA's commercial Arbitration Rules and the KCAB's Arbitration Rules regarding the clauses of jurisdiction and administrative conference, number of arbitrators, communication with arbitrator, vacancies, preliminary hearing, exchange of information, oaths, evidence by affidavit and posthearing filing of documents or others, interim measures, serving of notice, form of award, scope of award, delivery of award to parties, modification of award, release of liability, administrative fees, neutral arbitrator's compensation, and expedited procedures. In conclusion, for the vitalization of KCAB and its ADR system, the following measures should be taken : the effective case management, the development of on0-line ADR, the establishment of ADR system of electronic commerce disputes, and the variety of dispute resolution rules in each expert field.

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A Trend of Research in Community Health Nursing (지역사회간호학 관련 논문 연구동향 분석 -학회지 발표 논문을 중심으로-)

  • Lee, In-Sook;Kim, Yu-Na;Choi, Key-Won;Chin, Young-Ran
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.288-298
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    • 2001
  • This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

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Adolescent Health Promotion and Development of School Health Education (청소년기의 건강증진과 학교보건교육의 발전방향)

  • Yoo, Jae-Soon
    • Journal of the Korean Society of School Health
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    • v.11 no.1
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    • pp.27-50
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    • 1998
  • Adolescent health is considered to contribute to health promotion in the home and community in the near future as well as individual health. However, adolescent health has been neglected from education field because of competitive school education focused on the university entrance examination That's why I suggest in this study that we should pay much more attention to adolescent health condition and try to make It better, in terms of man-power development and life-health promotion for nation development The purposes of this study are as follows First, to look into a variety of adolescent health problems Second, to find out the situation and problems of current adolescent health promotion and school health education Third, to make an effort to find, based on the current situation, various developments of adolescent health promotion and school health education in terms of practical, political and environmental change There are used study methods as adolescent-related, school heath-related literature review and anlysis of statistical data The results and suggestions are as follows Teenagers have a great variey of health problems including most Important physical, mental and social developments Recently, chronic diseases, emotional problems, health-risk behaviors linked With adolescents are on increase The complicated disorders of physical, mental, social health rather than paricular aspects of health or health-behavior problems influence adolescent health problems adolescence is regarded as the period when most health-related behaviors are formed. Therefore, adolescent health promotion would he assured by developing the ability of controlling multi-dimensional health determinants in the early stage. Health promotion is a positive concept that each individual, family and community makes real efforts to improve their health To achive this, we need health educational, organizational, political and environmental supports. Adolescent health promotion in Korea has been systematically treated in the category of school health Current school health services have had lots of systemic, constitutional, administrative and educational flaws Accordingly, I'm concerned that we can afford to accept a variety of adolescent health needs However, I would say that if were not to make those flaws better, it's certain that Korean national competitive power and the quality of the lives of most Koreans Will he threatened someday We have to develop Comprehensive School Health Crriculum(CSHC) and set up its standards to Improve adolescent health. CSHC is an organizational and costant process. CSHC means an Important part of overall curriculums. In addition, I could say that it's an Important school health education acivity including current school health services-health care service and school health environment. In conclusion, in order to develop CSHC, we require school nurse's role changes, establishment and management of intergrated subject of health education, striking revision of school health law(or legislation of school health promotion law), reorganization of administration system, big changes in curriculum for school health educators.

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A Preliminary Study on Mobile Medical Unit for Emergency Medical System (응급 의료체계용 이동 의료단위에 대한 기초연구)

  • Yang, Minkyu;Lee, Young;Suh, Sangwook
    • Korean Journal of Construction Engineering and Management
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    • v.18 no.6
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    • pp.57-64
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    • 2017
  • Recently, the disaster situation has been diversified and compounded worldwide as well as in Korea. And the damage scale of each disasters have increased, and following economic loss is also increasing immensely. In Korea, especially the out break frequency of large-scale disasters has increased. Disasters caused by earthquakes are also very likely to occur. When a major accident such as Mauna resort collapse accident, Ferry sewol sinking accident occurred, systematic emergency medical care at the site at the time of disaster occurred in order to operate an emergency medical facility corresponding to the site, which is not systematic. The need for this service is urgent. If highly reliable emergency medical system function at appropriate times in the disaster site, secondary damage can be reduced and the whole situation would be back to normal shortly. Therefore, it is necessary to provide an emergency medical system capable of quickly and safely responding to disaster sites in relation to various damage scale. For the purpose, thorough analysis on mobile medical units of inside and outside the country was accomplished. As a result, Mobile Medical Unit of outside the country are trailer type, tent type, container type etc. At home, these types have been studied and will be proposed early next year as a temporary solution. Here we introduce suitable types for our country.

A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning (농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究))

  • Yeh, Min-Hae;Lee, Sung Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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