• Title/Summary/Keyword: Primary Care

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Nursing Education in North Korea: Past 50 Years and Future (북한의 간호교육 -반세기동안의 변화와 전망-)

  • Yi, Ggod-Me
    • Research in Community and Public Health Nursing
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    • v.12 no.2
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    • pp.437-449
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    • 2001
  • Purpose: To understand the development of nursing education of North Korea after 1945. Method: First, collecting primary sources published in NK. Second, collecting secondary sources published in South Korea. Third, interview with South Korean medical personnels who visited NK. Forth, interview with medical personnels who escaped NK. Result: After 1945 NK increased health care facilities in short time and had the policy of training medical personnel in short time. Nursing education was focused on the basic practice. NK could begin free medical treatment for the laborer in 1947. Post Korean War restoration and free medical treatment system of national level in 1950s and 1960s served to the health promotion of NK population. The medical personnel training policy continued and the number of R.N. in NK had increased 13 times in 15 years. NK has tried to increase the quality of health care service and medical personnel since 1970s. Nursing education in medical colleges is three-year course but 6 month training courses in general hospitals continue. They focus on primary prevention and oriental medicine in nursing curriculum reflecting the characteristics of NK medial care. But English and high technology is very poor, and there is no computer related curriculum. Conclusion: nursing education in NK has developed reflecting the changes of NK society and health care since 1945. After 1980s NK is in deep economic depression and it is hard to recover from the state with their hands. In this state, we cannot expect the development of nursing education in NK.

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Challenges and Strategies for Unified Health System of South and North Korea (남북 건강보장공동체 형성을 위한 초기단계의 과제와 전략)

  • Jeong, Hyoung-Sun;Shin, Hyun Woung;Kim, So Yoon
    • Health Policy and Management
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    • v.28 no.3
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    • pp.315-319
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    • 2018
  • This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

The Characteristics of the Families with Pneumoconiosis Patients (진폐환자 가족의 특성)

  • Park, Young Mi;Lee, Sung Eun
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.84-91
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    • 1999
  • Pneumoconiosis is a pathological change which is caused by coal dusts. It is a chronic disease that is not cured thoroughly but need treatment and nursing care through all lifetime of the patient. The family of the patient will be suffered from the physical and mental difficulties in the consequence of pneumoconiosis. The study is to find out the characteristics of the families with pneumoconiosis patients. The subjects of the study were 300 families with pneumoconiosis patients who were under medical treatment in Taeback, Donghae, Jeongsun Occupational Medical Center. The period of the study was from the 8th to the 31st of August, 1998. The data were collected by the structured questionnaires included the family intensity measurement which was translated by "Oh". The general properties of the subjects were calculated by frequency and percentage with SAS program. The followings are the summaries of the study. 1) The mean age of the pneumoconiosis patients was 62.3 years. The mean duration of diseases was 11 years and 7 months and the mean duration of hospital stay was 6 years and 4 months. 2) The mean age of the primary care giver was 55.7 years. The proportion of highschool education was 9.6% and it was quite low level compared to other primary care giver groups. 3) The average number of family members were 1.76 person(2.76 persons included patient). The economic status was somewhat high compared to other families with chronic patients. 4) The mean score of family intensity was 41.2(item mean=3.4). With the result, it is recommended to develop a program to improve the quality of family life. For example, there will be social support program for pneumoconiosis patients family sponsored by Social Insurance for Occupational Diseases.

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A Study on the Oral Health Literacy and Related Factors of Mother's in Some Areas

  • Kim, Mi-Jeong;Lim, Cha-Young;Son, Ju-Lee
    • Journal of dental hygiene science
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    • v.21 no.1
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    • pp.52-62
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    • 2021
  • Background: This study aims to provide basic data for development of the level-based oral health care program depending on the mother's oral health literacy by finding out how mother's oral health literacy can effect on the preschool children's oral health and behavior. Methods: The survey was conducted on 192 mothers who have preschool children and the data were analyzed by t-test, ANOVA, multiple regression analysis to identify differences in verbal and functional oral health literacy. Results: The study showed statistical significance (p<0.05) in educational level depending on differences in verbal and functional oral health literacy by sociodemographic factor. In differences in verbal and functional literacy depending on experience of education for oral health behavior and oral health, statistical significance (p<0.05) was showed highly on verbal and functional literacy in the case that subjects have an experience of education for oral health and their children have not been experienced of oral illness. And when it comes to the case that subjects have experience of education for oral health within one to two years, statistical significance was showed highly on verbal literacy. It showed that verbal and functional oral health literacy effects to oral health care behavior of children judging from results that the higher level of mother's verbal oral health literacy, the higher score of children's oral health knowledge, attitude and behavior. Conclusion: It is necessary to develop the systematic program which is appropriate for characteristics of each oral period in childhood depending on level of primary caregiver's oral health literacy, and systematic education should be preceded to enhance the literacy of the caregiver. It is considered necessary to improve the oral health care of children by developing a manual for oral health care education to enhance primary caregiver's oral health literacy.

A Comparative Study of the Current State of Response to COVID-19, Knowledge, Attitudes, and Support of Local Public Health Care Practitioners (지역별 보건진료 전담공무원의 코로나 19 대응 현황과 지식, 태도, 지지도 비교연구)

  • Yim, Eunshil;Seo, Inju;Kim, Soon-Gu
    • Journal of Korean Academy of Rural Health Nursing
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    • v.15 no.2
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    • pp.57-65
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    • 2020
  • Purpose: The study was done to compare the status of dispatch of public officials in charge of health care in response to COVID-19 according to location of primary health care posts and the practitioners' knowledge, attitude and support related to COVID-19. Methods: Among the 193 practitioners surveyed, 175 people in Chungcheong-do, Jeolla-do and Gyeongsang-do were selected for final analysis according to work status and differences in knowledge, attitude and support. Data were analyzed using χ2 and one-way ANOVA, followed by a Scheffé-test. Results: There was a statistically significant difference by region in the number of days and places for dispatch teams to respond to COVID-19. In particular, in the case of support, the overall score was low, but Gyeongsang-do, which had the longest number of dispatch days due the occurrence of a large-scale confirmation of patients, showed higher support compared to other regions. Knowledge of COVID-19 was high, but there were no regional differences. Conclusion: Regarding performance of COVID-19 response tasks, the support level was low, indicating that psychological support and appropriate compensation from the local government are required. In addition, it is necessary to prepare a system for the provision of alternative services to prevent a work gap in health clinics.

The Seosan County Family Planning/Maternal & Child Health Service Research Project, Korea -Project Design and Findings of the Baseline Survey- (가족계획(家族計劃) 및 모자보건사업(母子保健事業)의 효율적 통합방안(統合方案)에 관한 연구(硏究)(서산군(瑞山郡)) -기초조사보고(基礎調査報告)-)

  • Bang, S.;Cho, T.H.;Lee, S.J.;Han, S.H.;Lim, K.J.;Ahn, M.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.163-192
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    • 1983
  • In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

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Analysis of Factors that will Ensure Effective Health Care Delivery System (효율적인 의료전달체계 확보를 위한 요인 분석)

  • Rhee, Hyun-Sill;Kim, Mi-Sun;Oh, Jin-Yong;Lee, Seung-Yoon;Jeong, Dong-Jin;Lee, Tae-Ro
    • Journal of Digital Convergence
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    • v.10 no.6
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    • pp.303-310
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    • 2012
  • In order to analyze factors that support effective health care delivery system, this study aimed to research general public's perception on the functions of medical institutions(based on the levels of treatment: primary care, secondary care, and tertiary care), choices of medical institution when contracted with an unfamiliar disease, and recognition of diseases based on their severities. We collected data using self-administered survey from 400 general public living in Seoul, S. Korea from April 25 to May 18, 2011. The analysis was conducted using frequency analysis, chi-square test, and t-test; we analyzed the data to see if there are differences based on gender, age, and level of education. The result of both recognition of functional differences of medical institutions and selection of medical institutions when contracted with unfamiliar diseases showed that there were no significant differences based on the gender; however there were significant differences when considering the age and education. Looking at the result of the knowledge of the disease classification based on its severity, there were significant differences in age, gender, and education. In order to provide sustainable and effective health care delivery system, utilization of primary care as well as education and promotion regarding the functional differences of medical institutions and classification of disease based on its severity need to be encouraged.

Development of a Recording System for Home Health Care for Postpartum Women adn Their Newborns (병원 포괄 수가제 도입에 대비한 산욕부 및 신생아 가정간호 기록지 개발)

  • Kim, Hea-Sook
    • Women's Health Nursing
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    • v.2 no.1
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    • pp.25-39
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    • 1996
  • The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

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Associations Between the Continuity of Ambulatory Care of Adult Diabetes Patients in Korea and the Incidence of Macrovascular Complications

  • Gong, Young-Hoon;Yoon, Seok-Jun;Seo, Hyeyoung;Kim, Dongwoo
    • Journal of Preventive Medicine and Public Health
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    • v.48 no.4
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    • pp.188-194
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    • 2015
  • Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

Utilizing Patterns and Attitude on Collaborating Care of Korean Traditional Medicine and Western Medicine among Cerebral Apoplexy Patients (양.한방 협진병원 뇌졸중 입원환자 진료이용실태와 협진에 대한 태도에 관한 연구)

  • Kim, Dae-Hwan;Lee, Key-Hyo
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.76-101
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    • 2004
  • The primary purpose of this study was to provide the basic information for improving collaborating care of Korean traditional medicine and western medicine by surveying utilization and attitude on it among cerebral apoplexy(CA) patients hospitalized at a general hospital with both the western and Korean traditional medical department in Busan metropolitan city, Korea. The survey was conducted on 170 patients, 80 from Korean traditional medical department, and 90 from western medical department. The major results of this study were as below: First, CA patient's medical utilization patterns including selecting medical institution, term of treatment and type of medical institution at first-aid were significantly variated by their socio-demographic characteristics such as religion and job. Second, the perceptions of collaborating care, such as effectiveness and reduction of treatment period, were better at respondents who were hospitalized at oriental medical department and had been experienced with collaborating care. Third, the major contents of collaborating care which utilized by respondents in side of western medicine were physical therapy, x-ray, pathologic diagnosis, and medication, and in side of Korean traditional medicine were acupuncture, herbal medication, moxa cautery, cupping a boil therapy. Fourth, overall satisfaction on collaborating care was good(3.5 of 5.0) and was significantly variated by age and religion. Fifth, respondents perceived that collaborating care was most helpful for rehabilitation and the major problem of current duplicate medical system was increasement of medical expenditures, and the major obstacle of collaborating care was prejudice against each other medicine. The results of this study imply that effective marketing for collaborative care suitable for age and religion of customers and patient satisfaction strategy is needed to activate collaborating care.

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