• 대한치과의사협회지
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• 제48권3호
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• pp.174-176
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• 2010

Compared to the specialist program, the advanced general dentistry program (AGD) is designed to guarantee that dentists dealing with primary care services possess overall dental care proficiency and contribute to offering better care to customers. This program is also believed to help resolve the imbalance among the number of candidates for specialization, which came to the authorities' attention throughout the implementation of the dental specialist program. KDA will continue to implement AGD while pushing for the establishment of the program by complementing it with adjustment measures and regulations provided the dental community agrees to such actions.

• 가정과삶의질연구
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• 제26권1호
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• pp.31-49
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• 2008

This study has been performed to explore verbal and behavioral expression of sexual desires among male elderly residents who have been living in long tenn care facilities. There are three topics covered in this study; first, in what situations and how seriously do care workers encounter expression of sexual desires of the elderly residents? Second, what kind of negative consequences do they believe those sexual behaviors will lead to? Third, how can we implement defensive measures against the sexual behaviors? In this study, twenty three care workers working full time in five retirement and care facilities were asked about their experience and perception of the above study agendas, and answers of the qualitative interview were drawn as follow; first, the elderly residents apparently show a variety of sexual harassment and provoking behaviors such as sticking to specific women, physically touching and attacking, and induce obscenely activities against female residents, care workers, and volunteer visitors. Second, their sexual behaviors are often influenced by their isolated and abandoned emotionality as well as living situation in rural areas. Third, their sexual behaviors often critically affect care work plan and facility managements by severely discouraging female care givers and community supporters. Therefore in this study, suggestions and defensive measures were made as follows: first, education and counselling programs toward female workers and volunteers need to be developed, and the programs should cover psychological and behavioral mechanism of sexuality in later life. Second, self control plans need to be empowered toward the elderly residents; in the plans, the elderly residents shall be encouraged to evaluate primary cause and proper solutions of sexual behaviors of their peering residents. Third, combination of healthy housing and care facilities for frail elderly need to be integrated in a neighboring location, so that when residents and workers encounter extreme episodes of sexuality of healthy residents in a housing facility, the problematic sexual residents are partially transferred into a neighboring care facility and thereafter other residents and cafe givers are relieved from stressful contacts with the extremely sexual residents.

• Journal of Hospice and Palliative Care
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• 제23권3호
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• pp.114-125
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• 2020

Purpose: This descriptive study investigated the effects of nurses' knowledge of withdrawal of life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants' scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65±0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion: This study showed that perceptions of hospice were an important factor influencing nurses' attitudes toward withdrawal of life-sustaining treatment. Therefore, it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

• 농촌의학ㆍ지역보건
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• 제14권1호
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• pp.16-29
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• 1989

The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

• 보건행정학회지
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• 제26권1호
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• pp.4-11
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• 2016

Background: Hospital admissions for ambulatory care sensitive conditions (ACSCs), which are widely used as an indicator of poor access to primary care, can be used as an efficiency indicator of healthcare use in countries providing good access to health care. Korea, which has a national health insurance (NHI) system and a good supply of health care resources, is one such country. To quantify admission rates of ACSC and identify characteristics influencing variation in Korean health care institutions. Methods: By using NHI claims data, we computed the mean ACSC admission rate for all institutions with ACSC admissions. Results: The average ACSC admission rate for 4,461 institutions was 1.45%. Hospitals and clinics with inpatient beds showed larger variations in the ACSC admission rate (0%-87.9% and 0%-99.6%, respectively) and a higher coefficient of variation (7.96 and 2.29) than general/tertiary care hospitals (0%-19.1%, 0.85). The regression analysis results indicate that the ACSC admission rate was significantly higher for hospitals than for clinics (${\beta}=0.986$, p<0.05), and for private corporate institutions than public institutions (${\beta}=0.271$, p<0.05). Conclusion: Substantial variations in ACSC admission rates could suggest the potential problem of inefficient use of healthcare resources. Since hospitals and private corporate institutions tend to increase ACSC admission rates, future health policy should focus on these types of institutions.

• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.332-340
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• 2022

Background: Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period. Methods: We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation. Results: Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292). Conclusion: Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.

• 보건행정학회지
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• 제27권1호
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• pp.88-94
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• 2017

The aim of this study was to investigate the current and trend of healthcare status of South Korea compared to Organization for Economic Cooperation and Development (OECD) countries. We used the position value for relative comparison (PARC) method for measuring the healthcare status of South Korea by five parts of healthcare policy (demand, supply, accessibility, quality, and cost). Additionally, we conducted Mann-Kendall test for analyzing the trend of PARC from 2000 to the present. Demand, supply, accessibility, and quality of healthcare of Korea were located upon the average of OECD countries, and showed an increasing trend from 2000 to the present. However, primary care and screening for cervical cancer were placed at a lower level compared the OECD average. In conclusion, the current state of healthcare in Korea seems to be generally beyond the average among OECD countries. However, some parts, including primary care, need to be improved.

• 한국보건간호학회지
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• 제21권2호
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• pp.158-170
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• 2007

Purpose: To measure the sexual life and life satisfaction of the elderly in a rural sea village. Method: Data were collected from November 20, 2006 to January 10, 2007 through a personal. interview with 262 elderly registered at one primary health care post in Gyeongsangnam do using a questionnaire. Results: The mean life satisfaction score was each 20.9. Of the scores related to life satisfaction according to general characteristics, there were statistically significant differences in age(p=.003, p=.026), education level(p=.036), presence of spouse(p=.016), residence(p=.039), economic status(p=.000, p=.013), monthly spending(p=.000, p=.000), economic supporter(p=.001, p=.022), and perceived health condition(p=.005, p=.009). Of the scores related to life satisfaction according to sexual life characteristics, there were statistically significant differences in importance of sexual life(p=.000, p=.047), performance of sexual life(p=.018), frequency of sexual life(p=.006), satisfaction of sexual life(p=.002, p=.005), and sexual life of youth(p=.022, p=.000). Conclusion: We should investigate influencing factors on sexual life and life satisfaction of the elderly and include knowledge about sexual life of the elderly in health promotion programs for the elderly.

• 기본간호학회지
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• 제24권2호
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• pp.146-156
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• 2017

Purpose: The aim of this study was to identify Russian inpatients' expectation and satisfaction with nursing service, and further, to analyze the relationship between these variables. Methods: A structured questionnaire was used to survey for 81 Russian inpatients. The survey was conducted from January to June, 2014. Results: Empathy and assurance significantly influenced nursing service expectation and satisfaction. Nursing service expectation was statistically significant for the number of visit to Korea, and nursing service satisfaction was statistically significant for gender, monthly income and primary care giver during hospitalization. Revisit intention was significantly different according to religion, medical department and primary care giver during hospitalization. There were positive correlations between nursing service expectation and satisfaction, and between nursing service satisfaction and intention to revisit the hospital. Conclusion: The results of this study show that the level satisfaction with nursing service influences Russian inpatients' intention continue using the hospital. Therefore, in order to increase the intention to revisit the hospital Korea hospital employees, especially nurses, need to develop nursing service strategies according to general characteristics, culture and nationality of foreign patients.

• 한국농촌간호학회지
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• 제15권1호
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• pp.30-40
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• 2020

Purpose: This study was done to describe a community health practitioner's nursing case management for a terminal cancer patient registered in the public health post. Methods: For this purpose, data were collected through the patient and family through home visits, health clinic offices, and phone calls. The nursing process was carried out from August to November 2019. Results: The patient suffered the most from anorexia and lack of energy. Also he expressed psychologically uncertainty about disease and death anxiety caused by long-term treatment. In order to reduce the death anxiety, Community Health Practitioner (CHP) asked him to express his life stories and listened to him. CHP provided information of appropriate medications and alternative foods for symptoms such as gastrointestinal disorders and anorexia to the patient and family. Observing the situation of the patient and family, CHP guided the patient and family to prepare for death and has confirmed to them that the process was not with the patient alone. Conclusion: CHP's this experience has shown the possibility for CHP to help the terminal cancer patient and family to prepare peaceful death in their communities.