• 한국농촌간호학회지
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• 제4권1호
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• pp.41-50
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• 2009

By the rural area health care special law in 1980, Primary health care posts were established in rural areas as fundamental elements of the national health system. Nurses have been deployed to the posts after taking an education course mandated by the special law. However, health care posts have confronted environmental changes over the past 30 years such as an aging and decreasing rural population and advanced traffic systems, which make it necessary to reshape their form and role. Therefore, some guidelines are suggested for future role enlargement of health care posts by analyzing their current management and duties. The guidelines are as follows: 1) enlarging the portion of prevention and management of chronic degenerative diseases, 2) development and practice of diverse health promotion programs, 3) extension of primary health care for the increasing older population, 4) development of health programs for married immigrants, 5) practice of timely maternal child health programs, 6) development of adequate health care posts for low-income people in rapidly urbanizing rural areas and in poor areas in big cities, and 7) revision of laws and institutional arrangements for the role enlargement of health care posts to match social changes and customer needs.

• 한국간호교육학회지
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• 제5권1호
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• pp.97-105
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• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

• 대한간호학회지
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• 제42권7호
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• pp.965-973
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• 2012

Purpose: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. Methods: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. Results: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. Conclusion: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

• 여성건강간호학회지
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• 제14권4호
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• pp.278-289
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• 2008

Purpose: This study was a survey to provide basic data about nursing interventions for improving the quality of life among family caregivers for the elderly by examining their care burden, burnout, and quality of life, and by confirming the correlation between each of them. Method: The subjects were 215 people in Seoul and Gyeonggi Province who understood the purpose of this study and participated voluntarily from April 1 to June 4, 2007. Data was analyzed by the SAS program. Result: 1. Concerning primary caregivers of the elderly, it was found that their care burden was slightly high, burnout was high and quality of life was good on the whole. 2. When it comes to the correlation among care burden, burnout, and quality of life among family caregivers, it was found that burnout increases in proportion to care burden, quality of life decreases as care burden increases, and bigger burnout leads to a lower quality of life. Conclusion: The quality of life among primary caregivers should be improved by reducing their care burden and burnout. Thereby, a priority might be considered for admission to nearby, comfortable nursing homes or failing that, home visiting services, rather than family support in the home.

• 한국농촌간호학회지
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• 제14권1호
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• pp.17-22
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• 2019

Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.

• 재활간호학회지
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• 제2권2호
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• pp.243-256
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• 1999

The purpose of this study was to identify the degree of self-care activities of stroke patients, the family burden, and the educational needs of primary caregivers. A descriptive survey research was conducted in 97 stroke patients and their respective primary caregivers. Data were collected by the interviews using a structured questionnare from July 26th to August 5th, 1999. NIH stroke status was $12.15{\pm}8.40$, the degree of self-care activities of stroke patients was $26.85{\pm}9.39$. The score of objective burden of primary caregivers was $31.24{\pm}4.81$ and subjective burden was $24.30{\pm}6.99$. The score of the educational needs was $89.78{\pm}9.99$. We present several imformations about clients from these scores as follows: The patients were convalescent and their depentant level of self- care was middle range; The objective burden was higher than the subjective burden; And the educational needs of family caregivers were very high. The Elain Mattis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the educational needs of primary caregivers of stroke patients. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to care stroke survivors at home.

• 한국농촌간호학회지
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• 제4권1호
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• pp.31-40
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• 2009

Purpose: This research was done do identify and analyze the beginnings of the community health practitioner system in the Republic of Korea (ROK) around 1980. Method: Primary sources were collected and analyzed, mainly newspapers around 1980, the act for health service for rural areas, and other relative publications. Results: The government of the ROK was trying to solve the problem of doctorless villages and regarded the introduction of primary health care (PHC) services using registered nurses (RNs) to be an economic solution to this problem. The Korean Nurses' Association presented 'a plan for community health service' to the government party and medical association in 1976. In this plan, RNs would provide primary care at the sub-county (myun) level, and hospital would provide secondary care. The Korean Public Health Development Research Center was awarded the project 'RNs and nurse aids as CHP for primary care service and their training'. In 1977, 25 RNs began to work as PHC in 3 areas, and interim findings showed that RNs were very capable of doing PHC. The Ministry of Health and Welfare announced long term plans for health and welfare administration including a tertiary health care delivery system. RNs after training were posted to rural areas with no medical services to do medical treatment for mild cases. The Act for health services for rural areas was enacted on December 31, 1980. Enforcement Ordinance and Enforcement Regulations were enacted in 1981. In 1981, 257 CHP were selected, trained, and deployed. In 1983, the president of the ROK announced continuation of the CHP system for residents of medically vulnerable areas. The number of CHP increased from 257 in 1981 to 2038 in 1989.

• 재활간호학회지
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• 제2권2호
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• pp.206-214
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• 1999

The effect s of social support on post-stroke depression were investigated. Social support was classified into three categories : primary caregiver's, significant other's, and professional support. And primary caregiver's and significant other's support were divided into their relation, living state (which means they living together or not), frequency which they met at, and perceived satisfaction about the support, respectively. Professional support was divided into number of professionals who take care of, frequency they met at, and perceived satisfaction. The subjects were 254 stroke patients who had been discharged and were taken follow-up care at the out patient department. The depression was measured using CES-D. Out of the primary caregiver's support, only relation and perceived satisfaction were identified to affect the post-stroke depression. The patients who primarily their spouse takes care of were less depressed than those who their adult children take care of. None of the significant other's support affects the post-stroke depression. Only perceived satisfaction of the professional support was found to affect the post-stroke depression. So it was found that the quality, not the amount, of care was important to post-stroke depression. These results also support the claim that the facilities and teaching programs for primary caregivers are necessary.

• 한국농촌간호학회지
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• 제12권2호
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• pp.45-54
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• 2017

Purpose: The purpose of this study was to provide a survey of patients with dementia registered and managed by primary health care posts. Method: Computation of 2016 dementia data registered in Health Care Center programs of 14 municipalities in ChoongNam province was analyzed. Data collection was done based on a pretest for dementia prevention and general management of registered dementia patients. Results: Results showed; Screening tests for dementia, 40% of population 60 or over, average number of cases, 174, average number of dementia registrants, 3.1, programs for prevention, approximately 70% special policy measures and 28% cognitive rehabilitation programs, counseling and education operating well overall, average number of dementia registrants/clinic 11.8, with women accounting for 70%, elders with less than 3 years of education, 75%, residence type cohabitation by married couples, 41%, and elders with Alzheimer type dementia, 64%. Conclusion: During early detection of dementia and follow-up examinations, high-risk groups (women, elders) should receive a dementia examination. In management of dementia there is a need to develop various programs including physical, economic, and emotional support not only for patients, but also for families. Health care managers also need systematic education to give them expert knowledge of dementia and management of dementia.

• 한국농촌간호학회지
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• 제18권2호
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• pp.92-98
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• 2023

Purpose: This study describes a case report of wound care performed by a community health practitioner for a rural older adult with diabetic ulcers. Methods: Data were collected from a rural older adult who had a diabetic lower extremity ulcer, and wound dressing was applied over 20 weeks after the skin graft operation. Results: The patient visited a primary healthcare post for regular ulcer care, and a community health practitioner applied appropriate wound dressings and managed the patient's diabetic condition. Conclusion: In rural areas, where healthcare resources are scarce compared with urban areas, rural nurses, such as community health practitioners, are primarily required to manage rural residents' health problems. Advanced nursing practices such as complicated wound care should also be appropriately provided to patients by enhancing rural nurses' competencies in the changing health care environment.