Public health centers in Korea play an important role at the community level in encouraging residents to participate in cancer screening, usually by sending reminders in the mail and by making phone calls. However, there have not been any studies on the effectiveness of these interventions by public health centers in Korea. The purpose of this study was to evaluate this question. The study was limited to male subjects aged 50-59 years living in one district of Daegu, Korea. A total of 923 subjects were selected for the study among the target population for gastric and colorectal cancer screening as part of the National Cancer Screening Program in 2012. The subjects were randomly assigned to one of four groups: control, postal intervention, telephone intervention, and telephone and postal intervention. Three months after the interventions, the results were confirmed by the National Health Insurance Corporation. Logistic regression analyses were performed to find differences in participation rates in cancer screening for each group. Men who received telephone and postal intervention were most likely (40.5%) to undergo gastric cancer screening, in comparison to the men who received telephone intervention only (31.7%), postal intervention only (22.2%) and those in the control group (17.9%). Also, men who received telephone and postal intervention were most likely (27.8%) to participate in colorectal cancer screening, followed by the men who received telephone intervention only (24.3%), postal intervention only (16.5%), and men in the control group (13.5%). Combined telephone and postal intervention and telephone only intervention as well produced significantly increased rates of participation in cancer screening in comparison to the control group. There was no significant difference, however, between the postal intervention only and control groups for either colorectal or gastric cancer screening.
This study was carried out to examine the effects of nutrition education program developed by Jincheon Public Health Center on preschool children's nutrition knowledge and dietary habits and the parents' dietary attitudes. The subjects of this study were five- and six-year-old children as well as their parents. A 5-week nutrition education program was implemented to 104 children in five day care centers, and 107 children in three day care centers were investigated as a control group. Activity tools designed for each lesson such as puzzles, food magnets, story, songs, Pierrot costume, and balls were used. Nutrition knowledge and dietary habits of children and dietary attitudes of parents were evaluated before and after education. Mean nutrition knowledge score in the education group was significantly higher than that in the control group after education (p < 0.001). Mean dietary habit score of three questions (three meals a day, eating at fixed time, eating breakfast) in the education group was also significantly higher than that in the control group after education (p < 0.01). In addition, parents in the education group showed significantly higher mean dietary attitude score than those in the control group even though they did not receive education (p < 0.001). Our nutrition education program was found to be effective in improving nutrition knowledge and dietary habits in preschool children as well as improving dietary attitudes in their parents.
본 논문은 고령화 사회의 공공도서관에서 제공되는 노인대상 프로그램 개발의 기초자료 수집을 위해 서울시 소재 노인종합복지관과 공공도서관 홈페이지의 노인교육 프로그램을 비교하였다. 프로그램 내용을 건강, 문해/교양, 정보화교육, 죽음준비교육, 취미, 취업/자원봉사의 6가지 세부주제로 구분하여 각 기관별 해당 주제를 조사하였다. 두 기관에서 가장 많은 교육프로그램이 제공된 분야는 취미분야였으며, 노인종합복지관에서는 공공도서관보다 3배이상의 프로그램을 운영하고 있었다. 공공도서관의 경우, 취미(34.1%), 기타, 문해/교양(24.4%), 건강과 정보화교육(22.0%), 취업/자원봉사(17.1%), 죽음준비(7.3%)순으로 프로그램이 제공되었으며, 문제점에 따른 제언을 제시하였다. 그리고 죽음준비교육 프로그램의 일환으로 '행복지도 만들기'를 14주차에 걸쳐서 시행할 수 있도록 프로그램을 예시하였다.
Purpose: The study was done to describe competency level in communication and professional competence of Public Health Nurses and to test effect of competency level in communication on professional competence of Public Health Nurses (PHNs). Methods: A correlational research design was used and 153 PHNs working at nine Public Health Centers (PHCs) in four Metropolitan cities agreed to participate. Participants completed a structured questionnaire measuring the study variables with socio-demographic characteristics. Data were analyzed using descriptive statistics and multiple regression analysis with the PAWS Statistics 18. Results: The mean of competency level for communication and professional competence were above average for the test instruments utilized (90.3 and 68.4 respectively). The level of communication competency differed by age and location of PHCs, and professional competence differed by location of the PHCs. The level of communication competency was the most important affecting professional competence and explained 32.9% of the professional competence. Conclusion: Nurses with better communication competency had more professional competence. In the future, repeated study is needed, and communication program is needed to develop and train PHNs to improve their professional competence.
Purpose: The purpose of this study was to gain an in-depth understanding of the characteristics and competencies of practice experienced by public health center nurses(PHNs) during the early response phase of the coronavirus disease 2019(COVID-19) pandemic. Methods: PHNs were recruited from public health centers(PHC) in ten cities in Korea, using purposive sampling. They participated in semi-structured, in-depth interviews from December 21, 2020, to February 18, 2021. The interviews were transcribed verbatim and analyzed using qualitative content analysis. Results: Three themes and nine categories were drawn from the findings. The three themes that emerged from the data analysis were as follows: 'Handling expanding work scope and overwhelming workload beyond prepared competencies, willing to go anywhere.', 'Performing tasks of cooperation and communication required in the disaster management administrative system.', 'Demonstrated proficiency in clinical nursing practices, but recognized the need for further development of leadership and administrative capabilities.' Conclusions: The experiences of the subjects' have implications for the development of content for community nursing education that cultivates basic competencies to respond to real pandemic situations during undergraduate education. It is proposed that it would be necessary to establish a support system for developing specialized competencies in public health nursing.
To compare differences of LOS between the group of inpatients via referral centers(the referral group) and the group of inpatients via different routes (the general group) and analyze factors which determine the difference. The 9,484 cases of newly inpatients of Mar., Jun., Sep., Dec. of year 2003 were used for the data. We calculate the Case-mix index of length of stay($CMI_{LOS}$) to compare LOS adjusted with the disease as the ratio of a patient' LOS to all patients' average LOS by 21 classification diagnosis group. We conducted t-test to compare differences of $CMI_{LOS}$ between two groups and multiple regression to analyze factors determining the difference. $CMI_{LOS}$ was 0.94 in the referral group, which was smaller than 1.01 in the general group. LOS was 7.5days in the referral group, which was 0.6day shorter than that in the general group. Multiple regression also showed that $CMI_{LOS}$ was smaller in the referral group than in the general group after controlling patients' general characteristics, diagnostic information variables. The referral centers can be said to playa role in decreasing LOS. We suggest that variety of depth studies on referral centers should be continued at the strategic level of hospital management using additional medical informations.
The purpose of this study is to offer information related to recommended dietary allowances for young children and food guidelines for preschool children in Sweden. Sweden, located in Europe, is the most developed country for young child care system. Swedish nutrition policy background, Swedish recommended dietary allowances for young children, and food guidelines of early childhood education center in Sweden were used. The number of Swedish child care centers increased from 70,000 in 1970 to 700,000 in 2000. The Swedish Institute of Public Health promoted children's indoor and outdoor activity. The aim of the Swedish public health contains children's safety, good food habits, and eating food safely. Swedish Food Administration made recommended dietary allowance and food guidelines for children care centers. The aim of food guidelines was to increase energy, calcium, iron, and dietary fiber intake. Swedish RDA contains minimum and maximum intake as well as mean intake for macro and micro nutrients. The fat intake ratio of energy is increased for younger children. For preschool children, the food guideline is determined by dietary allowances for breakfast, lunch, and snack respectively. Food guideline contains meal time schedule, menu for each meal using food model, amount of food for age group, and recommended dietary allowance for each meal. It is recommended for Korean early childhood education center: 1) Korean RDA for young children should be made range of intake, minimum and maximum intake. 2) Food guideline should be make for Korean child care center. 3) Korean child care centers should offer an afternoon snack twice for children who return home late. 4) Nutrition education program for preschool teachers should be developed for children's good eating habits and health promotion.
Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.
Purpose: The purpose of this study was to analyze the role and tasks of nurses who were working for the elderly in the visiting health services at the public health centers. Methods: Literature reviews, two rounds of meetings with 5 experts and a two-round Delphi technique with 15 experts were performed in this study. Results: The nurses' role and job analysis revealed 5 roles, 16 duties and, 71 tasks. The nurses' roles, including discovery and registration of households/groups in visiting health service in the community, case manager, administrative management, program planning, operation and evaluation, and development of job competency. Sixteen duties included client registration and management, need assessment and plan establishment, education, consultation and support, seasonal health care, prevention and monitoring of infectious diseases, basic nursing care, chronic disease management, linkage and utilization of resources, team cooperation and coordination, home environment management, monitoring and support for intervention outcomes, evaluation, administrative management, program planning, operation and evaluation, development of professional competency and, adoption of fourth industrial revolution technology. Conclusions: Based on the results, the government should provide sufficient nursing personnel to provide universal preventive health services for the elderly and a job training program to perform these roles well.
A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.
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