• Korean Journal of Health Education and Promotion
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• v.7 no.2
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• pp.78-88
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• 1990

The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.398-411
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• 2001

The separation system of pharmacy and clinic has begun on the purpose of preventing drug misuse and abuse since July 1st of 2000. The system revealed some conflicts between doctors. pharmacists and consumers. Consequently pharmaceutical law and related policies undergone some change. Now in an early period of the implementation of the system, the necessity to examine relevance of those policies and law enforcement to medical doctors' prescriptions pattern evolves. This study tries to verify the pattern through a field study. For the purpose, 930 prescriptions collected in May of 2001, from a pharmacy located in Gangnam-gu in Seoul, were analysed. The prescriptions were issued from several clinics: 459 prescriptions from otorhinolaryngological clinic(ENT), 177 from internal medicine clinic(IM), 130 from ophthalmic clinic(Opt), 52 from obstetric and gynecologic clinic(OB & GY), and 112 from miscellaneous clinics. ENT, IM, Opt. OB & GY are situated in a clinic building of 40m distance. The general findings are following: 1) $88.8\%$ of the total patients came from 5clinics in nearby single clinic building. 2) Average prescribing days were 6.2 days and the average number of used drugs were 4.0 drugs, i.e. 2-4 times of WHO criteria 1-2 drugs. 3) Use of antibiotics in the oral administration drugs rated $71.8\%(WHO: \;22.7\%)$ 4) Use of injection rated $31.3\%(WHO:\;17.2\%)$ 5) $96.2\%$ of the patients use multiple antibiotics in the injection and oral administration together. 6) The patients had multiple disease : ENT patients 1.7 disease and 1M patients has 2.7 disease in average and several regular prescribing types evolved particularly in the ENT prescription. With this result we found that drugs. especially antibiotics are still abused a lot, and there were significant differences in the number of used drugs and prescrbing days between the clinics. It implies somes differences of the preparation work and time for pharmacists. And preparation can be done in advance by pharmacists' own efforts through noticing regular prescribing types. The study suggests the followings: 1) Patient counseling should be done to minimize the incidence of adverse events. 2) The enforcement of the standardized differential preparation price system should be reconsidered. 3) Preparation of typical regularly appeared prescription in advance. which is regarded as 'a prearranged work between doctors and pharmacists' and has been prohibited should be reconsidered. 4) Drug utilization review program should be established to prevent drugs abuse. especially antibiotics abuse.

• Journal of Korean Public Health Nursing
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• v.12 no.1
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• pp.103-115
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• 1998

As the studies that smoking can be a major cause to various diseases have been made, many following researches on the outcome of stop-smoking education were in progress. Even though researches based on the knowledge about smoking and status about the teenagers were prevalent, the research based on the outcomes in long time basis were not in progress. Therefore, I tracked the people who went through 5-Day Stop-Smoking School that has taught through complexed structure of behavioral, intellectual, and psychological education. I made researches on the average of success and the hardest point during their efforts to stop just to show the necessity of going through re-education. The objectives of this study were the ones who have completed the education on the years 1990, 1991. 47 were selected from 364 people that completed the training, and who were able to be contacted on the phone line. This study was conducted from 27 Oct. to 7 Nov. 1997 through verbal interviews based on the questionnaire. The questionnaire used here was made by myself, assisted by my professor. Analysis was made through unstructured open questions. The data was analyzed using SPSS program. The major results were as follows ; 1) General characteristics of the objectives are $97.0\%$ were male, $17\%$ ages below 40s, $34\%$ in the age group of 40s, and $48.9\%$ over 50s. Religiously christian 340/0, buddhist $19.1\%$, no religion or any other reason $46.8\%$. Status married $93.6\%$, unmarried $6.4\%$. There is someone smoking in the family $36.2\%$, no one smokes $63.8\%$. Reputation salary men $55.3\%$, personal business $27.7\%$. 2) The average of success is $42.6\%(20/47)$, the failure is $57.4\%$. 3) The results from the study 'When was the hardest point in the process of stop smoking' : For the successors the first week $33.3\%$, after the first week $66.7\%$. For the failures the first week $55\%$, after first week $45\%$(Statistics not precisely done), the most effective element that helped through the hardest point was the family $40\%$, personal determination $30\%$. 4) The necessity of re-education : Successors needed $55\%$, not needed $45\%$. Failures needed $48.1\%$, not needed $51.9\%$(Statistics not precisely done). The perfect time for reeducation : Successors in 6 months $50\%$, irregular time basis $50\%$. Failures in six months $36.4\%$, after six months $27.3\%$, irregular time basis $36.4\%$(Statistics not precisely done). Synthesizing the result of the study can't generalize the long-term effect of the stop-smoking due to the number of the objectives,. but recognize the fact that 47.6 have experienced success, and also the self-determination and the support from the family are desirable. Seeing the fact that both are great motivation to stop smoking. Since the first week is necessary. The necessity of re-education is rather high, so this education should be planned to be done repeatedly in a long term along with close observation, instead of short education.

• Journal of Korean Public Health Nursing
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• v.3 no.1
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• pp.101-119
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• 1989

In the present, since a five-year plan for economic development which was started in the early 60's has been successfully promoted for a quarter century, with consolidation in a department of social welfare in our country the participation. in economic society for women is more required than any other times. As a professional occupation for women is incereaing through a high-standard specialization, I think the upbringing for productive woman expert who has a strong motive of accomplishment as a developed person as well as a technical and skilful capacity which can be contributed to the growth of organization is very important. So in this study, I am evaluating the technical disposition of character of professional nurses working with hospital and also trying to supply the basic data being served to th extension of a skillful ability as a nurse, understanding the important factor related to it. The research method applied here is that we used 527 of formed questionnaires which were distributed to 7 University and General Hospitals, somewhat large in a scale, located in Seoul as an analytical material. It was performed between October 11, 1988 and October 18, 1988. An implement which was invented by Cho Moo-Sung is used after being amended and supplemented, which can measure the disposition of professional character. The formation of questionnaires of the disposition of character is 26 totally, 10 for Open-disposition, 11 for Active-disposition, 5 for wise-disposition, and it was measured. 'Ye', or 'No' through an one-half-standard and the environment of hospital organization is composed 12 questions from one point of 'Very Good' to 5 points of 'Very Bad.' Collected materials were analysed through an electronic calculation into the average value, the standard deflection, percentage, person correlative number, $X^2-test, m$ stepwise multiple regression. Summarizing the result from this research is as follows; 1. The average age of the subjective person of this investigation is 28.6 and the average career as a nurse is 6.0 years. 2. The Open-disposition that technical nurses showed is mostly half and half. 3. The Active-disposition of professional nurses was discovered affirmative largely and what they said in their questionnaires describes that they are very active answering $88.2\%$ for the disposition of self-control, $87.3\%$ for the people who think the training more seriously. 4. It was found out that the wise·disposition of technical nurse showed $90.7\%$ of 'Yes' about a new alternative of inquisitive question and we can see a progressive and profound aspect here. 5. As technical character of nurses, mutual relations between Active-disposition, Active-disposition, and wise­disposition were very profitably revealed as 0.42 in justice relations and also suggested that relations between Open-disposition, Active-disposition, and wise-disposition are 0.27 and 0.20 respectively. 6. What nurses recognize about the environment of hospital organization is reasonably acceptable while they feel very bad about rewards and punishments showing average 3.1 comparing to average 2.2 about time­control each other. Considering the prosperity of Active-disposition upon the result what I mentioned above, th possibility which is contributed to the productive improvement of hospital organization is very great and I think it can be more developed as a professional woman who has a strong motive of accomplishment, in advance.

• Journal of Korean Public Health Nursing
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• v.10 no.1
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• pp.58-79
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• 1996

재미 한인들의 급격한 증가와 더불어 미국 간호학의 한인들에 대한 문화적 지식의 유입을 필요로 하게 하였다. 더구나 기존 연구들은 한인들이 질병을 비효율적이며 부적절하게 관리하는 것으로 보고하고 있어 이에 대한 연구의 필요성이 더욱 증가하였다. 기존 연구에 의하면 초기 이민 경험은 이민자들의 건강과 질병 관리에 크게 영향을 미치는 것으로 나타났다. 이 연구에서는 비평적 문헌 고찰을 통하여 초기 이민 경험이 재미 한인들의 질병관리에 어떻게 영향을 미치는지에 관하여 살펴보고 이에 근거하여 재미 한인들을 위한 적절한 간호의 방향을 제시하고자 했다. 의학도서 목록 전산망과 기타 문헌 자료를 이용하여 1966년부터 1995년까지의 의학, 보건학, 생물학, 심리학, 사회학 문헌들을 살펴보았다. 체계적인 문헌 고찰을 위하여 4개의 세부적인 주제 아래 문헌들을 구분하여 고찰하였다 첫째. 일반적인 이민자들의 초기 이민경험, 건강, 질병 관리가 고찰되었고. 둘째로 재미 한인들의 초기 이민 경험이 고찰되어졌으며, 셋째로, 재미 한인들의 건강. 질병관리가 고찰되어졌고, 마지막으로 이들을 위한 간호의 방향을 제시해 줄 기존의 간호 모델들이 고찰되어졌다. 문헌 고찰 결과, 재미 한인들의 부적절한 질병 관리는 그들의 초기 이민 경험들과 관련되는 것으로 나타났다 첫째 문화적으로 결정되어진 신념이나 태도들이 재미 한인들의 적절한 질병 관리를 방해하는 것으로 나타났다. 둘째, 재미 한인들도 본국인들과 마찬가지로 질병관리를 위해 현대의학. 한방, 무속, 민간요법을 사용하는 것으로 나타났는데. 한방의 사용이나 이러한 치료법들의 흔용은 한인들의 적절한 질병 관리를 방해하는 것으로 나타났다. 셋째, 문화적 차이, 언어장벽, 그리고 비언어적 의사소통의 차이점에서 오는 오해들이 재미 한인들의 질병 관리를 부적절하게 만드는 것으로 나타났다. 넷째, 이민생활에서 오는 여러 어려움들 또한 재미 한인들의 질병관리를 어렵게 만드는 것으로 나타났으며, 다섯째. 사회적 지지의 부족 역시 재미 한인들의 적절한 질병관리를 힘들게 하는 것으로 나타났다. 마지막으로 적절한 간호 모델의 부재가 이들을 위한 적절한 간호의 제공을 어렵게 하고 있는 것으로 밝혀졌다. 이러한 결과에 근거를 두고 초기 이민 적응기에 있는 재미 한인들에게 적절한 간호를 제공하기 위한 몇 가지 제안들이 제시되었다. 첫째, 이민자들에게 적절한 간호가 제공되기 위해서도 문화적 배경을 고려해야 하겠다. 문화적으로 적절한 간호를 위해서 간호 제공자들은 자신들의 문화와 다른 간호 대상자의 문화도 존중해 주어야 하며, 문화적으로 결정되어진 건강 신념들과 질병 관리 행태도 생명을 위협하지 않는 한 존중해 주어야 할 것이다. 또한 간호제공자들은 자문화 중심적인 사고방식에서 벗어나야 하며, 간호 대상자들의 상황을 총괄적으로 이해하여야 하고 이민자들의 어려움에 대해 공감을 가지고 간호를 제공하여야 하겠다. 둘째, 간호 제공자들은 한방에 관한 지식을 가지고 한 의학 혼용으로 인한 위험으로부터 간호 대상자를 보호하여야 할 것이다. 셋째, 문화적 차이나 자민족 중심적 사고방식으로 인한 오해를 막기 위하여 간호 제공자들은 간호 대상자와 자주 상호 교류함으로써 배우는 자세로 간호 대상자를 대하여야 할 것이며, 자신의 자민족 중심적인 사고방식을 인지하고 언어적, 비언어적 의사소통의 문화 집단별 차이를 앎으로써 오해의 소지를 줄여야 할 것이다. 넷째, 적절한 간호의 제공을 위하여 의사소통을 위해 대화만을 직접 번역해 주는 통역자와는 달리 문화적 배경까지도 이해하고 해석해 주는 문화적 통역자의 도움을 밟아야 할 것이다. 다섯째, 한국문화는 가족 중심적 문화이므로 간호 대상자의 혈연관계를 이해하고 그에게 크게 영향을 주는 가족원을 간호 중재에 참여시킴으로써 치료 효과를 높여야 할 것이다. 마지막으로 효과적인 간호를 위하여 재미 한인을 위한 적절한 간호 모델을 개발함으로써 체계적인 간호의 방향을 제시할 수 있어야 할 것이다.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.963-976
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• 1999

This study was undertaken to investigate the general characteristics of students, which include the degree of satisfaction, motives of admission, the recognition of advantages and disadvantages, opinion of students on self-directed learning, and planning and anticipatory effects after graduation. Data was collected through a questionnaire survey over a period of four months, from May 1997 to August 1997. The subjects used for this study consisted of 322 RN students sampled from six RN-to-BSN programs in Korea using the census sampling method. Statistical methods employed for this study included discriptive statistics, M ANOVA, and F-test. The results of the study are as follows 1. The RN students' motives of admission to RN-to-BSN programs were ‘for personal advancement’, ‘to earn a BSN degree’, and ‘for professional development’ in this order. 2. The RN students' responses to the advantages of RN-to-BSN programs were ‘acquisition of new knowledge and a BSN degree’ and ‘to gain professional thinking and a broader view’, while as the disadvantages of RN-to-BSN programs were ‘geographical isolation of institutions’, ‘limitation of information’, and ‘underdeveloped school environments’ in this order. 3. The survey based on opinions toward self-directed learning showed that there was a need of detailed guidelines for self-directed learning. Most agreed that it was a very effective learning method for a RN student, and the self-directed learning method Increases motives for learning. 4. The students' anticipatory effect after graduation were ‘self-achievement’, ‘development of professional skills’, and ‘admission to post-graduate school or programs to study abroad’. 5. The students were very satisfied with the quality of faculty members, and satisfied with the quality of lectures and teaching. However, students were unsatisfied with rented lecture rooms, and very unsatisfied with self-directed learning methods. 6. School nurses showed higher statistical significances in the need for teaching material and anticipatory effect after graduation than other RN students working in hospitals and public health agencies. Also, school nurses, public health nurses, and industry nurses showed higher statistical significances in motives of admission than RN students working in hospitals. Further more, staff nurses, school nurses, and industry nurses showed higher levels of satisfaction toward a RN-to-BSN programs than nurses in higher positions, such as administrators or directors of nursing. 7 City residents were more satisfied with RN-to-BSN programs than rural residents. Otherwise, the rural residents had higher motives for admission, a bigger need for teaching materials, and recognition of the disadvantages of RN-to-BSN programs than city residents. Finally, RN students who earned below a monthly income of ￦1,000,000 showed higher motivation for admission than those who earned more than ￦1,000,000.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.176-189
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• 2002

The purpose of this study were to illustrate the various medication error types and causes and identified to related drugs to provide basic data for preventing nurses' medication error by analysing 73 cases of AJN 'medication Error' column(1993, Oct -2000, Nov). Nurses' types of medication error were classified into 7 types. The most frequent error types are wrong medication$(21.9\%)$ and the wrong dose$(21.9\%)$ together. The others are wrong $time(4.1\%)$, $omission(2.7\%)$, mechanical $error(2.7\%)$, incorrect IV $rate(1.4\%)$. wrong route $administration(1.4\%)$ in order. Nurses' causes of medication error were 9 kinds. The most frequent type is confusing between similar drug shape, color, size, name, injection devices and patient's $name(43.9\%)$ and the others are lack of knowledge about $drugs(26.8\%),\; slips(7.3\%),\; miscalculating\;dose(4.9\%)$, incorrect adjusts $devices(4.9\%)$, difficulty to read or illegible decimal $point(4.9\%),$ $abbreviation(2.4\%)$, fatigue with $overwork(2.4\%)$ and no communication with $patient(2.4\%)$ in order. Related drugs with medication error are as follows. - dose unit(IU. minims. mcg/min. mEq) : Heparin. insulin. synthetic calcitonin, some enzymes and hormones, vitamins, some antibiotics, tuberculin injection. MgSO4 injection. nitroglycerin - similar size, color and shape drug : $0.9\%$ N/S and acetic acid $0.25\%$ for irrigation. premixed 2mg lidocaine sol. and $0.9\%$ N/S, gentamycin 20mg/2mL for children and 80mg/2mL for adult, dextroamphetamine 5mg and 10mg capsule. sedatives chloral hydrate 250mg/5mL and 500mg/5mL - similar name :Aredia(pamidronate disodium) and Adriamycin(doxorubicin), Lamictal (lamotrigine) and Lamisil 250mg. Elderpryl and enalapril, cefotaxime and cefoxitin, carboplatin and cisplatin, sumatriptan and zolmitriptan, Celebrex and Celexa, Humulin and Humalog, Percodan and Percocet, Diabeta and Diabinese, Epivir and Retrovir, Xanax(alprazolam) and Zantac(ranitidine) - decimal point : low molecular weight warfarin, methotrexate - unfamiliar drug uses of familiar drug ; methotrexate. droperidol, imipramine, propranolol - number of drug name(misleading chemical name) : 6-thioguanine, 6-mercaptopurine, 5-fluorouracil - type of administration route : Oxycodone(OxyContin). - administration time : acarbose(Precose). - injection way (Z-track method): hydroxyzine - epidural cathether : LMWHs(enoxaparin, dalteparin), - ADD Vantage self contained delivery system : ceftriaxone(Rocephin)

• 재활복지
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• v.21 no.1
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• pp.47-70
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• 2017

The aim of this study was to explore the effects of the epidemiological factor (depression), the behavioral factor (activities of daily living), the predisposing factor (self-efficacy), reinforcing factors (family support, professional support), and enabling factor (resource availability, accessibility) on quality of life in home-dwelling disabled people in rural areas. The conceptual model for this study was established on the basis of the PRECEDE model which was developed by Green and Kreuter. Data were drawn from the "Preliminary Investigation for Community-centered rehabilitation" conducted by a public health center located in the O province in 2011 and 186 of 190 disabled people who participated in the survey were included in the final analysis. Data were analyzed using Direct effects on quality of life arose from latent variables depicting the epidemiological factor (depression)and reinforcing factor (family support, professional support), while indirect effects arose from the behavioral factor (activities of daily living), the predisposing factor (self-efficacy), and enabling support (resource availability, accessibility). This model explained 85.5% of the variance in quality of life among rural disabled individuals. These findings may have shed some light on the necessity of including strategies to reduce depression and to strengthen supports from family and healthcare professionals when performing rehabilitation programs to improve quality of life in home-dwelling disabled people in rural areas. Furthermore, it suggested that it would be useful to develop specific strategies and tactics which might increase self-efficacy and to expand linkages between public health centers and other professional institutions such as hospitals for community-centered rehabilitation services for individuals with disabilities.

• Asian Journal for Public Opinion Research
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• v.7 no.2
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• pp.94-112
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• 2019

Objective: The objective of this study was to compare the quality of life (QOL) of patients with end-stage renal disease (ESRD) between patients receiving hemodialysis (HD) and patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to compare personal characteristic factors relating to the quality of life in patients with ESRD. Method: This study used a descriptive research design. The sample was recruited using purposive sampling that included 76 ESRD patients receiving either HD or CAPD at a dialysis clinic in Phraphutthabat Hospital, Saraburi Province, Thailand. Data was collected using the Quality of Life Questionnaire for Chronic Kidney Disease ($KDQOL-SF^{TM}$) version 1.3. Independent t-test and ANOVA procedures were used to analyze study data. Results: The results revealed that the HD patients had a moderate level of QOL. The highest scoring dimension of QOL was the encouragement of staff at the dialysis unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=89.29$, SD =16.88) and cognitive function (${\bar{X}}=88.57$, SD=11.82). On the other hand, the lowest scoring QOL dimension was physical problems (${\bar{X}}=50$, SD=51.89), and pain (${\bar{X}}=50$, SD=39.03), followed by work status (${\bar{X}}=53.57$, SD=45.84) and burden from kidney disease (${\bar{X}}=58.48$, SD=31.07). The CAPD patients also had a moderate QOL. The highest scoring QOL dimension was the encouragement of staff in the renal unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=95.61$, SD=14.20) and cognitive function (${\bar{X}}=88.83$, SD=13.52). The worst scoring QOL dimensions were work status (${\bar{X}}=44.44$, SD=42.72), general health (${\bar{X}}=53.61$, SD=39.05), and pain (${\bar{X}}=62.70$, SD=41.14). The difference overall and in each dimension of QOL in ESRD patients who were treated with HD and CAPD was not statistically significantly different. The QOL was not significantly different among patients with different personal characteristics except for income and duration of treatment; in those cases, the difference in QOL was statistically significant (p=.05). Conclusion: The overall QOL and life expectancy of patients with ESRD treated with HD and CAPD are not affected by gender, age, marital status, education, occupation, or type of health coverage. QOL was not significantly different, except for patients with different incomes and duration of renal replacement therapy, whose QOL was significantly different. The QOL of patients receiving dialysis should be studied to develop a QOL program for patients with chronic kidney disease who receive dialysis.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.16-24
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• 2005

Objectives : To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. Methods : Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. Results : About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socioeconomic level. Desired charges were about 10,000 won for the bath service, 20,000 won for the rests services per day, and about 500,000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as $63{\sim}71%$. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. Conclusions : Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.