Purpose: The purpose of this study was to identify the current management status and the policy issues of visiting nursing programs at public health center in urban area. Method: A questionnaire surveys was conducted on all public health nurses in 25 health centers in Seoul. Result: The major results were as follows: The characteristics of the visiting nurse showed that the average age was 41.1 years, and total nursing experience was 122 months. Their visiting nursing experience was only 30 months. The recipients of visiting nursing services consisted of 60.1% females, and 32.5% of the recipients were over 65 years. The major health problems of the recipients were hypertension, diabetes mellitus, arthritis and psychiatric problems. The visiting frequency was an average of 5.4 times per day, and 357 families were managed per visiting nurse. The major problems of visiting nursing programs were the shortages of visiting nurse manpower. The most important related policy issue was being in charge of a workload, which was not related to the visiting nursing services. Conclusion: By analyzing work for visiting nurses and identifying weak points, this research can present recommendations to be practically used as baseline data for establishing policy in relation to vitalizing visiting nursing programs.
The purpose of this study is to investigate the conditions and problems of anti-smoking education programs in government office for civil servants. A mail-in survey was carried out for the chief of the general affairs of 248 government offices. 1. There were 154 responses to the surveys. Only 34 governmental offices have carried out anti-smoking education programs for civil servants. 2. Only one office has a department to supervise and anti-smoking program. 17 offices have 1 worker and thirteen offices have no manpower to supervise anti-smoking program. 3. Only eight offices have budgeted for anti-smoking programs. The average budget was 3,750,000 Won. Expected budget for smoking cessation program was 7,500,000 Won. 4. 25 offices have an anti-smoking lecture program for civil servants. Only five offices have an anti-smoking counseling for smokers. 5. Only seven surveys responded that civil servants had a positive response to anti-smoking programs. 6. The most important problem of anti-smoking programs in governmental offices was the lack of concern of civil servants. Governmental offices have to provide the greatest administrative services and services concerning the quality of life for citizens. Anti-smoking education programs in governmental offices for civil servants was the beginning of an activity of the services concerning the quality of life for citizens. Governmental offices have to actively implement anti-smoking programs for civil servants.
There has been 10 years since The Health Promotion Act was legislated. The government began to establish a health promotion fund on the basis of Health Promotion Act in 1995, and to manage and operate the fund from 1998. It is evaluated that health promotion program have had various outcomes in many aspects. First, there has been growing awareness of the impotance of health promotion through the establishment of Health Plan 2010 and the effort to actualize the Plan. Second, the importance of securing health equity and identifying health determinants have been recognized during the planning process of Health Plan 2010. Third, the health promotion program have mainly focused on improving healthy life style of the population. As a result, desirable health behavior change of the population could be expected from the result of 2005 National Health and Nutrition Survey. Fourth, public health centers began to play a crucial role in implementing health promotion programs, and began to build infrastructure for health promotion programs. Fifth, the outcomes of health promotion programs by public health centers and private health organizations have been increasing. Finally, training for health promotion personnel and their participation in the program could be the foundation for the higher level of outcome achievement from the health promotion programs. Important challenges for future health promotion would be identification of the determinants and risk factors of health in Korea, establishment of local health promotion plan, building infrastructure for health promotion, creation of specific action model by public health center, development of diverse health promotion programs and health promotion program for the elderly, conducting research for evidence concerning major factors reducing the need for health care through prevention disease activities, and establishment of evaluation and feed back system for health promotion programs.
Purpose: The purpose of this study was to evaluate demonstration health promotion programs offered by 18 health centers in a structural aspect of the health centers. Methods: The Evaluation Committee was organized with professors from collaboration universities and researchers of this study. Using structure evaluation frame. reports from 18 health centers were reviewed by the committee. Evaluation categories included organizational change, manpower construction, budget, and manpower training and education. Results: Only 5 health centers out of 18 have independent health promotion department. Nurses played a major role for health promotion programs. Other health personnel participated in the health promotion programs included dental hygienists, nutritionists, and exercise specialists. Related to program budgets. local government support rates were varied by the region. Various kind of manpower training was offered to health personnel for the health promotion programs including smoking control. exercise, alcohol, nutrition, and so forth. Conclusion: The study results indicated that establishment of independent health promotion department, maintenance of same manpower construction, provision of diversity manpower training were the factors that foster effective health promotion programs.
This study was conducted to get a resonable set of budget allocation to public health programs. Matrix Delphi technique was used to obtain the logic of study results and eventually to form a human model which could predict opinion of professionals on budget allocation. Thirty-two professionals in academic and governmental area responded to Delphi survey. Questionnaire was developed using matrix formation, and the matrix was formed by 6 decision criteria on budget allocation and 26 public health programs. The decision criteria are as following: size of problem(morbidity), severity of problem, social equity, importance of prevention, technical feasibility and efficiency of programs. Severity of problem dropped out of the model because it had significant correlation with the size of problem. A total score of each program was obtained by weighting the relative importance of each criteria which also were given by survey respondents. These total scores indicate that the most important public health program is vaccination for infants and children in terms of budget allocation. Monitoring communicable diseases, mental health program, and anti-smoking program are the next. In addition, respondents were asked of the desirable budget size of each program. The result was rearranged by multiple regression model using the scores of each decision criteria. In this process, the current budget size of central government was provided to the respondents, and included in the model. h set of desirable budgets modified using tile model was obtained. Considering the current size of budget, tile results of the model is very different from that of the total score. Managing dementia is ranked the first. Health promotion program for the elderly, rehabilitation of the disabled and monitoring communicable diseases are the next. The need to increase the budget of vaccination for the infants and children was not found as so high. The matrix structure in Delphi survey gave us the precise basis to make optimal decision, and made it possible to develop an opinion predicting model. However the plentifulness and diversity of professional opinions were not fully obtained due to the limited number of decision criteria.
Objective : This study was conducted to development of public health promotion programs for menopausal women using Traditional Korean Medicine (TKM). Method : 4 domestic data bases were used to derive TKM intervention that could improve women's menopausal symptoms. Based on this, the program was organized through consultation with experts from the academic community. Results : Program was composed of 3 categories, lecture, therapy and practical exercise. The lecture was made with 'Understanding of menopause', 'Understanding of meditation', and 'Dietary therapy on menopause'. In therapy, 少府(HT8), 合谷(LI4), 內關(PC6), 三陰交(SP6) and 加味逍遙散(Gamisoyo-san) were chosen by expert discussion. Meditation, aromatherapy, walking and palate test were selected for practical exercise. Conclusion : Programs could be used to improve women's health in menopause.
Purpose: Hypertension has been a major cause of death in Korea since the 1970s, and has resulted in being a significant economic burden to the finances of national health care. The Ministry of Health and Welfare made several efforts. but hypertension control programs in Korea are still non standardized and ineffective. We wanted to investigate the current hypertension control program in public health centers systematically and suggest the direction for future programs. Method: The design of this study is a cross sectional investigation. From September to October in 2002, we sent a set of questionnaires to all PHCs, and 179 centers responded (response rate = 74.0%). The instrument was developed based on components of National health systems. Results: 1) Resources: The department responsible for hypertension control programs is the Department of Health Promotion. Health Education Center, Community Health Center, Citizen's Health Center, etc. The chief personnel of those departments are nurses. but 27.4% of PHCs have no full time nurse for hypertension management programs. PHCs had a lot of teaching materials (nine types per a PHC) and most of the recommended contents were included. But, periodical evaluation and revision were not being made, 2) Management: Nurses' (13.03 9.46 in 23 score) actions for hypertension control were not qualitative, but regular training and evaluation were seldom carried out. Need assessment (25.9%) and evaluation (about 10-20%) for the hypertension control program were indicated as low. 3) Programs: Programs focused on individuals rather than community or public, and 2nd prevention rather than 1st, 3rd prevention. Conclusion: The Ministry of Health and Welfare has to construct the infrastructure for hypertension control programs. Related scholars and committees should develop and declare standardized manuals for hypertension control and the management system, as well.
The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.
This study was conducted to evaluate factors related to the recogniton and behavioral intention for smoking cessation programs. Five effective smoking cessation programs were considered: acupuncture, nicotine patch, clinic program, mass education, and alliance programs. To explain the health behavior for smoking and smoking cessation programs, a five-stage behavioral intention model was built, and 500 questionnaires were completed through a telephone survey. Stages of the model included recogniton of the programs, past experiences, present smoking status, intention for smoking, and behavioral intention for smoking cessation programs. The results showed that the recogniton rate of the programs were low in general, therefore strategies of education, public relations, and advertisement need to be pursued. Nicotine dependency resulted in the fact that success rates were low although trial rates of smoking cessation were high among smokers. The necessity for smoking cessation programs was suggested. And the significant factors related to the intention for smoking cessation were individual attitude and reluctancy to pay time and money. Others' attitude was insignificant to subjects' smoking cessation. Purchase rates for nicotine patches were 11.3% for male and 27.3% for female, those for acupunture were 7.6% for male and 10.0% for female. There were very low purchase rates for clinic, mass education, and alliance programs. In conclusion, evidence-based and effective smoking cessation programs need to be promoted by medical doctors. Strategies in education, public relations, and advertisement also need development. In addition, continuing legal and systematic support for smoking cessation would lower the smoking rate and ultimately contribute to the nation's health.
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