• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.93-114
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• 2005

The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.125-131
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• 2005

Injury has recently become a major world-wide health problem. Injury related deaths occur in many actively working young people and produce major social and economical losses. However health related specialists do not recognize the importance of injury and there have not been many studies related to this problem. This research studied the trends of injury related research in Korea, mortality rate and prevalence rate, socio-economical losses and control in Korea and out of the country, based on literature from Korea and without such as statistical yearly reports on causes of deaths and OECD health reports, as well as WHO web sites. Studies in Korea about injury were very few, with 9 in the 1960's, 5 in the 1980's, 4 in the 1990's and 5 in 2000's. Mortality rate of injury was higher in Korea than in England, USA or Japan, especially in car accidents, suicide and falls. In Korea, the yearly trends in mortality rates were highest in car accidents but those rates are falling, suicide is steadily rising, with highest rate in 2003. Falls is in second rank with no change in rates. In 2003, the ten causes of death in Korea were suicide in 5th rank, transport accidents in 7th rank, and falls in 10th rank. Considering age groups, in the teens, transport accidents were 1st rank, in the 20's and 30's, suicide was 1st rank, and although there were some differences, falls, drowning, assault, fire were in the top 10. Prevalence rates of injury could not be known, but in 2001, according to the National Health and Nutrition Survey, lifelong injury was 10%, and yearly major injury was 1.3%, major injury for two weeks was 0.1%, and minor injury was 10%. In other foreign countries, injury has become to be recognized as a major health related problem, and much programs are being set up to reduce injury related deaths and injuries. WHO is putting much effort in prevention of violence and transport accidents, and in the USA, Canada and Europe, there are injury surveillance systems. Recently, as suicide is increasing rapidly and providing much problems, each country are managing suicide prevention programs. In Korea, Ministry of Construction and Transportation is managing and guiding the policies for prevention of transport accidents. In September of 2004, the Ministry of Health and Welfare has set up a 5 year plan of suicide prevention.

• Journal of Preventive Medicine and Public Health
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• v.25 no.4 s.40
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• pp.413-428
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• 1992

The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For cesarean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals and between hospital groups by size. The most freqeunt indication of C/S was repeated operation, followed by cephalopelvic disproportion (CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons fur admission were 'failure to initial treatment', 'suspected bacterial pneumonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activiteis would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studios with plentiful subjects and more representative diseases or procedures should be tried.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Korean Journal of Oriental Medicine
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• v.16 no.3
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• pp.67-75
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• 2010

Objectives : In order to study the standardization of Qi-gong, and the important spread of education in Qi-gong, we investigated to the cognition of Qi-gong. Method : The descriptive investigation was accomplished to examine the level about the standardization of Qi-gong and the propensity with the Qi-gong training specialist, Qi-gong experience people and non-experience people on a national scale. The data of 572 question papers (140 specialists, 132 Qi-gong experience people, 300 non experience people) were analyzed. The period of the data collection was from Jun, 1, 2009 to Jun, 30, 2009. Result : The motives of Qi-gong participation were Qi-gong training and the individual health. The merit of Qi-gong was beneficial to health. The difficulties of Qi-gong training were the serial motion and doing training alone. And in order to popularize Qi-gong, the motion must simple and the spread of Qi-gong need. The reason of non-participation was the deficiency of the contact opportunity and the reason of participation was beneficial to health. In the future, the national policy for the activation of Qi-gong was the spread of the national exercise through the standardization of Qi-gong. Qi-gong was used in the side of the prevention and the principle of Qi-gong need the modern reinterpretation. And the effect of Qi-gong was more effective in musculoskeletal disease and the valuable part of Qi-gong was the health-longevity. Conclusion : With this, in order to develop the value of Qi-gong, the national support policy will be necessary. And the standardization of Qi-gong motion and program, the development of easy exercise, the educational prevalance, and publicity campaign will be necessary.

• Journal of Korean Physical Therapy Science
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• v.5 no.1
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• pp.549-556
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• 1998

To survey the recognition of Community Based Rehabilitation(CBR) by Public Health Center(PHC) Physical Therapists in Seoul Province. This study analysed general characteristic of Physical Therapists and cognition, participation, education, problems and requirements for CBR. The subjects of this study were 31 therapists who work at PHC in Seoul Province and Seoul City Childerns Municipal Hospital. Data was collected for 18 days from April 13 to 31, 1998 and results computed from 25 responses. First, Female therapists outnumber males. The age category 30 to 35 old represented 44.0% of the total number studied. 48.0% of therapists had worked more than 7 years and therapists usually 84.0% worked from 3 to 4 years at the PHC. Junior colleage graduates were 72.0%, and respondents with family responsibility were 52.0%. Second, Recently pain control and therapeutic exercises has become the major requirement of patients at PHC(56.0%). If the offered expanded services, a rehabilitation programe at PHC(36.0%) was highly. When asked about a working guide book, nobody had one. Third, 64.0% of therapists were aware of the present level of CBR, 28.0% of them had gotten an information from newspaper and mass media. Fourth, For CBR, 72.0% had positive ideas in which they could participate. 56.0% wished to compose a team of various rehabilitation specialists. 52.0% wished for the meeting day to be flexible and 64.0% desired to meet once or twice a week. Fifth, Almost all(92.0%) desired more educational opportunity about CBR. Example, once or twice a year(48.0%) and training period of 4 to 7 day(44.0%). They wanted to learn theory and parctice together(88.0%) and 48.0% wanted national mutirehabilitation center as a educational managing organization. Sixth, The most important requirement for accomplishing CBR by Physical Therapists was job security and adequate number of therapists(48.0%). Required number of physical therapists in the PHC was 3(52.0%). The cooperative agency should be the distict govement(32.0%) and community welfare center of the disabled persons(32.0%). Factors inhibiting the execution of CBR were lack of physical therapists(56.0%), and equipments for pain control and for therapeutic exercises(68.0%).

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.75-80
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• 1998

To survey the recognition of Community Based Rehabilitation (CBR) by Public Health Center(PHC) Physical Therapists in Kyoungki Province. This study analysed general characteristic of Physical Therapists and congnition, participation, education, problems and requireanents for CBR. The objects of this study were 37 therapists who work at 27 of 39 PHC in Kyoungki province and data was collected for 20days from Jan. 12 to 31. 1998 and the results computed from 32 responses. First, Female therapists outnumber males. The age category 30 to 35 old represneted $56.2\%$ of the total number studied. $59.4\%$ of therapists had worked more than 7 years and therapists usually$(46.9\%)$ worked from 6 month to 2 years at the PHC. Junior college graduates were $84.4\%$, and respondents with family responsibilirt were $65.6\%$. Second, Recently pain control has become the major requirment of patiants at PH$(53.1\%)$. If they offered expaneded services - a rehabilitation program $(53.1\%)$, home vistation $(31.3\%)$. when asked about a working guide book, nobody had one. Third, $68.7\%$ of therapists were aware of the present level of CBR, $40.9\%$ of them had gotten an information from educated colleagues, and $68.7\%$ of therapists were aware of the present level of CBR, $86.4\%$ of therapists felt responsible to provide rehabilitation Fourth, For CBR, $93.7\%$ had positive ideas in which they could participate. $73.3\%$ wished to composed a team of various rehabilitational specialists. $73.3\%$ wished for the meeting day to be flexible and $86.6\%$ desired to meet once or twice a week. Fifth, Almost all$(96.9\%)$ desired more educational opportunity about CBR. Example, once or twice a year$(56.2\%)$ and training period of 4-7 days $(43.7\%)$. They wanted to learn theory and practice together$(74.2\%)$ and $74.2\%$ wanted the mational multi-rehabilitation center as a educational managing organization. Sixth, The most important requirment for accomplishing CBR by physical therapists was job security and an adequate number of therapists$(84.4\%)$ Required number of physical therapists in the PHC was 3 $(43.7\%)$. The cooperative agency should be the district goverment organization $(56.2\%)$. Factors inhibiting the execution of CBR were lack of administrative support, physical therapists, and equipments for pain control and for therapeutic exercise.

• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.101-114
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• 1999

This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.225-238
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• 2002

The purpose of this descriptive study was to assess sexual orientation and Knowledge and attitudes with regards to AIDS in military personnel, and to provide basic data for developing a further sex education program for them. The data were collected in June 2002 on 242 service members of A Branch of the Ground Army located in Chung-Chung Do Region. They responded to a survey questionnaire that consisted of 68 items: 14 items on sexual orientation. 39 items on knowledge about AIDS, and 15 items on attitudes toward AIDS. The data were analyzed using SAS program. The study results are as follows: 1. Sexual orientation of the military personnel 1) In terms of sexual orientaion, harassment and assault, only $26.4\%$ of the subjects responded as, 'know well'. Appropriate awareness of the legal liability was reported by $21.6\%$ of the subjects regarding sexual harassment and $78.1\%$ of the subjects regarding sexual assault. 2) Pre-marital cohabitant was supported by $89.2\%$ of the subjects. 3) The Korean military personnel showed liberal attitudes toward sexuality as $46.4\%$ of them reported having sexual-relationship with the dating partner is acceptable. 4) The attitudes of the most subjects toward homosexuality was found to be unfavorable. 5) Subjects were m the need of appropriate sex education. of which substantial knowledge on sexual intercourse was the most needy area. 2. Knowledge and attitudes toward AIDS of the military personnel 1) The subjects' level of knowledge on AIDS was relatively low, showing the average score of $22.31\pm7.23$ points (range: 0-39 points). The higher level of knowledge was reported by those who had high level of education, father alive. and less number of brothers in their family. 2) The subjects' attitudes toward AIDS was relatively positive. The attitude toward AIDS was also found to be more positive in those who had high level of education and less number of brothers. 3) There was a positive but weak correlation between knowledge and attitude toward AIDS. The study finding showed that the sexual orientaion of the Korean military personnel was moderately positive and liberal. However, their awareness of sexual harassment and assault and AIDS was still found to be low. As Korean enlisted military service men are likely to be in the ages with strong sexual desire, it may be important for them to have appropriate sexual orientation and attitudes toward AIDS. Therefore, it is recommended to develop further practical and sound sex education programs within the military unit in order to meet their education needs as well as to utilize sex education specialists as the instructors of those programs.

• Journal of Korean Academy of Nursing
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• v.35 no.8
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• pp.1493-1499
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• 2005

Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.