Qualitative Study on Experiences of Responding to COVID-19 of Therapists in Long-term Care Hospitals (요양병원 치료사의 코로나19 대응 경험에 대한 질적 연구)
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- Journal of Korea Entertainment Industry Association
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- v.15 no.4
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- pp.337-347
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- 2021
This study is a qualitative study conducted to provide basic data for therapists working in long-term care hospitals to improve their countermeasure strategies for new infectious diseases and improvement of the treatment room infection management system, and to help therapists understand their infection management work. Colaizzi's phenomenological research method was applied as the research method. Telephone interviews were conducted with nine occupational therapists and physical therapists working in nursing hospitals. The contents of the interview were recorded with the consent of the study subjects, and additional confirmation was received by email. The recorded content was analyzed after transcription, and the meaning and nature of the experience coping with COVID-19 were described. The content was organized into 6 themes, 17 main meaning and 49 meaning units. In accordance with the COVID-19 situation, the infection control system has been strengthened by reinforcing infection control education in nursing hospitals, practicing infection control, and supervising infection control outside business hours. It was found that the treatment environment was changed due to the restriction of treatment activities by practicing distancing in the treatment room, adjusting rest and meal times during working hours, and strengthening infection control. In addition, the therapist's role has been expanded and the paradigm of treatment has changed, such as considering the untact intervention, and they have experienced cohort quarantine, pre-tested for COVID-19, vaccinations, and side effects from COVID-19. However, due to the infection work, the therapist's work burden is increased, and the person is experiencing fear, depression, and work stress from the spread of COVID-19. They were also aware of the need for nursing hospital care personnel support, such as guaranteeing rest after vaccination and providing infection control tools and equipment. The results of this study are expected to be used as basic data for human and physical support for the development of infectious disease response strategy programs in nursing hospital treatment rooms and for infection control in nursing hospitals.
At the start of the new century, South Africa probably had the largest number of HIV-infected people of any country in the world. The only nation that comes close is India with a population of one billion people compared to South Africa's figure of 57 million. The tragedy is that this did not have to happen. South Africa was aware of the dangers posed by AIDS as early as 1985. In 1991, the national survey of women attending antenatal clinics found that only 0.8percent were infected. In 1994, when the new government took power, the figure was still comparatively low at 7.6 %. The 2004 figure which has been published is 26.5%. This article tracks the epidemic globally, in the region and in South Africa. I explain some of the basic concepts around the disease and look at what may happen with respect to numbers. The situation is bad, and the number of people falling ill, dying and leaving families will rise over next few years. This will impact on South Africa in a number of important ways. This article assesses the demographic, economic and social consequences of the epidemic. It disposes of a number of myths and present the real facts. The AIDS in South Africa is not related to individuals only. It warns that AIDS in Africa is becoming a community and systemic problem. The acuteness of the problem does not stem merely from the fact that communities are affected, or could even be wipe out by the end of this decade, but from the fact that AIDS will place incredible burdens and obligations upon medical services, health care and religious communities such as churches. The facts confront churches' mission with the important question: who is going to take care of all the patients and where? The reality is that people dying of AIDS will have to be cared for at home by relatives and friends. A further question that arises is whether our people are prepared for this. AIDS was considered to be a homo-plague and the hunt was on for a scapegoat in the light of the fatal implication of the disease. At present we are in the strategic phase where we all realize that it will be of no avail to scare people with the ominous threat of AIDS AIDS destroys the optimism of our achievement ethics. This exposure of the culture of optimism is also an exposure of the so-called 'human basic fear which accuses Christianity that their concept of sin is a damper on man's search for liberation and basic need to be freed from all Imitation. AIDS is also a test for our ecclesiastical genuineness and the sincerity of our mission sensibility. It poses the question: How unconditional is Christian love? Is there room for the AIDS sufferer in the community of believers, despite the fact he is an acknowledged homosexual? The question to put to the church is whether the community of believers is an exclusive to put to the koinonia which excludes homosexuals. They may be welcome on principle, but in actual fact are not acceptable to the church community. As South Africa enters the new century, it is clear that the epidemic is not having a measurable impact. However, the impact of AIDS is gradual, subtle and incremental. The author's proposal of what is currently most needed in South Africa is that the little things will make a difference. It's about doing lots of little things better at grassroots level, with the emphasis on doing. There are so many community, churches and NGOs initiatives worth building on and intensifying. One must not underestimate the therapeutic value of working together in small groups to overcome a problem
Recently, as the information communication technology develops, the discussion regarding the ubiquitous environment is occurring in diverse perspectives. Ubiquitous environment is an environment that could transfer data through networks regardless of the physical space, virtual space, time or location. In order to realize the ubiquitous environment, the Pervasive Sensing technology that enables the recognition of users' data without the border between physical and virtual space is required. In addition, the latest and diversified technologies such as Context-Awareness technology are necessary to construct the context around the user by sharing the data accessed through the Pervasive Sensing technology and linkage technology that is to prevent information loss through the wired, wireless networking and database. Especially, Pervasive Sensing technology is taken as an essential technology that enables user oriented services by recognizing the needs of the users even before the users inquire. There are lots of characteristics of ubiquitous environment through the technologies mentioned above such as ubiquity, abundance of data, mutuality, high information density, individualization and customization. Among them, information density directs the accessible amount and quality of the information and it is stored in bulk with ensured quality through Pervasive Sensing technology. Using this, in the companies, the personalized contents(or information) providing became possible for a target customer. Most of all, there are an increasing number of researches with respect to recommender systems that provide what customers need even when the customers do not explicitly ask something for their needs. Recommender systems are well renowned for its affirmative effect that enlarges the selling opportunities and reduces the searching cost of customers since it finds and provides information according to the customers' traits and preference in advance, in a commerce environment. Recommender systems have proved its usability through several methodologies and experiments conducted upon many different fields from the mid-1990s. Most of the researches related with the recommender systems until now take the products or information of internet or mobile context as its object, but there is not enough research concerned with recommending adequate store to customers in a ubiquitous environment. It is possible to track customers' behaviors in a ubiquitous environment, the same way it is implemented in an online market space even when customers are purchasing in an offline marketplace. Unlike existing internet space, in ubiquitous environment, the interest toward the stores is increasing that provides information according to the traffic line of the customers. In other words, the same product can be purchased in several different stores and the preferred store can be different from the customers by personal preference such as traffic line between stores, location, atmosphere, quality, and price. Krulwich(1997) has developed Lifestyle Finder which recommends a product and a store by using the demographical information and purchasing information generated in the internet commerce. Also, Fano(1998) has created a Shopper's Eye which is an information proving system. The information regarding the closest store from the customers' present location is shown when the customer has sent a to-buy list, Sadeh(2003) developed MyCampus that recommends appropriate information and a store in accordance with the schedule saved in a customers' mobile. Moreover, Keegan and O'Hare(2004) came up with EasiShop that provides the suitable tore information including price, after service, and accessibility after analyzing the to-buy list and the current location of customers. However, Krulwich(1997) does not indicate the characteristics of physical space based on the online commerce context and Keegan and O'Hare(2004) only provides information about store related to a product, while Fano(1998) does not fully consider the relationship between the preference toward the stores and the store itself. The most recent research by Sedah(2003), experimented on campus by suggesting recommender systems that reflect situation and preference information besides the characteristics of the physical space. Yet, there is a potential problem since the researches are based on location and preference information of customers which is connected to the invasion of privacy. The primary beginning point of controversy is an invasion of privacy and individual information in a ubiquitous environment according to researches conducted by Al-Muhtadi(2002), Beresford and Stajano(2003), and Ren(2006). Additionally, individuals want to be left anonymous to protect their own personal information, mentioned in Srivastava(2000). Therefore, in this paper, we suggest a methodology to recommend stores in U-market on the basis of ubiquitous environment not using personal information in order to protect individual information and privacy. The main idea behind our suggested methodology is based on Feature Matrices model (FM model, Shahabi and Banaei-Kashani, 2003) that uses clusters of customers' similar transaction data, which is similar to the Collaborative Filtering. However unlike Collaborative Filtering, this methodology overcomes the problems of personal information and privacy since it is not aware of the customer, exactly who they are, The methodology is compared with single trait model(vector model) such as visitor logs, while looking at the actual improvements of the recommendation when the context information is used. It is not easy to find real U-market data, so we experimented with factual data from a real department store with context information. The recommendation procedure of U-market proposed in this paper is divided into four major phases. First phase is collecting and preprocessing data for analysis of shopping patterns of customers. The traits of shopping patterns are expressed as feature matrices of N dimension. On second phase, the similar shopping patterns are grouped into clusters and the representative pattern of each cluster is derived. The distance between shopping patterns is calculated by Projected Pure Euclidean Distance (Shahabi and Banaei-Kashani, 2003). Third phase finds a representative pattern that is similar to a target customer, and at the same time, the shopping information of the customer is traced and saved dynamically. Fourth, the next store is recommended based on the physical distance between stores of representative patterns and the present location of target customer. In this research, we have evaluated the accuracy of recommendation method based on a factual data derived from a department store. There are technological difficulties of tracking on a real-time basis so we extracted purchasing related information and we added on context information on each transaction. As a result, recommendation based on FM model that applies purchasing and context information is more stable and accurate compared to that of vector model. Additionally, we could find more precise recommendation result as more shopping information is accumulated. Realistically, because of the limitation of ubiquitous environment realization, we were not able to reflect on all different kinds of context but more explicit analysis is expected to be attainable in the future after practical system is embodied.
Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.
To prepare for the complicated international relationship regarding Korean Peninsula after reunification, this thesis started off with the awareness that Unified Korea should build its international posture and national security at an early stage by determining its appropriate military strength for independent defense and military strategies that Unified Korea should aim. The main theme of this thesis is 'The research on appropriate military strength of the Unified Korean military'. To derive appropriate military strength of Unified Korea, this research focuses on conflict scenario and relative balance strategy based on potential threats posed by neighboring countries, and this is the part that differentiates this research from other researches. First of all, the main objective of the research is to decide appropriate military strength for Unified Korea to secure defense sufficiency. For this, this research will decide efficient military strategy that Unified Korea should aim. Than by presuming the most possible military conflict scenario, this research will judge the most appropriate military strength for Unified Korea to overcome the dispute. Second, after deciding appropriate military strength, this research will suggest how to operate presumed military strength in each armed force. The result of this thesis is as in the following. First, Unified Korea should aim 'relative balance strategy'. 'Relative balance strategy' is a military strategy which Unified Korea can independently secure defense sufficiency by maintaining relative balance when conflicts occur between neighboring countries. This strategy deters conflicts in advance by relative balance of power in certain time and place. Even if conflict occurs inevitably, this strategy secures initiative. Second, when analyzing neighboring countries interest and strategic environment after unification, the possibility of all-out war will be low in the Korean Peninsula because no other nation wants the Korean Peninsula to be subordinated to one single country. Therefore appropriate military strength of the Unified Korean military would be enough when Unified Korea can achieve relative balance in regional war or limited war. Third, Northeast Asia is a region where economic power and military strength is concentrated. Despite increasing mutual cooperation in the region, conflicts and competition to expand each countries influence is inherent. Japan is constantly enhancing their military strength as they aim for normal statehood. China is modernizing their military strength as they aspire to become global central nation. Russia is also enhancing their military strength in order to hold on to their past glory of Soviet Union as a world power. As a result, both in quality and quantity, the gap between military strength of Unified Korea and each neighboring countries is enlarged at an alarming rate. Especially in the field of air-sea power, arms race is occurring between each nation. Therefore Unified Korea should be equipped with appropriate military strength in order to achieve relative balance with each threats posed by neighboring countries. Fourth, the most possible conflicts between Unified Korea and neighboring countries could be summarized into four, which are Dokdo territorial dispute with Japan, Leodo jurisdictional dispute with China, territorial dispute concerning northern part of the Korea Peninsula with China and disputes regarding marine resources and sea routes with Russia. Based on those conflict scenarios, appropriate military strength for Unified Korea is as in the following. When conflict occurs with Japan regarding Dokdo, Japan is expected to put JMSDF Escort Flotilla 3, one out of four of its Japan Maritime Self-Defense Force Escort Fleet, which is based in Maizuru and JMSDF Maizuru District. To counterbalance this military strength, Unified Korea needs one task fleet, comprised with three task flotilla. In case of jurisdictional conflict with China concerning Leodo, China is expected to dispatch its North Sea fleet, one out of three of its naval fleet, which is in charge of the Yellow Sea. To response to this military action, Unified Korea needs one task fleet, comprised with three task flotilla. In case of territorial dispute concerning northern part of the Korean Peninsula with China, it is estimated that out of seven Military Region troops, China will dispatch two Military Region troops, including three Army Groups from Shenyang Military Region, where it faces boarder with the Korean Peninsula. To handle with this military strength, Unified Korea needs six corps size ground force strength, including three corps of ground forces, two operational reserve corps(maneuver corps), and one strategic reserve corps(maneuver corps). When conflict occurs with Russia regarding marine resources and sea routes, Russia is expected to send a warfare group of a size that includes two destroyers, which is part of the Pacific Fleet. In order to balance this strength, Unified Korea naval power requires one warfare group including two destroyers. Fifth, management direction for the Unified Korean military is as in the following. Regarding the ground force management, it would be most efficient to deploy troops in the border area with china for regional and counter-amphibious defense. For the defense except the border line with china, the most efficient form of force management would be maintaining strategic reserve corps. The naval force should achieve relative balance with neighboring countries when there is maritime dispute and build 'task fleet' which can independently handle long-range maritime mission. Of the three 'task fleet', one task fleet should be deployed at Jeju base to prepare for Dokdo territorial dispute and Leodo jurisdictional dispute. Also in case of regional conflict with china, one task fleet should be positioned at Yellow Sea and for regional conflict with Japan and Russia, one task fleet should be deployed at East Sea. Realistically, Unified Korea cannot possess an air force equal to neither Japan nor China in quantity. Therefore, although Unified Korea's air force might be inferior in quantity, they should possess the systematic level which Japan or China has. For this Unified Korea should build air base in island areas like Jeju Island or Ullenong Island to increase combat radius. Also to block off infiltration of enemy attack plane, air force needs to build and manage air bases near coastal areas. For landing operation forces, Marine Corps should be managed in the size of two divisions. For island defense force, which is in charge of Jeju Island, Ulleung Island, Dokdo Island and five northwestern boarder island defenses, it should be in the size of one brigade. Also for standing international peace keeping operation, it requires one brigade. Therefore Marine Corps should be organized into three divisions. The result of the research yields a few policy implications when building appropriate military strength for Unified Korea. First, Unified Korea requires lower number of ground troops compared to that of current ROK(Republic of Korea) force. Second, air-sea forces should be drastically reinforced. Third, appropriate military strength of the Unified Korean military should be based on current ROK military system. Forth, building appropriate military strength for Unified Korea should start from today, not after reunification. Because of this, South Korea should build a military power that can simultaneously prepare for current North Korea's provocations and future threats from neighboring countries after reunification. The core of this research is to decide appropriate military strength for Unified Korea to realize relative balance that will ensure defense sufficiency from neighboring countries threats. In other words, this research should precisely be aware of threats posed by neighboring countries and decide minimum level of military strength that could realize relative balance in conflict situation. Moreover this research will show the path for building appropriate military strength in each armed force.
Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.