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Curriculum Development for Hospice and Palliative Care Nurses (간호사를 위한 호스피스 완화의료 교육과정 개발)

  • Choi, Eun-Sook;Kim, Hyun-Sook;Lee, So-Woo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.77-85
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    • 2006
  • Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

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A Comparative Study on the Curriculum of Nursing Education in America and Korea (한.미 간호 교육과정의 비교 연구 -간호대학과정을 중심으로-)

  • 김정자
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.60-82
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    • 1977
  • The purpose of this study is first, to analyse the present nursing education and the curriculum in Korea in view of the changes and the new tendency of nursing education and second, to compare our curriculum with that of America, where nursing activities are actively earring on and, third, to try to find out what we should reconsider and improve in our nursing education. The object of this study is the educational program and the curriculum from 1973 to 1976 by selecting each five from colleges and department of nursing in Korea and America. The results of the study were as fellows : . 1. The aim of nursing education puts impassion the role of leader, knowledge and technology of nursing, welfare of society and service of community in both the America and Korea. In Korea nursing is mainly restricted to the treatment of diseases, while in the America the items of the aim of nursing are mainly extended to the capacity for Self- realization of nurse, in Korea they are restricted to the treatment of diseases. 2. In Korea the rate of credit of the curriculum of nursing education is the highest in professional education, next in general education, next in supporting science and educational subject, while in America the rate of the credit is the highest in general education, next professional education and then supporting Science and educational subject isn′t included in the curriculum. 3. In both Korea and America the role of the animal credit allotment in general education, is the highest in the first year and the rate in supporting science is the highest in the second year. In Korea professional subjects are concentrated in the third year while in America there is a tendency that they are increasing in number in the grade order. 4. There is a tendency that the rate of the credit allotment of the main professional subjects in curriculum is higher in Korea than in America : that is, in Korea the rate of the allotment of the credit is the highest in medical - surgical nursing, next maternal - child nursing, next community - health nursing and the psychiatric nursing and there in a great difference in the rate of the allotment of each credit. While in America the rate of the allotment of the credit is the highest in community - health nursing, next in medical- surgical nursing, next in maternal - child nursing, and then in psychiatric nursing and there is little difference in the rate of tile allotment of each credit. 5. From general education, supporting science and professional education, they have considered the continuity and sequence in the structure of nursing curriculum of Korea and America. While in Korea we have partly made integration in tile content of the subjects. Most of the school in America, they have made integration in the content of subjects especially in all subjects, but in Korea we haven't made it in all subjects. 6. In the system and form of nursing education Problem solving method, Dialectical method and operational method are introduced in some America schools and in others there is a tendency that the whole nursing education has the system based on Preventive frame - work or Health -illness frame work ; while only one college has an attempt for Health - Illness continue in Korea. 7. In Korea nursing education, as the importance of health- nursing and team nursing, the aim which is also comparatively emphasized is about health management and service of collective community. The subject pertaining to the aim is the studies of community health nursing, which are more in number in America. 8. When we consider the association between the social, general aims ?f the nursing education and the formation of the curriculum in Korean nursing school the courses of study concerning "the role of leadership and cooperative personal relation": "nursing care for the group": dynamic nursing care": and "the system of the public health nursing associated with the understanding of the regional community" are insufficient as compared with those of America. Especially, the lack of the behavioral science including the nursing care connected with the care for the group, the basic science on the clinical and developmental psychology, anthropology in known to be a prominent issue.

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The Current Status of the Discussions on International Norms Related to Space Activities in the UN COPUOS Legal Subcommittee (우주활동 국제규범에 관한 유엔 우주평화적이용위원회 법률소위원회의 최근 논의 현황)

  • Jung, Yung-Jin
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.1
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    • pp.127-160
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    • 2014
  • The UN COPUOS was established in 1959 as a permanent committee of the UN General Assembly with the aims to promote international cooperation in peaceful uses of outer space, to formulate space-related programmes within the UN, to encourage research and dissemination of information on space, and to study legal problems arising from the outer space activities. Its members have been enlarged from 24 members in 1959 to 76 in 2014. The Legal Subcommittee, which has been established under COPUOS in 1962 to deal with legal problems associated with space activities, through its first three decades of work has set up a framework of international space law: the five treaties and agreements - namely the Outer Space Treaty, Rescue Agreement, Liability Convention, Registration Convention, Moon Agreement - and the five declarations and legal principles. However, some sceptical views on this legal framework has been expressed, concerning the applicability of existing international space law to practical issues and new kinds of emerging space activities. UNISPACE III, which took place in 1999, served as a momentum to revitalize the discussions of the legal issues faced by the international community in outer space activities. The agenda of the Legal Subcommittee is currently structured into three categories: regular items, single issue/items, and items considered under a multi-year workplan. The regular items, which deal with basic legal issues, include definition and delimitation of outer space, status and application of the five UN treaties on outer space, and national legislation relevant to the peaceful exploration and use of outer space. The single issues/items, which are decided upon the preceding year, are discussed only for one year in the plenary unless renewed. They include items related to the use of nuclear power sources in outer space and to the space debris mitigation. The agenda items considered under a multi-year work plan are discussed in working group. Items under this category deal with non-legally binding UN instruments on outer space and international mechanism for cooperation. In recent years, the Subcommittee has made some progress on agenda items related to nuclear power sources, space debris, and international cooperation by means of establishing non-legally binding instruments, or soft law. The Republic of Korea became the member state of COPUOS in 2001, after rotating seats every two years with Cuba and Peru since 1994. Korea's joining of COPUOS seems to be late, in considering that some countries with hardly any space activity, such Chad, Sierra Leone, Kenya, Lebanon, Cameroon, joined COPUOS as early as 1960s and 1970s and contributed to the drafting of the aforementioned treaties, declarations, and legal principles. Given the difficulties to conclude a treaty and un urgency to regulate newly emerging space activities, Legal Subcommittee now focuses its effort on developing soft law such as resolutions and guideline to be adopted by UN General Assembly. In order to have its own practices reflected in the international practices, one of the constituent elements of international customary law, Korea should analyse its technical capability, policy, and law related to outer space activities and participate actively in the formation process of the soft law.

Analysis of Microbiological Contamination in Cultivation and Distribution Stage of Melon

  • Park, Kyeong-Hun;Yun, Hye-Jeong;Kim, Won-Il;Kang, Jun-Won;Millner, Patricia D.;Micallef, Shirley A.;Kim, Byeong-Seok
    • Korean Journal of Soil Science and Fertilizer
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    • v.46 no.6
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    • pp.615-622
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    • 2013
  • The purpose of this study was to evaluate microbial contamination of melons in Korea. A total of 123 samples including melon fruits, leaves, seeds, soils, and irrigation water were collected from farms and markets to detect total aerobic bacteria, coliform, Escherichia coli, and pathogenic bacteria such as Bacillus cereus, Listeria monocytogenes, Salmonella spp., and Staphylococcus aureus. Samples were collected from Iksan and Nonsan farms to monitor bacterial levels on pre-market melons. The total aerobic and coliform bacteria on melon cultivation were between 0.43 and 6.65 log CFU $g^{-1}$, and 0.67 and 2.91 log CFU $g^{-1}$, respectively. Bacillus cereus, a fecal coliform, was detected in soils and melon leaves from Iksan farm at 2.95, 0.73 log CFU $g^{-1}$, respectively, and in soils from Nonsan farm at 3.16 log CFU $g^{-1}$. Market melon samples were collected to assay bacterial load on melon being sold to consumers. The contamination levels of total aerobic bacteria in agricultural markets, big-box retailers, and traditional markets were 4.82, 3.94, 3.99 log CFU $g^{-1}$, respectively. The numbers of coliform in melon on the markets ranged from 0.09 to 0.49 log CFU $g^{-1}$. Listeria monocytogenes, Salmonella spp., and Staphylococcus aureus were not detected in any samples. The count of total aerobic bacteria on melon seeds ranged from 0.33 to 3.34 log CFU $g^{-1}$. This study found that irrigation water, soil, manure and various farm work activities including post-harvest processes were latent sources of microbial contamination. These results suggest that hygienic management and monitoring of soil, water, and agricultural material should be performed to reduce microbial contamination in melon production.

호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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A Study on the Establishment of Management Methods about Occupational Dermatoses (직업성 피부질환에 대한 현황 파악 및 관리 대책 수립을 위한 연구)

  • Lim, Hyun-Sul;Cheong, Hae-Kwan;Choi, Byung-Soon;Kim, Ji-Yong;Sung, Yeol-Oh;Kim, Yang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.617-637
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    • 1996
  • Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

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Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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Estimation of Genetic Parameters for Growth-Related Traits in 1-Year Old of Two Korean Abalone Subspecies, Haliotis discus hannai and H. discus discus, by Using Multiple Traits of Animal Model (다형질 Animal Model에 의한 12개월령 한국산 전북 2 아종의 성장관련형질에 대한 유전모수 추정)

  • Choe, Mi-Kyung;Han, Seock-Jung;Yang, Sang-Geun;Won, Seung-Hwan;Park, Choul-Ji;Yeo, In-Kyu
    • The Korean Journal of Malacology
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    • v.24 no.2
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    • pp.121-130
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    • 2008
  • In other aquaculture species, large improvements in growth have been achieved through selective breeding. Ezo abalone(Haliotis discus hannai) and disk abalone(H. discus discus) are major aquatic animals cultured in Asia, but selective breeding for the promotion of growth with these abalones has not been actively pursued. Recently significant efforts are being made to promote production of these species through selective breeding in Korea. The aims of this work were to estimate the general genetic parameters, heritabilities, and genetic and phenotypic correlations on growth-related traits at 1-year old in two Korean abalone subspecies, H. discus hannai and H. discus discus, by using multiple trait animal model. The data were collected from the records of 1,504 individuals produced from 22 sires and 26 dams in H. discus hannai and 297 individuals produced from 5 sires and 6 dams in H. discus discus, which evaluated by the Genetics and Breeding Research Center, National Fisheries Research & Development Institute(NFRDI). Genetic parameters were estimated for these abalone subspecies raised in Bukjeju branch, NFRDI, from May 20, 2004 to May 16, 2005, respectively. The heritability estimates obtained from restricted maximum likelihood(REML) were higher than expected, ranging from 0.40 to 0.43 for growth traits shell length, shell width and body weight in H. discus hannai and from 0.26 to 0.51 in H. discus discus, respectively. The heritabilities for shell shape and condition factor were lower than others of growth traits such as ranging from 0.09 to 0.19 in H. discus hannai and from 0.10 to 0.23 in H. discus discus, respectively. Genetic and phenotypic were > 0.93 between shell parameters and weight in two abalone species, respectively, indicating that breeding for weight gains could be successfully achieved by selecting for shell length.

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Occupational Stress of Hospital Workers (병원종사자의 직업성 스트레스에 관한 연구 - 서울시내 500병상 이상 병원종사자를 중심으로 -)

  • Lee, Woo-Cheon
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.1-33
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    • 1998
  • The purpose of this thesis is to study theoretical access to the methods that have been used for the research of occupational stress, thereby providing management methods of occupational stress of hospital workers. With a stress model of hospital workers set up from the viewpoint of organization management, 929 sets of questionnaires were collected from intern doctors, resident doctors, nurses, nursing aides, pharmacists, medical technicians, workers in patient affairs(reception and medical insurance workers), administrators and clerks from the 8 hospitals in Seoul with more than 500 beds. Upon variance analysis, correlation analysis and regression analysis of the collected questionnaires, this work examined how differences in stress caused by specific occupations and formulated a method of stress management for the hospital workers. The results are as follows. 1) If some duties of the nurses suffering from role-overloaded stress are transferred to the nursing aides dissatisfied with insufficient role, the two grunting groups can be satisfied at the same time. It is also necessary to transfer some jobs of the overloaded workers in patient affairs to the administrators, or the other way around. To reduce stress of conflict and ambiguity of role caused by the obscure division of roles between the workers, the role of each occupation should be delineated and the clear division of roles should be translated into action strictly according to that delineated. 2) Stress of inefficiency of organization from which the student doctors suffer can be relieved by management of participation. If they have access to the process of decision-making in general hospital affairs and consequently their understanding and the autonomy of job performance are promoted, such stress will be reduced. 3) To cope with stress of career development from which nurses, medical technicians, administrators, workers in patient affairs suffer, it is necessary to establish whether they have a chance to revive their careers, whether there are any ways of remotivation for less contributive workers, and whether they encourage each other to develope their careers. If they are given a chance to develope their careers, such stress will be relieved. 4) Pharmacists, suffering from stresses of living and personal relations, have strong cohesive power among themselves and organize a well-integrated team; thereby reducing the stress of personal relations and increasing productivity. 5) For administrators and student doctors confined to lesser social supports and for nurses and workers in patient affairs whose recognition of stress and job satisfaction are affected by social supports, emotional and informational supports for job performance help alleviate an individual's mental, and physical stress. 6) In addition to the above-mentioned stress-management methods, if an organizational coping strategy is provided according to the types of stress from the general viewpoint of the whole group of hospital workers, it would be of great help to managing stress. For example, the redesign of jobs, the management of objective, the improvement of working environment, the formation of an autonomous working group and various working plans can be set up for those who suffer from stress related to inappropriate role, while career counseling and development of career process can be provided for those dissatisfied with career development. Participation in the process of decision-making and the restructuring of the organization are needed for those who suffer from stress of malfunctioning organization, whereas creation of a supportive organizational atmosphere is desired for those who feel stressed due to personal relations. As well, such organizational coping strategies. as the increase of welfare facilities, seminars and educational programs and provision of health-promotion facilities can be provided.

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