• 한국노년학
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• v.36 no.4
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• pp.1037-1058
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• 2016

This study aims to investigate the female caregivers'experiences of aggression by nursing home residents, and to identify the policy strategies for violence prevention referred by the female caregivers. A total of 121 female caregivers with more than 6 months of working experiences had participated in this study. Of these, 56.2% had experienced verbal aggression, 51.2% physical aggression, and 27.3% sexual aggression, which reveals that client violence toward caregivers in nursing homes was at an alarming level. Although, physical and verbal violences were mostly caused unintentionally, about a half of the sexual aggression were caused deliberately. Aggression occurred the most when caregivers were providing the following services: changing the diapers or clothes, giving a bath, and serving meals. It was found that 'hitting' was the most common form of physical aggression and it was 'swearing' and 'touching or physical contacting' in the case of verbal and sexual aggression, respectively. Though there was a difference depending on the type of aggression, the most frequent reactions against client violence were to start a conversation or calm down the nursing home residents, and to leave the scene or ignore the incident. This means that the caregivers are coping very passively through resolving the aggressions by themselves, or overlooking the situation. The most frequently recommended strategy to prevent resident aggression was to provide educational programs on violence prevention to nursing home residents and caregivers(42.7%). Compared to the previous studies, this study indicates some differentiated strategies to prevent violence in nursing homes, which include hiring male caregivers, assuring directors to pay closer attention toward caregivers, using refined language between caregivers and residents, and keeping caregivers to wear appropriate clothes. Based on the study results, some policy recommendations on the prevention of client violence in nursing homes were suggested.

• Science of Emotion and Sensibility
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• v.17 no.3
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• pp.129-142
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• 2014

Due to the increase of the aged population and population of the disabled today, there is a growing demand for rehabilitation medical instruments. Furthermore, there is a growing demand for evaluation indices for services that should be provided for uses of the rehabilitation medical instruments. In order to evaluate rehabilitation medical instrument designs in this study, the basic index for design evaluations shall be identified to search for assessment plans. Through this, new evaluation indices will be deduced through discussions and analysis of rehabilitation medical experts, biomedical engineers, and designers. The results of this study are summarized as follows. First, the existing design evaluation indices were collected and analyzed to construct 10 rehabilitation medical instrument design evaluation indices and 44 sub-evaluation items. These will be important evaluation standards for designing rehabilitation medical instruments in the future. Second, the design evaluation indices that must be taken into consideration when developing health care rehabilitation medical instruments are the 10 design evaluation indices of usability, cognition, safety, learning, motility, durability, economic feasibility, space, aesthetics and environmental aspects. Third, design evaluation indices of environment, space, cognition, usability, economic feasibility and aesthetics are indices that must be taken into consideration for product design, while learning, safety, motility and durability are factors that must be given special consideration for rehabilitation medical instrument design evaluation indices. Fourth, if existing product design evaluation indices placed importance on environment, space, cognition, usability, economic feasibility and aesthetics of products for design evaluation indices, rehabilitation medical instrument design evaluation indices placed importance on learning, safety, motility and durability on top of usability and economic feasibility, which are the differences between the design evaluation indices of rehabilitation medical instrument and other product designs. The 10 rehabilitation medical device design evaluation indices and 44 sub-evaluation items were carried out in this study. This research is only on the overall rehabilitation medical device design evaluation indices. In future research, the evaluation indices will be applied in the actual rehabilitation medical design device through production of prototypes, while making revisions and supplementations where necessary.

• Tuberculosis and Respiratory Diseases
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• v.70 no.3
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• pp.199-205
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• 2011

Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second ($FEV_1$), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), $FEV_1$ and single breath diffusing capacity ($DL_{co}$) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, $FEV_1$ and $DL_{co}$ scores, with more social discussion included.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.15-41
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• 2001

Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.