• Title/Summary/Keyword: The Reality First and the Body After

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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Dual Faces of Nationalism reflected in Contemporary Korean Art and Society (현대 한국미술과 민족주의란 두 개의 얼굴)

  • Choi, Tae-Man
    • The Journal of Art Theory & Practice
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    • no.4
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    • pp.145-180
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    • 2006
  • In Korea, nation and nationalism are undeniable justice, absolute virtue and moreover system of desire. From the late Chosun Dynasty when the Korean Peninsula had to survive from the critical situation of being the arena of competition, and through the colonial period under Japanese imperialism, nationalism became stronger as a logic of survival. The policy of seclusion under closed and exclusive nationalism that didn't recognize the world situation well enough, eventually gave more pain to the nation. Nationalism in colonial Korea which was as reformed nationalism and on the other hand, as intransigent, resisting nationalism. Since the purpose of this writing is not for clarifying the argument raised on Korean nationalism, there is no use mentioning how it went with the change of time. But we have to focus on the fact that the word 'nation' which appeared under the influence of popular revolution and capitalism meaning 'a group of people', was translated and understood as a racial concept for strengthening the unity of 'single-race nation with five thousand years' history. First of all, there is nationalism used to fortify the system. 'The Charter of National Education' and 'The Pledge of Allegiance' were ornaments to intensify the ruling ideology and dictatorship to militarize entire South Korea for 'settling Korean democracy' professed nationalism. Also, another ruling ideology armed with 'self-reliance' put North Korea into the state of hypnosis called nationalism. Nationalism, claiming 'nation' outwardly, but in reality, being an illuminating, instructing ideology isolating each other was indeed a body with two faces. This made 'nation' in Korea mysterious and objective through work such as. The statue commemorating patriotic forefathers' and picture of national records' in South Korea art. Nationalism used to strengthening the system encountered the magical 'single-race' and made 'ghost' being an extreme exclusion to other nations. We can find pedigreed pureness not allowing any mixed breeds from the attitude accepting western art -via Japan or directly- and making it vague by using the word Korean and Asia. There's nationalism as a resistant ideology to solidify the system on the other side. It came out as a way of survival among the Great Power and grew with the task of national liberation to became as a powerful force facing against the dictatorship dominating South Korea after the liberation. This discussion of nationalism as a resistance ideology was active in 1980s. In 1980, democracy movement against the dictatorship of 5th Republic originated from military power which came out suppressing the democratic movement in Gwangju, spread out from the intellects and the students to the labors, farmers and the civilians. It is well known that the 'Nation-People(Minjoong)'s Art Movement could come out under this social condition. Our attitude toward nationalism is still dual in this opening part of 21st century. On one hand, they are opposing to the ultra-nationalism but are not able to separate it from nationalism, and on the other, they have much confusion using it. In fact, in a single-race nation like Korea, the situation of being nationalism and jus sanguinis together can cause dual nationalism. Though nationalism is included in the globalization order, it is evidence that it's effective in Korea where there are still modern fetters like division and separation. In particular, in the world where Japan makes East Asia Coalition but exposed in front of nationalism, and China not being free from Sinocentrism, and American nationalism taking the world order, and Russia fortifying nationalism suppressing the minority race after the dissolution of socialism, Korean nationalism is at the point to find an alternative plan superior to the ruling and resisting ideology.

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A Study on the Entrance Rituals seen in the 『Jeon-Gyeong』 (『전경』에 나타난 입문의례에 관한 연구)

  • Kim, Tae-su
    • Journal of the Daesoon Academy of Sciences
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    • v.24_2
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    • pp.85-115
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    • 2015
  • The Reordering of the Universe(天地公事) pursuing the Latter world(後天)'s ideal world while denying the Former world(先天) is composed of enormous rituals. The Dosu(度數) is formed through these rituals and the world is transformed according to the Dosu. The people who follow the Sangje(上帝), the subject of this universe reordering and also participate in the Reordering of the Universe are called as the followers. The follower group can be said as a ritual group in the aspect that they participate in the ritual for the Reordering of the Universe. They not only observed the rituals but also actively participated in them, so took certain roles in forming the Dosu. That is, they performed certain, given roles in developing the rituals, or actively proposed their ideas under the Sangje's leadership, and participated in the process realizing the Dosu. Therefore it can be said that they were a group initiatively participating in the process overcoming the Former world's Sangguk(相克) world, and making the latter world's ideal world. It seemed that the followers at that time might have gone through a certain entrance ritual process in order to join in such a follower group. The 『Jeon-Gyeong』 recorded the entrance rituals of a man called as Cha Gyeong Seok among tremendous followers relatively in detail. According to the 『Jeon-Gyeong』, he first had to get a unique test in the entrance process, and the test was proceeded in several stages: the wisdom test reflecting the Sangje's unusual intelligence, the patience test to endure physical, psychological pains for the great ethic, and the test to evaluate the testee's ability to give up past oneself and to follow the Sangje with a new body & mind. In the process separating himself from the past his appearance, Gyeong-Seok, the candidate to enter, faced a liminal situation, and then performed the incorporation rite. In this process, the purification rite going him out of the past relationship of benefits & grudges was performed, and he was given the regulations to comply as a member of the follower group. Through such serial processes, his entrance in the follower group was allowed. What requested to the candidate in this entrance process was the severance from one's past. For that, the candidate was needed to go out of his past life habits, to free from the relationship of benefits and grudges, and to sever him from his past faults. Such severance was the precondition for him to go out of the Former world's negative reality and to break from the Sanggeuk habits. Another thing requesting to the candidate as well as the severance from his past was to establish a new ideal. The new ideal should be matched with the ideal of the Reordering of the Universe whose main ideology was the Haewon-Sangsaeng(解冤相生). Such ideal can be said as the driving force to proceed toward the new ideal world of Latter World. And the candidate was requested to purify his mind and to participate in the Universe Fair Judgement (天地公庭). That can be said as an important condition for the new member directly to participate in the ritual of the Reordering of the Universe dramatically transforming the world. Finally, the candidate was given the regulations for his ascetic practice(修道) as well as his participation in the Reordering, and was requested to comply them. After becoming a member of this follower group, one had to practice his asceticism through the compliance with such regulations and the training of mantras(呪文) in order to accomplish the goal called as Dotong(道通). By fulfilling these requirements, the newly entered member could have the qualification to perform a certain role in the ritual of the Reordering of the Universe, and could accomplish his religious ideal.