• Research in Community and Public Health Nursing
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• v.29 no.3
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• pp.267-278
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• 2018

Purpose: This study is to investigate working conditions including job stress among visiting nurses in public health centers in Korea. Methods: An social network based mobile survey was conducted in May 2017 (N=936, response rate: 47.0%). Results: The visiting nurses in this study had their average total career as a nurse is 13.7 years. The 68.3% of them were employed in an indefinite term, 17.0% were hired in a fixed term, and 11.0% came from outsourcing. They responded as high job-stress level including inadequate compensation (71.22/100) and job demands (71.91/100). They experienced down-talk (63.4%), swearwords (32.9%), being made a dirty face (39.9%), sexual jokes (30.8%), or being likened or evaluated with their appearance sexually (14.3%). Among the causes of job related conflicts and discrimination, deprived salary level was the most frequent reason (83.4%). The conflicts and discrimination were incurred by government officers (52.4%). There were no significant differences in overall job stress, emotional labor, organizational commitment, violence, and discrimination experience based on their employment types. Conclusion: The differences in working conditions among the non-regular nurses were trivial, and their overall working conditions were poor. It is necessary to improve non-regular nurses' working conditions in order to make up the limitations of the Korean healthcare system which is centered on hospitals.

• The Korean Nurse
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• v.36 no.3
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• pp.49-69
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• 1997

The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

• Korean Journal of Occupational Health Nursing
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• v.6 no.2
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• pp.156-167
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• 1997

In Korea, based on the Revised Law of Occupational Safety and Health a new entity of institution was set up in 1990 to provide occupational health services to SSE in which three sorts of personnel as a team have to be involved. These institutions, in charge of scores to hundreds of workplace area-wide, have been providing occupational health services without payment from employers or employees, and government reimburses through the Occupational Injury Prevention Insurance since 1993. As a service provider, a team is composed of doctors, nurses and industrial hygienists. Undergraduate and postgraduate educations for the SSE occupational health are not specified and the question on the performance of the personnel has been raised. This study was designed to analyze the facilitating factors of and barriers to the performance and its improvement of these personnel. In 1997, the survey was conducted with all 58 institutions. Structured questionnaires were mailed to 200 personnel who were providing the occupational health service for SSE. The response rate was 51.7% for doctors, 58.6% for nurses, and 60.3% for industrial hygienist, respectively. Results are as follows : 1) There is a guideline for occupational service mandated by the government. Under the guideline, the minimum frequency of visiting workplace is assured with six times of doctors, 17 times for nurse and industrial hygienist in a year. There are one doctor for every 200 factories, one nurse and one hygienist for every 100 factories. 2) All respondents have basic qualification for occupational health service. About 16.7%. of doctors are certified in industrial medicine or preventive medicine, and 64.7% of industrial hygienists had first grade certification. Totally 66.7% of personnel have been involved in occupational health for more than one year. 3) As a support system for the performance improvement, 66.3% respond that they have been provided with educational materials, advice related to industrial environment and guidance of MSDS from Korea Industrial Safety Corporation. Most respondents indicate the lack of concern of employers and employees as a main barrier to the improvement of the service. Also they are in the need of the training opportunity more focused on SSE. The Governments policy for SSE is a principal facilitating factor. Training program focused on SSE situation, manpower, technical support, etc. are areas to be improved to have a better occupational health service for SSE in Korea.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.28-38
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• 2019

Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.39-57
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• 1999

Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.151-161
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• 1974

Home visiting as a Public Health Horsing function is believed to be of therapeutic value to, the patient. However, home visiting is time consuming and expensive. Is the gain in knowledge and treatment for patients with Tuberculosis in Korea enough to make the necessary outlay in finances and personnel worthwhile\ulcorner While this study does not attempt to completely answer this question it does, under the following objectives, attempt to answer part of the question. The objectives of the study were to l) ascertain if there is a difference between patients, who receive home visits from the public Health Nurse and those who do not, in the following areas: a) their compliance with medical regimen, b) their ability to answer general questions about Tuberculosis, and c) their compliance with medical advice concerning prevention (B.C.G. immunization) and early diagnosis (contact X-rays), and 2) to determine if there is any correlation between the patient's answers to questions about Tuberculosis and his action both in the areas of treatment and prevention. The patients participating in the study were all newly diagnosed patients at Kwangju Christian Hospital. A control group and an experimental group were selected. The patients in the control group were seen according to the regular schedule at the Kwangju Christian Hospital except that they received no home visits from the Public Health Nurses. The patients in the experimental group were visited on an average of three times during the first two months of their treatment by the investigator, a Public Health Nurse. At the end of two months the patients in the two groups were compared as to compliance both in the treatment and preventive areas. They were also compared according to their answers to a questionnaire regarding both the prevention and treatment of Tuberculosis. The following results were obtained : 1. Patients in the experimental group (68.2%) showed a significantly higher compliance rate for medical treatment than patients in the control group (43.2%). 2. Patients in the experimental group (87.5%) showed a higher compliance rate for B.C.G. immunization than those in the control group (40%). 3. Women patients in the experimental group showed a higher mean score (7.2$\pm$2.6) on the questionnaire than did women in the control group (6.2$\pm$3.4). The results of this study seem to indicate that while home visiting is beneficial to the patient with Tuberculosis as far as treatment is concerned, something more concrete needs to be done if home visiting is to help the patient learn more about Tuberculosis and its prevention. Further study is indicated in the following areas: 1) A similar type of study over a longer period of time involving more subjects and using Korean Public Health Nurses to make the home visits. 2) Study to develop an adequate approach to education considering the problems unique to patients with Tuberculosis living in Korea.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1488-1502
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• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Journal of Korean Academy of Rural Health Nursing
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• v.1 no.1
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• pp.5-10
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• 2006

Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

• Journal of agricultural medicine and community health
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• v.39 no.2
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• pp.94-103
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• 2014

Objective: The purpose of this research was to define the factors influencing turnover intention of customized home health care nurses. Methods: Research participants were 237 nurses who worked in the customized home health care of 33 public health centers in Daegu city and Gyeong-Buk Province. The data were collected by self report questionnaires from July, 1 to August, 30, 2011. The data were analyzed by t-test, ANOVA, correlation coefficient, multiple stepwise regression using the SPSS program. Results: The average score for turnover intention was 3.12 (5 score) and job satisfaction was 2.41 (4 score). The scores for sub-categories of job satisfaction were operational factors, 1.99, personnel factors, 2.03, work factors, 2.64 and relationship factors, 3.04. Marital status, religion, visiting nurses career, employment status, work area were the significant factors related to turnover intention in these subjects. There was a significant negative correlation between job satisfaction and turnover intention (r=-0.354, p<0.001). Significant factors were job satisfaction, marital status, employment status (Cum $R^2$=0.198, F=17.179, p<0.001) that explained 19.8% of turnover intention. Conclusions: Customized home health care nurses management policy which includes job satisfaction and general characteristics of visiting nurses should be established to enhance of quality of customized home health care service.