• Title/Summary/Keyword: caring situation

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Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.5-23
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    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.

A Study on How to Provide Support to Poor Single Families based on Case Studies (저소득 한부모가정, 사례에 비추어 본 지원방안 연구 : 건강가정지원센터 활용을 중심으로)

  • Lee Seung-Mie;Kim Seon-Mi
    • Journal of Family Resource Management and Policy Review
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    • v.9 no.4
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    • pp.95-112
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    • 2005
  • The purpose of this study is to identify the characteristics and the limits of, as well as, Propose an improvement of, the government based policies that support poor single families. For this purpose, this study has analyzed the government based supporting policies for poor single families into four different aspects; income support, dwelling support, medical support, and child-caring support. Also, in order to analyze the situation of the poor single family as well as the limits of the government based supporting policies, an in-depth interview has been conducted with 8 personnel (including 7 single parents and 1 social worker). In the final analysis, a total of 5 case studies have been used to identify the characteristics of the government based supporting policies for various poor single families. As a result, it turned out that the economic situation of the poor single families were extremely unfavorable, and the quality of life was extremely low in the aspects of dwelling, nutrition, health child nurturing and education. Therefore, we are proposing the following supporting policies for the improvement of these families' living conditions: increasing income levels, providing job opportunities, securing dwelling places, providing medical support, and implementing child care benefit policies. Furthermore, we are proposing an expansion of the human services provided by the healthy family support center to these poor single families.

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Postmodernism and the Issue of Nursing (포스트모더니즘과 간호의 이슈)

  • 공병혜
    • Journal of Korean Academy of Nursing
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    • v.34 no.3
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    • pp.389-399
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    • 2004
  • Purpose: The purpose of this study was to illustrate the main stream of postmodernism which has influenced theory and research in the nursing science, and then to consider the meaning and value of what the postmodern perspective has meant to nursing science in the 21st century. Method: Derrida and Foucaults philosophical thoughts that characterized postmodernism through the interpretation of their major literature was studied. Based on their philosophy, it was shownhow Derrida's idea could be applied in de constructing the core paradigm in modern nursing science. In terms of Foucault's post-structuralism, reinterpretation of the nursing science in relation to power/knowledge was completed. Result: Postmodernism created multiple and diverse paradigms of nursing theory as well as nursing research. This was accomplished by de constructing the modernism of nursing science which was based on the positivism and medical-cure centralism. Specifically, the post-structuralist perspective revealed issuesaround the relationship of power and knowledge, which dominated and produced modern nursing science. Contemporary nursing science accepts pluralism and needs no unitary meta-paradigm, which can reintegrate multiple and diverse paradigms. Conclusion: In considering the issue of nursing science in postmodernism, it can be summarized as follows: the postmodern thinking discovers and reveals diverse and potential nursing values which were veiled by the domination of western modem nursing science. These were motivated to create nursing knowledge by conversation in interpersonal relationships, which can contribute to practical utilities for the caring-healing situation.

A study on perception of stress and coping patterns of family members of the hospitalized in patients (가족구성원의 입원으로 인한 가족의 스트레스와 대처방안에 관한 연구)

  • Kwon Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.35-52
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    • 1991
  • The purpose of this study was to assess the degree of stress and patterns of coping for that Stressful events on family members because of the hospitalization of the patients. Stress and coping were measured with a tool on the basis of Volicer and Bell's questionnaire. In data collection, the modified 38 items of Volicer's stress scale and Bell's 18 item coping scale were administered. The subjects consisted of 259 family members of general ward-patients in Seoul National University Hospital during April in 1990. They were randomly selected on the basis of relationship of patients; patient's spouse, patient's daughters or sons. The stressors of the family members were ranked as follows; The first rank Stressful events was related to the patient's diseases and pain, the second ones was related ·to caring of their patients and family's psychosocial life. Families used long term coping method significantly more than short term ones. The results indicated that there was no difference in use of coping method between pre and post hospitalization. Finding out more about situation and optimism were the most common coping methods, and the least frequent coping method was the use of drugs. In conclusion, the identification of perceived stress and coping patterns of family members provides useful information for family nursing and aimes at better nursing care for the hospitalized in patients.

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Understanding of Korean Behavior Pattern through Korean Traditional Thoughts. (전통사상속에 나타난 한국인의 행동양식에 대한 고찰)

  • Kim, Moon-Sil;Kim, Sook-Young;Kim, Aee-Lee;Chung, Seung-Eun
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.79-96
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    • 1995
  • A human being as a client has been understood only through a western cultural view so far, now we put forth efforts to set up the concept which is suitable for our korean nursing situation. This paper was reviewed to discover Korean behavior pattern through the concept of the human being in Korean traditional thoughts to keep in pace with above idea and develope the stem of the nursing knowledge. Behavior pattern usually has two aspects, the one is unconscious behavior which conform to old custom and the other is conscious one which abide by a conventional rule. The former was considered through the concept of human being in Tan-kun mythodology, Divination, Tong-hak (Cheondoism) and the latter was Buddism, Confucianism, Sung-ri hak (Human nature and natural Laws), Sil-hak (The rule of Heaven philosophy). Through these traditional thoughts, we can lead Humanity, Present-oriented, Family-focused, Ranking-centered, Fatalism, Projection in Korean behavior pattern and unconscious behavior correspond to the Naturalistic human being, conscious to Societic human being as well. Even though Korean behavior patterns were changed to the times, we found that Korean natural characteristics were remained in the of unconscious-conscious behavior. This point must be considered for caring a client better than anything else in our nursing situiation.

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Issues and Persyectivbes for Research on Living Environment of ‘The Third Age’ -focusing on Social constructionism approach- (제3의 연령기의 공간환경연구를 위한 관점과 쟁점 -사회구성주의적 접근을 중심으로-)

  • Hong, Hyung-Ock
    • Journal of Families and Better Life
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    • v.20 no.6
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    • pp.37-48
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    • 2002
  • Mid of 1980s witnessed the beginning of a new trend regarding the elderly as the Third Age Group, which is capable of positive selection for their later life. These changes are caused not only by the rising cost of caring them as the dependent to the society, but also by paradigm shift from the clinical and biomedical model to political economy and critical gerontology. The paradigm shift is based on the social constructionism as a perspective on the later life. In this communication the development of social constructionism is reviewed as an approach on the living environment for later life through literature survey. Emphases were made on the anti-ageism instead of ageism in the analysis of the social constructionism perspective for living environment in later life. Individual practice, influencing the practice of others, influencing agency policy, and developing theory were addressed and emphasized for the practice of anti-ageism. This study found the importance of the development of the social constructionism perspective on the study and practice regarding living environment for ‘the Third Age’ in Korean situation.

A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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Ethical Argumants and Problems Analysis Related to Induced Abortion (인공임신중절과 관련된 윤리학적 논쟁과 문제 분석)

  • Um, Young-Rhan
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.230-252
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    • 1996
  • Over one million cases of the induced abortion have been conducted annually in Korea. Among those cases, most of all were illegally done, but this has not been addressed in the literature. While Korean Nurse Association Code of Ethics presents the respect for life as one of the basic ideology, it was not dealt enough in nursing education. The purposes of the study were to activate the debate on the issues related to an induced abortion ; to introduce the related ethical theories ; and to seek the solution of the ethical problems, which will eventually result in establishing the morality of nursing practice. The ethical theories of an induced abortion have traditionally addressed two extreme perspectives ; the conservatives who emphasize the sanctity of human life and the right of life that will never ethically allow the killing fetus ; and the liberalists who insist the right to choice for women to control their body. Since these extreme theories has not been helpful to solve the ethical problems, the recent trend is leading to the modified theories both from conservative and liberal perspectives. The examples of the theories are the potentiality of fetus(Singer, 1993), the obligation of women to serve their body to fetus(Held, 1987), the Replacement theory (Callahan, 1987), and the Principle of Caring (Gilligan, 1982). The study conducted the indepth interviews with 17 women who experienced the induced abortion and the 6 cases were selected to be analyzed. The cases were analyzed and interpreted by using an integrated case method which was combined of the New Casuisty(Jonsen & Toulmin, 1988 ; Jonsen, 1991) and the Specified Principlism (Richardson, 1990 ; Degrazia, 1992). The result of analysis revealed three types of ethical problems ; (1) the responsibility of taking care of the baby to be born (2) the fear for the condition of the fetus, and (3) the choice of induced abortion as the method of birth control. The findings also revealed the related ethical principles for various situations ; the principle of caring was used for choosing an induced abortion by the subjects ; the principles of the potentiality of fetus and the obligation of women to serve their body were for the consideration for the life of fetus ; and the principle of replacement was utilized for the right to choice for women. The ethical principles related to an induced abortion introduced in the study provided the way to solve the moral problems by applying to the clinical situations for nurses. The study also revealed the possibility of modifying the current ethical theories from the method of applying the principles to the various situation in the study. The modified theories would be more useful to guide the clinical practice with similar ethical problems.

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Refusal of care by chronically and terminally ill patients : An ethical problem faced by nurses (간호사의 간호 제공 의무와 말기 환자의 간호 거부에 관련된 윤리 문제에 관한 연구)

  • 엄영란;홍여신
    • Journal of Korean Academy of Nursing
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    • v.24 no.2
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    • pp.190-205
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    • 1994
  • Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

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An Integrated Review on Main Caregiver's Burden of Elderly in Korean Nursing Home (한국 요양시설 노인의 주 돌봄자 부담감에 대한 통합적 고찰)

  • Kim, Eun Jeong;Sung, Kyung Mi
    • Journal of Digital Convergence
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    • v.17 no.6
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    • pp.267-277
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    • 2019
  • The purpose of this study is to investigate the burden of caring for the care-givers of the elderly in Korea by using an integrated literature review method. A total of 23 studies were analyzed using a search database. When care-givers had higher sense of filial and guilt or more than two diseases, they showed high level of feeling of burden. Also, they had high level of feeling of physical burden by their oldness, service period (especially at the period of 1-3 years). In the feeling of economic burden, they had high level of feeling of burden by their oldness, or elderly's disease periods. The feeling of burden by psychological condition was found in elderly in aged and the beginning of admission of nursing home. The feeling of burden by environment situation was found when the functional status of the elderly was bad. Therefore, we need to concern care-givers's feeling of burden with elderly people in the nursing home. In the future, I believe that the findings of this study will be helpful for development of the intervention program for alleviate burden for the care-giver.