• Title/Summary/Keyword: clinical skills

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A Study on the Administrative Enhancement for Health Center Activities (보건소(保健所) 행정(行政)의 기선을 위(爲)한 연구(硏究))

  • Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.3 no.1
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    • pp.97-110
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    • 1970
  • This survey was conducted to evaluate not only the present status of health center directors-their personal histories, their will to private practice in the future, their responses to governmental policies, -but also the distribution of doctorless myons, budget and subsidy, and director's opinions to the enhancement of health center activities. This survey questioned 116 health center directors and 16 health personnel from August to October of 1970 and obtained the following results; 1) The average ages of directors of kun, city, and total health centers were $43.2{\pm}7.8,\;42.1{\pm}7.7,\;and\;42.9{\pm}10.3$ respectively. 2) The average family sizes of directors of kun, city, and total health centers were $5.6{\pm}2.7,\;5.6{\pm}2.1,\;and\;5.6{\pm}2.6$ respectively. 3) Directors holding M. D. degrees were 79.3%, those holding qualified M. D. degrees ('approved director') were 20.7%. 4) M. P. H., M. S., and Ph. D. holders were 6.0%, 6.1%, and 4.3% respectively. 5) The average duration of present directorship in kun and city were 30.2 months and 20.4 months respectively. 6) The majority of directors had been employed in related fields before assuming current position : directorship at other health center 26.7%, army 22.4%, health subcenter 21.6%, private practice 19.0%. 7) Average length of directorship is 41.8 months. Average length of public health career, including health subcenter and present position, is 56.5 months. 8) Both rural and urban experience in health centers for regular directors is 16.3% and for approved directors, 12,5%. A total of 15.5% of all survey directors had experience in both rural and urban health center. 9) A total of 70.7% of health center directorships were staffed by local doctors. 10) Nearly 40% wanted to quit the directorships within 3 years and 60.3% had already experienced private practice. 11) Of the regular directors 17.4% felt strongly about devoting their lives to public health fields, but only 4.1% of the approved approved directors felt so. 12) There wire 432 doctorless myons among 996 respondent myons and 4.5 doctorless myons per kun. 13) The percentage of doctorless myon by Province are as follows, Cholla buk-do 57.2%, Cholla nam-de 55.0%, Kyungsang nam-do 52.0%, Kyungsang buk-do 49.7%, Chungchong but-do 42.4%, Kyonggi-do 32.9%. Cheju-do 30.8%, Kangwon-do 25.8%. 14) Two thirds of health critters have experienced the abscence of the director for a certain period since 1966 and the average span of the abscence was 18.2 months. 15) The percentage of doctorless myons increased proportionally with the span of the director's abscence. 16) The average budgets of health centers, kun, city and ku, were $W15.03\;million{\pm}W4.5\;million,\;W22.03\;million{\pm}W17.80\;million,\;W13.10\;million{\pm}W7.9\;million$ respectively. 17) Chunju city had the highest health budget per capita(W344) while Pusan Seo ku had the lowest(W19). 18) Director's medical subsidies are W30,000-50,000 in kun, and roughly W20,000 in city. 19) The older of priority in health center activities is T.B. control(31.1%), Family Planning and M. C. H.(28.0%), prevention of acute communicable disease and endemic disease (18.2%) and clinical care of patients(14.3%). 20) Nearly 32% opposed in principle the governmental policy of prohibiting medical doctors from going abroad. 21) Suggestions for immediate enhancing the position of director of health centers and subcenters: (1) Raise the base subsidy (48.2%), (2) Provide more opportunities for promotion (20.7%), (3) Exemption from army services(12.1%), (4) Full scholarship to medical students for this purpose only (7.8%). 22) A newly established medical school was opposed by 56.9% of the directors, however 33.6% of them approved. 23) Pertaining to the division of labor in Medicine and Pharmacy, the largest portion (31.9%) urged the immediate partial division of antibiotics and some addictive drugs to be given only by prescription. 24) More than half wanted a W70,000 level for the director's medical subsidies, white 36.2% stated W50,000. 25) Urgently needed skills in the kun are clinical pathologist (38.6%) and doctor (health center director) (25.5%); while in the city nurse (37.1%), doctors(clinical)(31.4%) and health educators(14.4%) are needed. 26) Essential treatment for the better health center administration; raising the base subsidy (22.7%), obtaining the power of personal management (19.3%) and the establishment of a Board of Health (14.3%). etc.

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A study on educational need of nurses for home care (간호사의 가정간호를 위한 교육요구 분석)

  • Moon Jung-Soon
    • Journal of Korean Public Health Nursing
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    • v.5 no.2
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    • pp.5-25
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    • 1991
  • This study was conducted from July to December 1990, in order to diagnose nurses' educational need for home care. The study subjects consisted of 145 nursing educators, and the 3 groups of nurses, namely 250 senior nursing students of diploma and collegiate program, 235 health center nurses, 521 university' hospital nurses in Seoul. Four types of questionaires were formulated by Delphi method. Two questionaires for the nursing educators were designed to measure their expectations of nurses' knowledge and of their skill for home care, and another two questionaires for the nurses to measure their actual home care knowledge and skill. The results of the study were as follows : 1) The mean scores of educators' expectation for home care knowledge were 17.68 for the care of dependence on medical equipment, 17.44 for the care of mobility impairment patient, 16.56 for the care of cardiopulmonary impairment patient, 16.40 for the care of nutrition and elimination impairment patient, '1.20 for the care of psychiatric disorder patient and 9.03 for the care of cancer and terminally ill patient,. 2) The mean scores of nurses' home care knowledge tested by 20 items were 14.36 for the care of mobility impairment patient, 13.28 for the c8;re of dependence on medical equipment, 13.78 for the care of cardiopulmonary impairment patient, 12.92 for the care of nutrition and elimination impairment patient, and those of tested by 10 items were 7.08 for the care of psychologic disorder patient, 7.80 for the care of cancer and terminally ill patient. The sum of means marked 69.23. As for the nurses' home care knowledge categorized by tasks in terms of the group, significant difference were shown in the care of mobility impairment(P=0.00), cancer and terminally ill(P=0.03), nutrition and elimination impairment(P=0.00) and psychologic disorder patient(P=0.00). No significant difference were shown in the care of dependence on medical equipment and cardiopulmonary impairment patient. 3) Regard to educational need of nurses' home care knowledge categorized by task according to the group it was found that all sampled nurses had educational need in the care of mobility impairment, dependence on medical equipment, cardiopulmonary impairment, cancer and terminally ill patient. It was found that health center nurses had educational need in the care of psychologic disorder. No educational need were found in the health center nurses whose career less than 2 years, in the care of mobility impairment, cardiopulmonary impairment and psychologic disorder patient, and in those of career with 2-5 year in the care of psychologic disorder patient. No educational need were found in the hospital nurses whose career more than 15 years, in the care of cardiopulmonary impairment patient and in those of career with 11-15 year, in the care of cancer and terminally ill patient. 4) The mean scores of educators' expectation for home care skill measured by Likert 5 points scale were 4. 21 for assessing, 4.49 for planning, 4.29 for basic care, 4.42 for curative care, 4.40 for rehabilitative care, 4.36 for emergency care, 4.53 for medication, 4.31 for nutritional care, 4.32 for other means for care, and 4.38 for evaluation. 5) Regard to nurses' home care skill measured by Likert 5 points scale of self evaluation, there was a significant difference between the nurses' home care skill and group(P=0.00l). The higher scores reported by students were vital sign checking and basic care while the scores of below medium were curative care and emergency care. The higher scores reported by health center nurses were vital sign checking, other means for care and care of specimen while the scores below medium were curative, emergency and nutritional care. The higher scores reported by hospital nurses were vital sign checking, care of specimen and basic care, while the score below medium was emergency care. 6) Regard to educational need of nurses' home care skill by nursing process activity according to the group it was found that health center nurses had educational need in all nursing skills including vital sign checking, care of specimen, health assessment, socioeconomic assessment, nursing diagnosis, care plan, basic care, curative care, rehabiitative care, psychological care, emergency care, medication, nutritional care, other means for care and evaluation. And students had educational need in all nursing skills except vital sign checking, and hospital nurses had educational need in all nursing skills except vital sign checking, care of specimen and basic care. 7) In short, the result of this study suggests that the curriculum should be organized in accordence with nurses' educational background and their career for the education of nurses for home care. It should be considered to develop the short term educational program focused on curative and rehabilitative care for health center nurse or community health nurse practitioner and which was focused on family care for hospital nurse. Concerning about this field practice for home care nurse, they are required not only community practice but also . clinical practice including emergency, curative and rehabilitative care.

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The Korean Practice Parameter for the Treatment of Attention - Deficit Hyperactivity Disorder(II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안(II) - 진단 및 평가 -)

  • Cheon, Keun-Ah;Kim, Ji-Hoon;Kang, Hwa-Yeon;Kim, Bung-Nyun;Shin, Dong-Won;Ahn, Dong-Hyun;Yang, Su-Jin;Yoo, Han-Ik;Yoo, Hee-Jeong;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.10-15
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    • 2007
  • Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

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The Effect of Simulation-based Training on the Competence of Basic Life Support of the students Emergency Medical Technology (시뮬레이션 교육이 응급구조과 학생의 기본소생술 수행능력에 미치는 영향)

  • Ko, Chong-Hyeon
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.31-45
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    • 2007
  • Purpose : The simulation-based training in this research consists of theory and practice. Before the training, target students took a test on the competence of basic life support. Based on the result, they were separated as the subject group and comparison group. The simulation-based training was offered to the subject group and the traditional training was given to the comparison group. As soon as the training was completed, a follow-up study was conducted. Methods : This research aimed to figure out the effect of the simulation-based training on the competence of basic life support of the students Emergency Medical Technology. To this end, the nonequivalent pretest-posttest-quasi-experimental design using a comparison group was conducted. Results : The first hypothesis was that 'The group who took the simulation-based training would show higher points in the knowledge of basic life support than the group who took the traditional training.' Among those who took prior theory education, the subject group showed $69.38{\pm}20.43$ points while the comparison group showed $76.25{\pm}21.33$ points(t = -0.658, p = 0.531). Among those who took prior theory education and training, the subject group showed $82.86{\pm}10.86$ points while the comparison group showed $79.33{\pm}15.45$ points(t = 0.705, p = 0.487). Since there were no significant statistical differences between the two groups, the first hypothesis didn't hold. It showed few differences between the two training methods. The second hypothesis was that 'The group who took the simulation-based training would show higher points in the basic life support skills than the group who took the traditional training.' Among those who took prior theory education, the subject group showed $65.75{\pm}7.66$ points while the comparison group showed $46.88{\pm}13.48$ points(t = -3.442, p = 0.004). Among those who took prior theory education and training, the subject group showed $79.50{\pm}11.40$ points while the comparison group showed $62.13{\pm}11.44$ points(t = 4.091, p = 0.000). Since there were significant statistical differences between the two groups, the second hypothesis held. It showed substantial differences between the two training methods. Conclusion : The group who took the simulation-based training showed more positive effects on the competence of basic life support than those who took the traditional training. Therefore, it is confirmed that the simulation-based training is a useful method to improve clinical work performance of the students Emergency Medical Technology.

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The factors to identify high risk family (고위험가족 선별을 위한 위험요인 분석)

  • 방숙명
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.351-361
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    • 1995
  • The main purpose of the study is to identify critical risk factors for development of a family assessment tool to screen high risk family. This study used a conceptual framework of family diagnosis developed by Eui-sook Kim's (1993) and analyzed risk factors to identify the high risk family. As employing a explorative and methodological study design, this study has four stages. 1. In the first stage, 34 family risk factors were identified by doing intensive literature review on conceptual framework of family diagnoses. 2. In the second stage, above risk factors were tested for content validity by consultation with 29 persons in community health nursing, nursing education, family theory, and social work. 3. In the third stage, existing survey data was used for actual application of the identified risk factors. The survey data used for this purpose was previously collected for the community diagnosis in a region of Seoul. At the final stage, through the comparison between high risk and low risk families, initially identified 34 risk factors decreased to 25 risk factors. Among 34 risk factors, six factors did not agree with content of questionnaries sand two factors were not significant in differentiating the high risk family Also, two risk factors showed high correlation between themselves, so only one of those two factors was chosen. As a result, twenty-five risk factors chosen to identify the high risk family are following ; 1. A single parent family due to divorce or death of a partner, or unweded single mother 2. A family with an unrelated household members 3. A family with a working mother with a young child 4. A family with no regular income 5. A family with no rule in family or too strict rules 6. A family with little or no support from other lam-ily members 7. A family with little or no support from friends or relatives 8. A family with little or no time to share with each other 9. A family with family history of hypertension, diabetus, cancer 10. A family with a sick person 11. A family with a mentally ill person 12. A family with a disabled person 13. A family with an alcoholic person 14. A family with a excessive smoker who smokes more than 1 pack / day 15. A family with too much salt intake in their diet. 16. A family with inappropriate management skills for family health 17. A family with high utilization of drug store than hospital to solve the health problems of the family 18. A family with disharmony between husband and wife 19. A family with conflicts among the family members 20. A family with unequal division of labor among family members 21. An authoritative family structure 22. A socially isolated family 23. The location of house is not residential area 24. A family with high risk of accidents 25. The drinking water and sewage systems are not hygienic. The main implication of the results of this study is clinical use. The high risk factors can be used to identify the high risk family effectively and efficiently. The use of high risk factors woule contribute to develop a conceptual framework of family diagnosis in Korea and the list of risk factors need to be revised continuously. Further researches are needed to develop an index of weight of each risk factor and to validate the risk factors.

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Professional Self-concept of Psychiatric Mental Health Nurse Practitioners in Hospitals and Public Health Centers (병원과 지역사회에 근무하는 정신보건간호사의 전문직 자아개념)

  • Yang Soo;Yu Sook Ja
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.351-362
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    • 2001
  • This study was conducted to investigate and compare the degree of professional self -concept (PSC) of the psychiatric mental health nurse practitioners (PMHNP) in hospitals and public health centers and to identify the factors predicting PSC of them, in order to provide basic data for developing PSC increasing program PSC. The 355 PMHNP were sampled from the university or general hospitals. mental hospitals, community mental health centers and public health centers across the country. The scales used in this study were PSCNI by Arthur (1990), PSI by Heppner & Petersen (1982) and the Index of work satisfaction by Slavitt et al. (1978). The results of the study were as follows : 1. The average item score of PSCNI of PMHNP in hospitals was $2.83\pm0.27$, and that of PMHNP in public health centers was $2.76\pm0.28$. There was significantly different between two groups (p=0.0202) 2. A comparison of the scores for the dimensions of the PSCNI were as follows ; the mean item score of professional practice of nurses in hospital was $2.90\pm0.30$, and that in public health centers was $2.83\pm0.35$. There were significant differences between two groups in the scores of professional practices (p=0.0315), leadership (p=0.0071) and skills (p=0.0231). 3. There were significant differences between two groups according to education (p=0.0057) with no significant interaction effect of group and education. 4. Job satisfaction (JS) was the highest factor predicting PSC of PMHNP in hospitals $(34.5\%)$, and problem solving inventory score (PS) was the highest factor predicting PSC of PMHNP in public health centers $(33.6\%)$. JS and PS accounted for $42.6\%$ in PSC of PMHNP in hospitals. and PS, JS, age, marital status, religion, and career accounted for $57.6\%$ in PSC of PMHNP in public health centers. In the light of these results. to gam the professional self-concept. nurses should be educated continuously through role modeling in clinical nursing and research. Also, nurse educators and administrators need to develop programs and policies to increase professional self-concept of nurses, particularly of community PMHNP.

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Provisional National Nutrition Targets and Strategies for Health Promotion of Koreans (국민건강증진을 위한 영양 부문의 2000년 잠정목표와 전략)

  • 김혜련
    • Korean Journal of Community Nutrition
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    • v.1 no.2
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    • pp.161-177
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    • 1996
  • This study attempts to propose a priority of national nutrition targets and strategies for health promotion by the year 2000 in Korea, as a part of the task set for national health promotion objectives and strategies. Among all of the important health issues raised, ten were chosen, nutrition was one priority area. In the first part, the current status of the nutrition-related health problems and risk factors are reviewed, in conjunction with the newly arisen health phenomena, such as changes in prevalence of lifestyle disease and causes of death, changes of food consumption patterns in our country. In the second section this study suggests six feasible national nutrition targets, eight implementing strategies and current major tasks on the basis of the assessment of present status and in consideration of the other health promotion goals and strategies, with reference to that of other developed countries. The main targets and strategies are suggested as follows ; Firstly, the national nutrition monitoring and surveillance system should be established for identifying the nutritional problems for our people, and current National Nutrition Survey is a strong need for improvement to a more comprehensive and reliable one. Secondly, effective administrative mechanism should be operation at national level for the development of nutrition policy. Ministry of Health and Welfare (MOHW) as well as local health department must be remarkably renewed and strengthened the nutrition section. And it is recommended that MOHW organize and operate “The Council of Nutrition”, in which all government authorities related with foodstuffs and nutrition would incorporated. The Council of Nutrition would act as an adjustor as well as a coordinator in nutrition related policy-making. Thirdly, healthy eating pattern will be supported by activities of introducing a nutrition labeling for providing consumers with the necessary information and skills for food selection. Fourthly, nutrition education, and nutrition intervention programs will be carried out in various settings such as health centers, schools, and clinical fields and workplace. Fifthly, the current dietary guidelines shall be continuously improved in detail, and publicly circulated to particular levels of people by age group and by health condition. And finally, researches and epidemiological studies particularly in regard to diet for development of chronic diseases are needed for more investigation and up-to-date national health and nutrition data should be collected with the support and cooperation from the various medical professional teams . (Korean J Community Nutrition 1(2) : 161-177, 1996)

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Psychometric Properties of the Persian Version of Satisfaction with Care EORTC-in-patsat32 Questionnaire among Iranian Cancer Patients

  • Pishkuhi, Mahin Ahmadi;Salmaniyan, Soraya;Nedjat, Saharnaz;Zendedel, Kazem;Lari, Mohsen Asadi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10121-10128
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    • 2015
  • Background: Cancers impose an increasing burden on health of the populations and individuals, but little is known about cancer patient satisfaction with care. The aim of this study was to assess the psychometric properties of the Persian version of European Organisation for Research and Treatment of Cancer (EORTC) In-Patsat32, as a recently developed questionnaire to assess cancer patient satisfaction with care and information provided during hospital admission. Materials and Methods: Complying with EORTC protocols, the Persian version of Inpatsat32 was translated and piloted in a small group of patients, then applied to 380 cancer patients admitted to different oncology wards in Tehran. Validity (convergent, discriminant, and divergent) and reliability of the tool was assessed through using multitrait analysis, factor analysis, intraclass correlations, Chronbach's alpha and test-retest (on a sample of 70 patients). Results: Good acceptance and high sensitivity of the questionnaire with low floor and ceiling effects were recognized, indicating power of the instrument to detect differences between groups with heterogeneous levels of satisfaction. Multitrait scaling analyses supported the convergent validity of the majority of scales (correlation coefficient >0.4) and favorable discriminant validity (item own scale correlation >0.8). There was no correlation between In-patsat32 scales and the EORTC-C30, which measures different concepts, confirming divergent validity of the tool. Internal consistency for all domains was high (${\alpha}$ >0.70) except for the hospital access score and the test-retest reliability was excellent (r=0.86-0.96). There was a weak responsiveness to change except for nurses technical skills. Principle component analysis confirmed five domains with much improved internal consistency (${\alpha}$ >0.9). Conclusions: The Persian version of the EORTC-in-patsat32 module is a reliable and valid instrument to measure cancer patient satisfaction with care received during their hospitalization period and can be utilized in clinical cancer research.

Effects of dental hygienist's job satisfaction and communication ability on communication within the organization (치과위생사의 직무만족도, 의사소통 능력이 조직 내 의사소통에 미치는 영향)

  • Han, Soo Yeoun;Im, Ae-Jung;Lim, Hee-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.154-159
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    • 2020
  • In this study, we set the occupational satisfaction and communication ability of clinical dental hygienists as the main variables, and investigated the factors that affect communication within the organization to improve the work of dental hygienists. Self-reporting questionnaires were administered to 200 dental hygienists working in dental hospitals and dental clinics in Seoul and Gyeonggi Province from May 18, 2019 to June 12, 2019. We analyzed the data with Pearson correlation analysis and multiple regression analysis. The significance level was set at 0.05. Research results: Job satisfaction (r=0.193, p<0.05) and communication ability (r=0.404, p<.001) showed a significant positive correlation with intra-organizational communication, and individual communication ability (β=0.461, P<.001), which was found to have a significant effect on communication within this organization. Therefore, in order to improve the communication skills of dental hygienists, they should be proud of their work as professionals, enhance their job satisfaction, and be able to have a clear expression of their own intentions and effective dialogue. Efforts should be made to provide opportunities such as opening related lectures during internal education and maintenance education.

The Effect of Group Treatment Based on Occupational Therapy for Children : A Systematic Review (아동 그룹 작업치료의 효과 : 체계적 고찰)

  • Lee, Ga-Young;Lee, Ji-Ho;Kim, Bo-Ram;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.14 no.2
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    • pp.33-45
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    • 2016
  • Objective : The purpose of this article is to study the effectiveness of a group occupational therapy for children via systematic review, and to provide clinical evidences. Methods : The systematic review initially included articles in Pubmed, Ovid, RISS, KISS, and DBpia, published until 2014. Total 14 articles have been chosen, using different keyword of each domestic/foreign studies. Selected articles were divided depending on the level of evidence, and eventually been organized into group PICO (Patient, Intervention, Comparison, Outcome). Results : The results indicated that there are more diagnosed children than normal in participants and especially children with sensory integration disorder (28.6%) appeared to be the most common. In intervention, group sensory integrative intervention had the largest frequency, and instruments measuring social skills were used most for analyzing the intervention results. The effectiveness of interventions showing statistically significant results were 40.7% of Total. Conclusion : Group occupational therapy for children should be provided to various diagnosis with widely better quality of interventions providing the enough support for the evidence level.