Purpose: This study was aimed to describe older adults' experiences of living with urinary incontinence and using diapers for its management in long-term care facilities. Methods: Qualitative data were collected through in-depth interviews with 22 participants in long-term care facilities. Content analysis was used to analyze the data. Results: Three themes and six categories were emerged. Participants navigated through those three categories as stages, including the initial stage of confronting the unacceptable reality, transitional stage of physical and emotional suffering, and adaptive stage of accepting the diaper usage as a part of life and hoping improvement. Six categories were feeling terrible with unavoidable use of diapers, being frustrated by nursing staff shortage and unsatisfactory care for urinary incontinence, physical discomfort from of wearing diapers and remaining unchanged, emotional difficulties due to using diapers, accepting and adapting to diaper usage as a part of life, hope for gender-specific quality care for urinary incontinence. Conclusion: The findings suggest that using diapers should not be mandatory to manage older adults' urinary incontinence in long-term care facilities. It is also critical to establish policies to address issues of nursing shortage and financial support for qualitative care to manage urinary incontinence in long-term care settings.
This study attempted to analize nurse's experiences about care giver including nurse's recognition of occupational care giver's existence, the helping part of occupational care giver's activities, problems between occupational care giver and nurse, and correlations between reasons of problems and each variable. The subjects of the study are 218 nurses who are working at general hospitals. The study informations gathered by using structured questionnaire which consisted of 38 items. The reliability of the instrument was cronhach's 0.8310. The collected data was analized by spss program for the statistics of percent, t-test, ANOVA, and Pearson's correlation. The study results were as follows : 1. For the nurse's recognition of occupational care giver's existence 70.2% of nurses(153 nurses) who felt occupaitional care giver's existence was helpful. The result showed 2.20 when transfered to score. 2. Occupational care giver's activities which were helpful to nurses were in order of following : simple serving, personal hygiene, companion of talking, room arrangement, and saftey management. 3. Among 10 items of the problems which nurses having experiences with occupational care givers, 4 items were related with nurses directly. 88.4% of the reasons of the problems were due to lack of occupational care giver's eduction. 4. For the relationships of general characteristics and nurse's reason of problems there was the significant difference in the nurse's status and education. There was the significant difference showed in the group of over status of charge nurse and over college education(T=-2.08, P<0.05, T=-2.13, P<0.01) 5. Correlation between nurse's recognition of occupational care giver's existence and the problems between care giver and the nurse revealed weak relationship (r=0.2002, P<0.01). However, correlation between nurse's recognition of occupational care giver's existence and degree of occupational care giver's helping and also relationship of degree of care giver's helping and problems between these two groups were not statistically significant.
This study investigated behavior problems of toddlers in the day care setting and difficulties of the caregivers due to such behaviors. The subjects were 24 toddlers enrolled in two day care centers and 56 caregivers at day care centers in Seoul. Toddlers were observed and teachers filled out questionnaires. Analysis of the data by $x^2$ and correlations revealed the kind of behavior problems frequently shown by toddlers, sex differences, differences between centers, and the caregivers' points of view regarding the frequency and difficulties of such behaviors.
By examining the experience of residential child care staffs, this study explored the multifaceted aspects of inclusive care and discussed the direction of successful inclusive education implementation in residential child care facilities. Interviews were conducted with 10 care staffs experienced inclusive education at residential child care facilities, and qualitative case study method was used to analyze transcribing data. Care staffs were reluctant to carry out inclusive education. They felt guilty due to not enough care either for disabled or non-disabled children in the process of adapting to inclusive education. They were calling for immediate communication channels to get the necessary support on time. They also recognized needs for professional education for care staffs regarding care of disabled children, and to dispatch special education teachers. It was found that all participants in the study disagreed on three-shift policy. Lastly, the support measures according to the multifaceted aspects of inclusive care in residential child care facilities were discussed.
Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.
Seo, Kyung Hwa;Jung, Yu Min;Kim, Min Ji;Lee, Sun Hee
Health Policy and Management
/
v.24
no.4
/
pp.396-412
/
2014
Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.
With the increasing number of women involved in social activities, beauty industry has flourished. More women than ever before are concerned about make-up, hair care, skin care, and weight control, etc. With the success and commercialization of beauty industry, unconfirmed beauty care services have been introduced in the market. However, the health hazard from diverse beauty care services has not been systematically addressed. This study has the following two purposes: 1) to examine the utilization pattern of diverse beauty care services; and 2) to examine the health hazard from beauty care services. For this study, two major universities located in Seoul area were selected. While 450 female college students were selected from one women's university, the other 450 were from mixed university. Using survey questionnaire, we interviewed with 900 female college students. The results are as follows: As for the beauty care patterns, makeup accounted for 78.6%, Skin care 49.5%, weight/body control 32.0%, hair care 81.5%, and cosmetic operation 14.9%, indicating significant high rates of makeup(x2=9.215, p=0.002) and hair care(x2=4.435, p=0.035) at both mixed and women's universities. The health hazard was measured using four questions. The past studies have not paid special attention to the methodological issue of how to ask health hazard. Depending on how to ask health hazard, the percentage of respondents reporting health problems varied. When the respondents were asked whether or not they had suffered health problems for a short period, over 60% of respondents reported health problems; when they were asked in other ways-1) whether or not they had suffered health problems for a long period, 2) whether or not they had suffered whole body problems, 3) whether or not they had permanent traces on skin due to beauty care activities-, the percentage of respondents reporting health problems dropped substantially to less than 10%, This finding indicates the importance of ‘words’ used in questions. The relationships between health problems and utilization of beauty care services were examined, using χ2 test or t test. We found that there was a significant relationship between health problem and beauty care.
Lee, So Hee;Kwack, Young Sook;Joung, Yoo-Sook;Lee, Soyoung Irene;Kim, Bongseog;Sohn, Seok Han;Chung, Un-Sun;Yang, Jaewon;Bhang, Soo-Young;Hwang, Jun-Won;Hong, Minha;Lee, Yeon Jung;Bahn, Geon Ho
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.25
no.1
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pp.1-5
/
2014
In order to resolve the decline in population due to low birthrates, the South Korean government is expanding its free child care policies with an increased budget. In anticipating the effects and problems of our system, it will be worthy of attention to refer to the child care systems of other countries. In this paper, we reviewed the past and present policies and the current situation of the child care system in North Korea. North Korea started its free child care system earlier than that of South Korea, for the purpose of utilizing the women's labor force and rearing children to be revolutionary men of Juche type (Kimilsungism), in order to construct a communistic society. 'Child Care Education Law', which is the legal foundation of the child care system, regulates institutions for nursery schools and kindergarten and informs people that the country is responsible for support of child care. Despite their interest and progress in both quantity and quality in the child care system until the 1980s, the free child care system was partially disrupted, and discrepancies between ideology and actual situation were revealed due to economic difficulties from the 1990s. Because people's survival and physical health have been threatened, it is barely possible to find any study investigating the effect of institutional child care from early childhood and the instillation of unique ideology by group education from the preschool period on mental health.
Background: Although patients with tuberculous-destroyed lung (TDL) account for a significant proportion of those with chronic airflow obstruction, it is difficult to distinguish patients with airway obstruction due to TDL from patients with pure chronic obstructive pulmonary disease (COPD) on initial presentation with dyspnea. We investigated clinical features differing between (i) patients with TDL and airway obstruction and (ii) those with COPD admitted to the intensive care unit (ICU) due to dyspnea. Methods: We reviewed the medical records of patients with TDL who had a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70% on a pulmonary function test (PFT; best value closest to admission) and patients with COPD without a history of pulmonary tuberculosis (TB) who were admitted to the ICU. Ultimately, 16 patients with TDL and 16 with COPD were compared, excluding patients with co-morbidities. Results: The mean ages of the patients with TDL and COPD were 63.7 and 71.2 years, respectively. Mean FVC% (50.4% vs. 71.9%; p<0.01) and mean FEV1% (39.1% vs. 58.4%; p<0.01) were significantly lower in the TDL group than in the COPD group. More frequent consolidation with TB (68.8% vs. 31.3%; p=0.03) and more tracheostomies (50.0% vs. 0.0%; p=0.02) were observed in the TDL than in the COPD group. Conclusion: Upon ICU admission, patients with TDL had TB pneumonia more frequently, more diminished PFT results, and more tracheostomies than patients with COPD.
Although the number of dual low-income families continues to increase, working mothers are suffering from difficulties from housework and child rearing due to the economic difficulties and poor residential environment. By understanding the needs about community space and child-care support services, this study will look into planning cooperative child-care environments for dual low-income families with infants and children. Through purposive sampling this research targeted 151 dual income families with an average monthly income level of 1-3 in Seoul. The collected data was analyzed by frequency analysis, descriptive statistics, and independent sample t-test using SPSS. The research results are as follows: According to the review, respondents responded positively to cooperative child-care. Out of the 20 general community spaces, the need for an indoor playground, recreation room, day nursery, separate garbage and reading room ranked high. Overall, 21 child-care community spaces and 11 child-care support services were generally rated highly.
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