• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.99-106
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• 1979

Accessibility to medical facilities and personnels has been known as one of important determinants of medical care utilization. This study attempted to identify the effects of medical accessibility in terms of geographical distance and occupational opportunity to the medical utilizations. Two-year-experiences of Yonsei University Health Insurance Cooperatives were used as the sources of data. Out patient utilization patterns of 713 members sampled from 4,352 members of Health Insurance Cooperatives were analyzed in order to identify the effects of medical accessibilities. Findings: 1 Average clinic visit rate of Yonsei Health Insurance is 1.66 per person per year. 2. The utilization rates of geographically more accessible group were 33% higher than that of less accessible group. 3. No marked difference in clinic visit rate were observed between medical and non-medical personnel and their family members. 4. Clinic visit rates among occupationally accessible group were slightly higher than those of less accessible. The utilization rate was more sensitively changed by the insurance policy changes in occupationally accessible group.

• Korean Journal of Human Ecology
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• v.23 no.5
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• pp.773-787
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• 2014

The purposes of this study were to examine effects which work events and affective reaction were experienced by employees on job satisfaction and service quality in local healthy family support center for family health enhancement. For the purpose, survey were conducted with employees working in 56 local healthy family support centers in Seoul and Gyeonggi region, and final data were resulted from analysis of 319 examines of those employees. The results of this study were as follows. First, work events had a significant effect on the affective reaction. Second, affective reaction had a significant effect on the job satisfaction. Third, job satisfaction had a significant effect on the service quality. Fourth, affective reaction worked as mediators between the work events and job satisfaction, affective reaction and job satisfaction worked as double mediators between work events and service quality. Based on those findings, we can propose practical and political implications towards improving service quality considering the work experience of personnel in the healthy family support center.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.23 no.1
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• pp.25-33
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• 2016

Purpose: This study aimed to survey caregivers of patients with Neuromuscular Rare and Incurable Disease (NRID) using invasive home mechanical ventilator (HMV), in order to compare the incident rate of pneumonia by tracheal suction procedures used. Method: Participants were 99 family caregivers of NRID patients using HMV. Participants were given a questionnaire consisting of 12 demographic items, 10 items about disease and HMV related characteristics, 11 items about tracheal suction procedures, and 2 items about the incidence of pneumonia. Data were analyzed using chi-square tests and t-tests. Results: The items that predicted the incidence of pneumonia were "change of irrigation saline every suction" (p=.047), "use of aseptic catheter every suction" (p=.004), and "instillation of normal saline before suction" (p=.027). In addition, these items were 47.4%, 51.4%, and 38.8% respectively. Conclusion: Family members caring for NRID patients with invasive HMV should be educated about tracheal suction, especially the necessity of changing irrigation saline after every suction, using the aseptic catheter for every suction, and instillation of normal saline before suction. Medical personnel such as home care nurses should periodically check tracheal suction procedures, and re-educate family caregivers when necessary.

• Journal of Society of Preventive Korean Medicine
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• v.2 no.1
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• pp.31-43
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• 1998

The ultimate goal of national health promotion services is the improvement of quality of life and health longevity through the implementation of health promotion services. The approach strategy for national health promotion summariged as follows: 1) A model for health promotion should be developed by the level of government. 2) Roles and functions between central government and autonomous local governments should be defined to carry out the health promotion services effectively. 3) New manpower for health promotion such as health educator should be trained and activated at hospitals, health centers, industries, school, and related community agencies. 4) School health education should be strengthened in order to teach: various health subject(smoking & alcohol, drug abuse, accident and safe, nutrition, environmental pollution and preservation, population & family planning, personnel hygiene, physical growth, stress, sex education, communicable disease, physical exercise etc) students through appointing health teachers at school base. 5) Health promotion services in industries should be activated using manpower such as health educator, exercise instructor, dietist and counsellor, 6) Health promotion services for the elderly should be activated. 7) Health screening services in the medical insurance and his/her family should be activated for health promotion services. 8) Health education material development center for health promotion should be established and the materials should be made to distribute to related groups, agencies and institutions (health conte.5, hospitals, schools, pharmacies, industries etc). 9) The pilot health promotion center in each automous local governments(large cities, provinces, Guns and Gu level) should be established and operated for community people. 10) The mass media such as TV, radio, newspapers and magazines should be used effectively. 11) Periodic evaluation of health promotion services should be carried out in order to help effective and successful planning for community health promotion in the future.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.225-238
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• 2002

The purpose of this descriptive study was to assess sexual orientation and Knowledge and attitudes with regards to AIDS in military personnel, and to provide basic data for developing a further sex education program for them. The data were collected in June 2002 on 242 service members of A Branch of the Ground Army located in Chung-Chung Do Region. They responded to a survey questionnaire that consisted of 68 items: 14 items on sexual orientation. 39 items on knowledge about AIDS, and 15 items on attitudes toward AIDS. The data were analyzed using SAS program. The study results are as follows: 1. Sexual orientation of the military personnel 1) In terms of sexual orientaion, harassment and assault, only $26.4\%$ of the subjects responded as, 'know well'. Appropriate awareness of the legal liability was reported by $21.6\%$ of the subjects regarding sexual harassment and $78.1\%$ of the subjects regarding sexual assault. 2) Pre-marital cohabitant was supported by $89.2\%$ of the subjects. 3) The Korean military personnel showed liberal attitudes toward sexuality as $46.4\%$ of them reported having sexual-relationship with the dating partner is acceptable. 4) The attitudes of the most subjects toward homosexuality was found to be unfavorable. 5) Subjects were m the need of appropriate sex education. of which substantial knowledge on sexual intercourse was the most needy area. 2. Knowledge and attitudes toward AIDS of the military personnel 1) The subjects' level of knowledge on AIDS was relatively low, showing the average score of $22.31\pm7.23$ points (range: 0-39 points). The higher level of knowledge was reported by those who had high level of education, father alive. and less number of brothers in their family. 2) The subjects' attitudes toward AIDS was relatively positive. The attitude toward AIDS was also found to be more positive in those who had high level of education and less number of brothers. 3) There was a positive but weak correlation between knowledge and attitude toward AIDS. The study finding showed that the sexual orientaion of the Korean military personnel was moderately positive and liberal. However, their awareness of sexual harassment and assault and AIDS was still found to be low. As Korean enlisted military service men are likely to be in the ages with strong sexual desire, it may be important for them to have appropriate sexual orientation and attitudes toward AIDS. Therefore, it is recommended to develop further practical and sound sex education programs within the military unit in order to meet their education needs as well as to utilize sex education specialists as the instructors of those programs.

• Journal of Korean Academy of Nursing Administration
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• v.23 no.2
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• pp.211-222
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• 2017

Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

• Journal of muscle and joint health
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• v.20 no.3
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• pp.197-206
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• 2013

Purpose: The purpose of this study was to investigate end-of-life care preferences of employees working in a university hospital. Methods: Of 650 eligible employees that were approached, 607 employees (386 nurses, 93 physicians, and 128 general staff) completed the Korean version of Preferences for Care Near the End of Life (PCEOL-K). Results: Among 5 dimensions of the PECOL-K, "Pain" was the most preferred care dimension and "Decision making by health care professional" was the least preferred care dimension. The item that received the highest mean score was "I want to let nature guide my dying and I do not want my life to be artificially prolonged in any way", and the lowest item was "I want health care providers to make all decisions about my care". As preferred care near the end of life, nurses gave lower scores to the life sustaining treatment and decision making by health care profession than physicians and general staff. Compared to physicians and nurses, general staff preferred the decision making by health care professional and by family. Conclusion: The results show that adequate pain relief is the most preferred care at the end of life among hospital employees and non-medical personnel preferred decision making by others.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.16-30
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• 2004

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.