• Title/Summary/Keyword: follow-up service

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A Meta-Evaluation of the Evaluation Project at the Family Support Center (가족센터 평가사업에 대한 메타평가)

  • Kang, bogjoeng
    • Journal of Family Resource Management and Policy Review
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    • v.28 no.2
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    • pp.27-38
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    • 2024
  • The purpose of this study was to identify issues in the family support center evaluation project by analyzing the differences in perception between evaluators and the family Support center using a meta-evaluation analysis model and seeking improvement alternatives. The results revealed a significant difference in group average: the evaluator group scored 4.21 out of 5 points, and the family center group scored 3.20 points. The improvement alternatives for each meta-evaluation item are as follows. In the evaluation environment, it is necessary to specify the purpose and utilization of evaluation within the guidelines of the Ministry of Gender Equality and Family. Evaluation input required the establishment of an evaluation support organization within the Korean Institute for Healthy Family. During the evaluation process, it was necessary to improve the use of the integrated family support information system and diversify communication channels. The evaluation results required the strengthening of follow-up education for family centers. In terms of evaluation utilization, it was necessary to strengthen support for various incentives and subcenters. This study provides implications for improving the evaluation system for various policy service delivery systems.

Nutrition Components and Physicochemical Properties of Acer termentosum Maxim. Leaf (벌나무 잎의 영양성분 및 이화학 특성)

  • Park, Sung Jin;Shin, Eon Hwan;Kim, Dong Ho;Rha, Young-Ah
    • Culinary science and hospitality research
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    • v.22 no.8
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    • pp.27-38
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    • 2016
  • This study examined the nutrient components and physicochemical properties of Acer termentosum Maxim. leaf as a natural health food source. To accomplish this purpose, the general and antioxidative contents of Acer termentosum Maxim leaf were measured. Total contents of carbohydrates, crude protein, crude lipid, and ash were 53.6%, 24.3%, 3.5%, and 3.5%, respectively. Caloric content of Acer termentosum Maxim was 246.5 kcal, while total dietary fiber was 46.7%. Regarding mineral contents, K was the most abundant mineral, followed by Ca, Mg, and P. Therefore, Acer termentosum Maxim is an alkali material. Total phenol contents of the 70% ethanolic extracts of Acer termentosum Maxim was $116.35{\pm}1.4mg\;GAE/g$. Total flavonoid contents of the 70% ethanolic extracts were $20.3{\pm}1.23mg\;RE/g$. The antioxidative activities of Acer termentosum Maxim. were significantly increased in a dose dependent manner on DPPH(1,1-Diphenyl-2-picrylhydrazyl) radical scavenging, ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt) radical scavenging, FRAP (ferric reducing antioxidant power) activity, reducing power. It is expected that follow up study of Acer termentosum Maxim through developing processed food and evaluation of their functional properties would provide useful information as a source of functional foods.

Study on the Multilevel Effects of Integrated Crisis Intervention Model for the Prevention of Elderly Suicide: Focusing on Suicidal Ideation and Depression (노인자살예방을 위한 통합적 위기개입모델 다층효과 연구: 자살생각·우울을 중심으로)

  • Kim, Eun Joo;Yook, Sung Pil
    • 한국노년학
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    • v.37 no.1
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    • pp.173-200
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    • 2017
  • This study is designed to verify the actual effect on the prevention of the elderly suicide of the integrated crisis intervention service which has been widely provided across all local communities in Gyeonggi-province focusing on the integrated crisis intervention model developed for the prevention of elderly suicide. The integrated crisis intervention model for the local communities and its manual were developed for the prevention of elderly suicide by integrating the crisis intervention theory which contains local community's integrated system approach and the stress vulnerability theory. For the analysis of the effect, the geriatric depression and suicidal ideation scale was adopted and the data was collected as follows; The data was collected from 258 people in the first preliminary test. Then, it was collected from the secondary test of 184 people after the integrated crisis intervention service was performed for 6 months. The third collection of data was made from 124 people after 2 or 3 years later using the backward tracing method. As for the analysis, the researcher used the R Statistics computing to conduct the test equating, and the vertical scaling between measuring points. Then, the researcher conducted descriptive statistics analysis and univariate analysis of variance, and performed multi-level modeling analysis using Bayesian estimation. As a result of the study, it was found out that the integrated crisis intervention model which has been developed for the elderly suicide prevention has a statistically significant effect on the reduction of elderly suicide in terms of elderly depression and suicide ideation in the follow-up measurement after the implementation of crisis intervention rather than in the first preliminary scores. The integrated crisis intervention model for the prevention of elderly suicide was found to be effective to the extent of 0.56 for the reduction of depression and 0.39 for the reduction of suicidal ideation. However, it was found out in the backward tracing test conducted 2-3 years after the first crisis intervention that the improved values returned to its original state, thus showing that the effect of the intervention is not maintained for long. Multilevel analysis was conducted to find out the factors such as the service type(professional counseling, medication, peer counseling), characteristics of the client (sex, age), the characteristics of the counselor(age, career, major) and the interaction between the characteristics of the counselor and intervention which affect depression and suicidal ideation. It was found that only medication can significantly reduce suicidal ideation and that if the counselor's major is counseling, it significantly further reduces suicidal ideation by interacting with professional counseling. Furthermore, as the characteristics of the suicide prevention experts are found to regulate the intervention effect on elderly suicide prevention in applying integrated crisis intervention model, the primary consideration should be given to the counseling ability of these experts.

A Follow-up Study of Fertility and Pregnancy Wastage of Women in Rural Area (추적조사에 의한 농촌 여성의 출산력과 임신소모율)

  • Park, Jung-Han;Kim, Sin-Hyang;Chun, Byung-Yeol;Kim, Gui-Yeon;Yeh, Min-Hae;Cho, Seong-Eok;Cho, Jae-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.21-30
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    • 1988
  • To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviwed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women-years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per ,100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.

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A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning (농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究))

  • Yeh, Min-Hae;Lee, Sung Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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Consideration on National Rituals and Folk Beliefs Found in 『Hajaeilgi』 (『하재일기』에 나타난 국가의례와 민간신앙 일고찰)

  • Song, Jae Yong
    • (The)Study of the Eastern Classic
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    • no.69
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    • pp.349-371
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    • 2017
  • "Hajaeilgi(荷齋日記)" was written by Ji Gyu-sik, a gongin of Saongwon(司饔院)'s branch, almost everyday for 20 years and 7 months from January 1st, 1891 until the leap month of June 29th, 1911. It deals with many different areas including domestic and foreign circumstances, custom, rituals, all the affairs related to the branch, and also everyday life events he did see or hear about. Particularly, Ji Gyu-sik did not belong to the yangban class, and we can hardly find diaries written by such class' people. Here, what this author pays attention to among the things written in "Hajaeilgi" is the contents about folklore. Ji Gyu-sik wrote in his "Hajaeilgi" about things related to folklore, for example, seasonal customs, folk plays, rituals, or folk beliefs that were actually practiced then as a person not belonging to the yangban class. Such diaries are rare, and its value is highly appreciated as a material, and it is meaningful in the aspects of folklore as well. Therefore, as part of the work to look into folklore found in "Hajaeilgi", this author focuses on national rituals and folk beliefs in it. The things that have been discussed earlier can be summed up as follows: About national rituals, it is sorry that it only deals with the emperor's enthronement and emperor and crown prince's birthday in garye(嘉禮); however, it is meaningful to know that the people faithfully carried out national ceremonies and celebrations then. Particularly, it is noteworthy that during the national ceremonies or celebrations, students were asked to sing the national anthem. About hyungrye(凶禮), only it deals with the court funeral rite. Aside from Minbi's funeral rite, the court funeral rite was performed properly at the right time according to the procedure like before, and also, it seems that the people fulfilled it faithfully by order of the government. Also, it can be learned from it that Japanese killed Minbi, burned the body with oil, and left the ashes behind. About folk beliefs, the branch held a memorial service at the shrine of the town regularly. The town, too, performed Gocheongsinsa each year. The money needed for the memorial service was collected from the town people differently according to their financial situations, and they prepared for jesu for the ancestral rite altogether. The memorial service was carried out in Sansindang or Bugeundang, too, and it was common that they summoned a shaman to perform a gut. The diary is valuable as material. After being a Christian, Ji Gyu-sik once tried to abolish sinsa jesa held in hoesa and get rid of saesin(賽神), that is, a gut or pudakgeori, but he had no choice but to follow the precedent. Meanwhile, it is also noteworthy that when the town suffered from floor and infectious disease, Ji Gyu-sik installed an altar in front of his house for the town's wellbeing and health, prepared for jesu including offerings and drinks, and held a memorial service to Hwangcheonhuto(皇天后土; the gods of heaven and earth) accompanied with the town people. Also, when he had any hardships in his family, Ji Gyu-sik summoned a shaman for a gut or offered a devout prayer to the mountainous god. Such shamanism or the things like worshiping Gwanseongjegun(關聖帝君) mostly in the beginning of January and telling fortunes about the year were all folk beliefs. This was very popular among the people, and it seems that it was deeply rooted in his life as well. Also, Ji Gyu-sik supported Fengshui beliefs, and it seems that it is not different from the people's general tendencies, either. As described above, "Hajaeilgi" dealing with national rituals and folk beliefs in it is valuable as material and is meaningful for research on forklore, and moreover, it is also significant in the aspects of forklore as well.

Dosage Adjustment before and after Warfarin - Rifampin Combination Therapy (와파린-리팜핀 병용 시 용량 조절)

  • Kim, Dong-Hyun;Kim, Kyung-Hwan;Choi, Kyung-Hee;Lee, Kwang-Ja;Lee, Hye-Suk;Son, In-Ja;Kim, Ki-Bong;Lee, Jae-Woong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.354-359
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    • 2008
  • Background: Warfarin is used as an anticoagulant and it is mainly excreted by the liver metabolism (the R-form is mainly metabolized by cytochrome p450 3A4, and the S form by cytochrome p450 2C9). Rifampin is usually used for tuberculosis or endocarditis, and it is a representative drug that induces the CYP families, including 3A4 and 2C9. The anticoagulation effect of warfarin decreases through the increased metabolism that's due to the induction of enzymes, and this iscaused by rifampin when patients take these two medicines together. No one has suggested appropriate guidelines regarding this drug interaction even though an appropriate adjustment of warfarin's dosage is needed. We examined the drug interaction in patients who received warfarin-rifampin combination therapy according to the time interval, and the factors affecting drug interaction were analyzed. Based on the data, we tried to determine the clinically available warfarin dosage guidelines before and after taking this drug combination. Material and Method: We reviewed the OO University Hospital anticoagulation service team's follow up sheets that were filled out from Jan '1998 to Sep 2006 for the patient who took warfarin - rifampin combination therapy (n=15). Result: The average INR of all the patient before rifampin administration was $2.25{\pm}0.52$ $(mean{\pm}SD)$, and that value for the first 100 days after rifampin administration was $1.98{\pm}0.28$. The p value for these two sets of data showed no correlation (paired t-test, p>0.05). The average INR of all the patient before rifampin cessation was $2.19{\pm}0.34$, and the value after rifampin cessation was $2.49{\pm}0.43$. The p value of these two showed correlation (paired t-test, p<0.05) but the average INR falls between the therapeutic INR range. Conclusion: The warfarin dose adjustment equation of before and after warfarin-rifampin combination therapy was derived based on this study's results because the warfarin dosage adjustment of the anticoagulation service team was considered appropriate.

A Study OR Investigation of the Factors having Affect on Junior Highschool Boys관 Practice of Health Care (중학교 남학생들의 건강관리 실천과 이에 영향을 미치는 요인 조사 연구)

  • 기경숙
    • Journal of Korean Academy of Nursing
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    • v.15 no.1
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    • pp.59-75
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    • 1985
  • Accepting the health as the fundamental human right, the nation and society came to admit the duty to give it to all the people. Korean government is expanding the Primary Health Care as one of the policies for developing the people's health by the lead of community. Like this current situation the School Health Service which is the center of community Health Service schould be active to keep, promote and maintain the health of students and teachers. This investigation was attempted to help to establish the basis of the Health Education Program which would perform the health education efficiently and bring the reforming of student's health control, by measuring the degree of junior high school student's practice concerning health care and con-firming the relationship of knowledge, concern and level of health. The subjects for this study were made up 296 boys at the third grade in a school, located in Seoul. The tool for this study was questionaire. Data were collected for five days, September 22∼26, 1983. The investigators explained the students how to answer the questions of the survey questionaire and then collected the survey cards immediately. The data were analyzed by means of percentages, Pearson Correlation Coefficient and Stepwise Multiple Regression. The results of this study are as follows. 1. The subjects' reaction to the practice concerning Health Care; According to the average proportion of practice concerning health care, subjects' practice in the aspect of Infectious Disease Care is the highest 82.4% and they showed their practice in the aspect of the accident prevention by 77.5% and in the aspect of mental health by 74.8%. Their practice in the aspect of personal hygiene and daily lifehabit is the lowest 71.2%. 2. Health Knowledge; The whole mark distribution of health knowledge is ranged from the lowest 4 point to the highest, 30 point, therefore point range is 26.0. The Average point is 16.58. 11.2% of students solved more than two thirds of personal knowledge levels. 81.4% of students did more than one third of them. 7.415 of students did less than one third of them. 3. Health Concern; The Students of the average 3.99 point respond positively to the question about the health concern, ‘They think health is more important than money’, this is the highest rate. The students of the average 2.78 respond“when they are sick, they enter the appointed hospital where they own choose”, while it is the lowest. 4. Subjects' response to the health level are at follow: Very healthy 26.0%, healthy 47.0%, less healthy 10.5%, 34.9% of them have ever been sick within two weeks, the number of symptoms they reported amount to 114 and the number of cases poi one person is 0.35. 5. The hypotheses test about the practice concerning health care and the factor which effect on it. 1) The main first hypothesis:“The more knowledge of health the subjects have, the better they practice health care.”was accepted. (r=0.1582, p <0.05) 2) The minor first hypothesis:“The more interest in health subjects have, the better they practice”was accepted. (r=0.4354, p <0.001) 3) The minor second hypothesis;“The healthier subjects are, the better they practice health care”was accepted. (r=0.1069, p<0.05) As other test, partical correlation test is performed in other refine whether health knowledge, a fact influencing the students practice concerning health care, is associated with the practice after controlling the third variables. First, after controlling health concern, the correlation of health knowledge and practice concerning health care was kept. (r=0.1347, p <0.005) Second, after controlling health level, the correlation of health knowledge and practice concerning health care was kept. (r=0.1526, p <0.005) And finally, after controlling economic state, the correlation of health knowledge and practice concern-ing health care was kept. (r=0.1413, p <0.05) Additionally Stepwise Multiple Regression between practice concerning health care and variables. 1.6591 of compliance was explained with the know-ledge (F=5.584, p <0.05), 20.0% of compliance was explained with the health concern added to knowledge. (F=63,213, p <0.005) As the above, health knowledge obviously have effects on the practice about the health care. But, contrary to researcher's expectation, health concern has more affects than health knowledge. Therefore, we must grope the plan to enhance health concern through the regular curriculum and systematic health education for students. Besides, we must study further on, to find the factors which have affect on the practice concerning health care.

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Perception and Satisfaction on Nutrition Counseling Service for Patients Consuming a Therapeutic Diet at Hospitals in Busan (부산지역 일부병원 치료식 섭취 환자의 영양상담에 대한 인식 및 만족도)

  • Yi, Jeong-Ryeh;Son, Eun-Joo;Lyu, Eun-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.9
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    • pp.1305-1312
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    • 2010
  • The purpose of this study was to investigate the perception and satisfaction on the nutrition counseling service for patients consuming a therapeutic diet at hospitals in Busan. The subjects were 153 inpatients at five hospitals with over 400 beds each. The research was performed through the interviewing process using questionnaires conducted from January to February, 2008. In a total of 88 patients, 57.5% had experienced nutrition counseling and were through the motives of counseling with doctors 64.2% and themselves 29.3% of the patients. In the method of nutrition counseling, 58% of the patients had an individual counseling. In the patients' perception on the nutrition counseling, 75.0% of the patients understood very well, 83.0% of them perceived the explanation as very important, 79.5% were very satisfied and 78.7% were helped in nutrition-management. On a scale of 5.00 for the nutrition counseling satisfaction, the average scores were 3.80 for 'explanation of knowledge', 3.71 for 'cognitive communication skills', 4.05 for 'effective communication skills' and 3.60 for 'facilitation skills'. The items of low scores in the nutrition counseling satisfaction were 'follow up diet-therapy after discharge', 'providing to personalized nutrition information', 'presentation of specific menu' and 'methods of menu planning'. There were significant (p<0.01) positive correlation between perception and satisfaction on the nutrition counseling. Therefore, it was suggested that dietitians increase the patients' satisfaction on the nutrition counseling with developing the model based on the patient-centered counseling.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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