• 가정∙방문간호학회지
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• 제27권3호
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• pp.241-249
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• 2020

Purpose: This study aimed to investigate possible ways to expand the services of home-visit nursing through a review of the progress, achievements, and obstacles of home-visit nursing; a pilot project of an integrated home-service; the application of the Omaha System; as well as a case analysis of providing home-visit nursing services. Method: An integrated review was conducted using various source materials, including laws, previous studies, and a case analysis. Results: In case analysis of providing visiting nursing service, rehabilitation nursing, end-of-life nursing, and dementia care showed high nursing needs. It was necessary that the various home visit nursing services in the intervention area of the Omaha System, administrative services, case management, and center operation activities were all included in the payment systems of long-term care insurance. Conclusion: In the future, home visit nursing services of long-term care insurance should be reborn in the form of a center for integrated case management in the community, which would set long-term goals until the time of a client's death and encompass the realm of human rights for health, quality of daily life, and a dignity of life.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제14권3호
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• pp.23-33
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• 2008

The purpose of this study was to propose the Guidelines for the Program and Space of Adult Day Care Center. Recently the Adult Day Care Center is extremely on demand caused by the increasing population of the elderly. In order to provide the affordable and efficient rehabilitation program the architectural setting should be turned to that purpose. In particular, the adult day center program must have the programs for three kinds of the elderly in terms of health status, for example, Altzheimer's disease, paralysis, and sickly elderly. Therefore this study propose the way of planning the program and spaces to give the appropriate care for Adult Day Care Center.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.42-50
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• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• Journal of Preventive Medicine and Public Health
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• 제29권1호
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• pp.43-50
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• 1996

We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.

• 한국보건간호학회지
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• 제21권1호
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• pp.15-24
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• 2007

Purpose: The study aim was to provide basic data needed for formulating systematic visiting nursing strategies by comprehending the characteristics and self-care ability of the object families of public health centers in Korea. Method: The research examined 252 families and 339 family members of the vulnerable class that were registered in a visiting nursing program of an urban public health center. The data of 220 families were analyzed using descriptive analysis, t-test, and ANOVA, after excluding any incomplete data. Result: 1. The most frequent characteristics of families were solitary families (52.8%) and financially vulnerable families (87.3%). The most frequent way of family detection was request of the community office. 2. The most frequent type of family problems were vulnerable families (93.2%), followed by patient families (91.0%). 3. The mean score was 11.67 for family self-care ability. 4. The variables of the number of family members, disease type of the patient family members, and the type of vulnerable family showed a significant difference of family self-care ability. Conclusion: This study suggests that vulnerable families demand specific nursing interventions focused on their own problems and that visiting nurses need to obtain and use supportive resources.

• 한국의료질향상학회지
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• 제27권2호
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• pp.2-17
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• 2021

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

• 가정과삶의질연구
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• 제28권1호
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• pp.1-11
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• 2010

The purpose of this study is to compare the cognition of SIDS as the first step for decreasing the SIDS death rate for the infant and for activity of infant-care in Korea. Participants were 409 child care center directors and 146 parents from 500 child care center directors and 200 parents who using child care center facilities for their children in Seoul. For analysis of research questions, frequencies, Cronbach $\alpha$, t-test,One-way ANOVA, Scheffee test were used with SPSSWIN 15.0. Through this study, we find the child care center directors have good cognition for it, but their effort for SIDS prevention is limited, because they don't have any official prevention education from authorized training center. Even though the parents have a low awareness for SIDS prevention than child care center directors, but they have high score in endeavor for SIDS precaution. Both child care center directors and parents want to receive systematic information from government side. Our infant should have a opportunity to grow up health and stability from reducing the risk of SIDS. In western countries such as U.S.A., U.K. and Japan have studied to decrease the SIDS death rate from thirty years ago, they have already government and social organization for preventing the SIDS. Nowadays, as you know well, our country birth-rate is falling by 1.08, therefore, it is important to decrease the infant death rate for keeping with our population. Also, it is relevant to the child-welfare and the child-safety and more better the child-care.

• 농촌의학ㆍ지역보건
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• 제42권1호
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• pp.24-35
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• 2017

이 연구의 목적은 한국형 일차의료 평가 도구(KPCAT)를 이용하여 한 농촌 지역 보건소의 일차의료의 질을 평가하는 것이다. 또 이 연구에서는 KPCAT 적용 및 결과 해석과 관계된 몇 가지 방법론적 이슈를 검토하였다. 농촌 보건소 진료 의사에게 4회 이상 진료받은 환자 79명이 KPCAT 설문에 응답하였다. 응답자의 특성을 빈도와 백분율, 중앙값과 사분위 범위, 평균과 표준 편차로 제시하였다. 일차의료의 질은 KPCAT 총점과 영역별 점수의 중앙값과 사분위 범위로 제시하였고 최댓값과 최솟값, 기대 점수와 함께 방사형 도표로 제시하였다. KPCAT 문항별 점수와 중앙값과 사분위 범위, 기대 점수 이상 응답자 비율, 잘 모름 응답자 비율을 제시하였다. 연구 대상 농촌 지역 보건소 일차의료 질의 중앙값과 사분위 범위는 각각 45점, 16점이었다. KPCAT 영역별 점수 중앙값이 기대 점수에 이른 영역은 최초 접촉 하나였다. KPCAT 문항별 점수가 기대 점수 이상인 응답자 비율이 50% 미만인 문항은 포괄성 4문항 중 2개, 조정 기능 3문항 전부, 전인적 의료 5문항 중 2개, 가족 및 지역 사회 지향성 4문항 전부였다. 잘 모름 응답의 처리 방침 개선, 잘 모름 응답률이 높은 문항의 타당성 검토, 응답 척도의 내용과 점수의 일치 등이 방법론적 개선 과제였다. 농촌 지역 보건소 일차의료의 질은 개선할 여지가 많았다. 특히 조정 기능과 가족 및 지역 사회 지향성 영역의 개선 필요성이 두드러졌다. KPCAT의 방법론적 개선을 통하여 타당하고 신뢰성 있는 일차의료 평가가 이루어지기를 기대한다.

• 한국치위생학회지
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• 제6권4호
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• pp.263-282
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• 2006

The purpose of study was to offer devices to activate the dental health class of community health center and to evaluate the present programs and to propose adequate guidelines for future public dental health program of dental health care in health center. For this study, the mail quastionnaire survey was carried out from the 116 dental hygienists who are working in community health center. Present condition and direction of public dental health service are as follows: dentist's office was 90% by area and work department. Dental health department was equipped in 91.7% of 'public health center', but 'health branch office' was 57.9%. Dental hygienist education condition of Public health center was the most frequency in 'At large city'. 'Have no entirely' of dental health education number of times was 35.8% in 3 years. That is 44.5% in supplement insturction. Most Dental hygienist's business was most 'teeth-sealant' and 'Old man false teeth prosthetic dentistry business'. Therefor, The Obstacle factors of dental health service activity were 'manpower tribe(average 3.92)', and next 'lack of understanding and support insufficiency of law(average 3.47)'. Curriculum for educational practice should be also designed for brightening the dental health service business. The most important thing for dental health service is 'expanding and improving the facilities Legal system' and next 'Opportunity enlargement and activation that can take dental hygienist's residency'.

• 혜화의학회지
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• 제22권2호
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• pp.119-141
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• 2014

Objective : This study was designed to health-Care services recognition comparison of patient between Korean Medicine 00 Hospital and Seoul 00 Health Center. Methods : 277 subjects were participated in this study. After a treatment, we analyzed a patient type by using a questionnaire. After all treatment, we conducted a survey about Medical Trust Scale, Medical Happiness Index Scale, Service Quality Scale. To evaluate a satisfaction degree, we analyzed results of survey statistically. Results : The results of the analysis, Korean Medicine 00 Hospital group got a higher score than Seoul 00 Health Center group statistical significantly on Medical Trust Scale, Medical Happiness Index Scale, Service Quality Scale. Conclusion : Korean Medicine 00 Hospital group got a higher score than Seoul 00 Health Center group. It was more effective in Korean Medicine 00 Hospital group than Seoul 00 Health Center group.