• Title/Summary/Keyword: in-home child support service

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Internet Use of Adolescents according to their Life Content and Type (청소년 생활시간의 내용과 유형에 따른 인터넷 이용)

  • Na, Young-Joo;Hwang, Jin-Sook;Lee, Eun-Hee;Koh, Seon-Ju;Park, Sook-Hee
    • Journal of the Korean Home Economics Association
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    • v.43 no.12 s.214
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    • pp.15-28
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    • 2005
  • This study groups the life content of adolescents according to their time spent during the week and compares their internet use. The data were collected from 2210 middle and high school students, including their life content and hours, and various internet factors such as self-evaluated internet addiction, internet support, internet experience, chatting subjects and the type of internet service. Adolescents were divided into five groups: TV-oriented group, computer-oriented group, peer-oriented group, self-study group and extracurricular institution group. The purpose of internet use, internet experience, chatting subjects, negative aspects of internet and internet addiction were different by adolescents' group type. The peer-oriented group had the highest real self image as opposed to the cyber self image and trusted other's words on the internet. The TV-oriented group had the lowest trust in the internet. The computer-oriented group received the highest internet support and internet experiences, but didn't use the internet for the purpose of information search. The self-study and extra-curricular institution groups used the internet the least, used it to solve stress and were interested in school circles on the internet.

A Survey on the Foodservice Management Practices at Child Care Centers in Gyeonggi Area (경기 지역 영유아 보육시설의 급식운영관리 실태 조사)

  • Sohn, Chun-Young;Pak, Hee-Ok
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.4
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    • pp.577-586
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    • 2011
  • This study was carried out to investigate food service management practices in various operation types of child care center in Gyeonggi area of Korea, and to provide basic information for improving food service management policies at child care centers. Self-administrated questionnaires were collected from 102 child care center directors. The statistical analysis was completed using SPSS ver. 18.0 program. Approximately 97.1% of the directors were women. The number of total children were difference in public, private and home care centers respectively (p<0.001), and time of operation was significantly (p<0.01). Only 8.9% of the centers employed a dietitian, whereas 92.5% of the centers employed cook or assistant cook, thus food service was not managed by professionals in most centers. All of the centers had been self-operated and meals were prepared in a conventional manner. In approximately 89.2% of the centers servings snacks twice a day. Menu planner of the centers which have no dietitian was the child care information center (47.5%) or the director (34.7%). In most centers, the directors was also purchasing manager and 36.0% of the center purchased food every day. These results indicated that food service management guidelines need to be established by the child care center type with the government control and financial support. We recommended that they furnish the efficient food service program for food service management.

Content Analysis of the Nursing Interventions and Telephone Calls to the Pediatric Nursing Unit (외래 및 퇴원환아 부모의 전화상담과 간호중재의 내용분석)

  • 한경자;최명애;강화자;박승현;김영미;권원경;안혜영
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.515-530
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    • 1996
  • A descriptive study was conducted to describe the content of nursing interventions and incoming telephone calls from the parents whose child was discharged to home or who has planned immunization during the period from March 15, 1995 to November 30, 1995. Detailed notes on 145 telephone calls and 243 nursing interventions were recorded by head nurses on pediatiric nursing units were entered to data collection and content analysis. The results of the study are as follows : 1. Six analysis categories for the records on incoming telephone calls were identified judgement-dependence, dependent -coping, self-initiated coping, support, adjustment and intermediation need. 2. Five analytic categories for the records on telephone interventions were identified : guidance, mediation, facilitating self -care abilities, support, instrumental use. 3. Problems related to physical signs and symptoms, medication, immunization, and vital signs were most often cited as concerns by parents and caregivers. 4. Instruction, suggestion, provision knowledge and information, reassurance related to physical problems, medication, immunization and clinic visits were most often used as an nursing interventions by head nurses on pediatric nursing units. In spite of the fact that the telephone calls were initiated by the parents, dependency of parents during the telephone calls was remarkable. The dependency of parents on judgement and decision making of the pediatric nurses should be understood in terms of the psychosocial content as well as cultural characteristics. Therefore, it is suppested that telephone interventions focus on facilitating the self-care ability of the parents whose children have chronic conditions. The results of this study will be useful as an essential reference in providing effective for children and their families after discharged from the hospital. The results can also be used as reliable data for extended pediatric nursing service in the health care delivery system as well as for the development of telephone intervention service program in responding to the current health care environment.

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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 Korean Academic Society 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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Study of The Area of Nursing Need by the Family Developmental Stage (가족발달단계에 따른 간호요구영역에 관한 연구)

  • 최부옥
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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Traditional Family Rites and Family Systems in Contemporary Korean Families From Middle-Aged Koreans' Perspectives (중년 기혼 남녀의 전통 가족 의례와 제도에 대한 인식을 통해서 본 현대 한국 가족의 변화)

  • Sung, Miai
    • Journal of Families and Better Life
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    • v.30 no.6
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    • pp.103-114
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    • 2012
  • This paper aims to investigate changes in Korean family structures by reflecting on the perception of traditional family rites and family systems. In-depth interviews were conducted with 17 married middle-aged men (9) and women (8) who had at least one child. Findings were as follows: First, both married middle aged men and women internalized Confucianism. They thought that the head of household, who was male as far as possible, was needed for the formation of a normal family. In addition, both of married middle-aged men and women recognized married women as outsiders based on Chul-ga-we-in-sa-sang. And they put parents-children relationships ahead of couple relationships and supported Jang-ja-woo-dae-sang-sok (privileging the eldest son over the other children in terms of the distribution of family resources and inheritance based on Confucianism). However, there were some differences to support the use of Hang-ryul-ja, which is based on expressing the character of generation by sharing the first name, and the importance of Jok-bo. which is based on traditional family genealogical records. Second, even though women internalized Confucianism, they did not attach traditional meanings to memorial services for ancestors to the extent that men did and defined family members as a procreation family boundaries unlike men, who defined family boundary as original family members and procreation family members. In conclusion, even though family laws and culture have evolved from the patrilineal family system to one which promotes gender equality, married men and women internalize Confucianism. Instead, some transformations are evident from the perspective of females in terms of memorial services for ancestors and family boundaries.

Development and evaluation of Pre-Parenthood Education Program for high school students based on Home Economics subject (고등학생을 위한 가정교과 기반 예비부모교육 프로그램 개발 및 평가)

  • Noh, Heui-Yeon;Cho, Jae Soon;Chae, Jung Hyun
    • Journal of Korean Home Economics Education Association
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    • v.29 no.4
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    • pp.161-193
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    • 2017
  • The purpose of this study was to develop and evaluate pre-parenthood education program(PPEP) based on Home Economics(HE) subject for high school students. The development and evaluation of PPEP based on HE subject in this study followed ADDIE model except implementation through 4 processes such as analysis, design, development, and evaluation. First, program development directions were set in three aspects such as 'general development', 'contents', and 'teaching and learning methods'. Themes of the program are 11 in total such as '1. Parenting, what is being a parent', '2. Choosing your spouse, happy marital relationship, the best gift to your children', '3. Pregnancy and birth, a moving meeting with a new life', '4. Taking care of a new born infant for 24 hours', '5. Taking care of infants, relationship with my lovely baby, attachment', '6. Taking care of young children, my child from another planet', '7. Parents and children in healthy family', '8. Parent-child relationship, wise parents to make effective interaction with their children', '9. Parents safety manager at home,', '10. Practice to take care of infants', and '11. Practice of community nurturing support service development'. In particular, learning activities of the program have major characteristics such as 1) utilization of cases including practice problems related to parenting, 2) community exchange activities utilizing learned knowledge and techniques, 3) actual life project activities utilizing learning contents related with parenting, 4) activities inducing positive changes in current life of high school students, and 5) practice activities for the necessities of life such as food, clothing and shelter supporting development of children. Second, the program was developed according to the design. Teaching-learning plans and materials for 17 classes were developed according to 11 themes. The developed plans include class flow and teacher's reference. It starts with receiving a class-related message from a virtual child at the introduction stage and ended with replying to the message by summarizing contents of the class and making a promise as a parent-to-be. That is the basic frame of class flow. Learning materials included various plans and reports necessary for learning activities and they are prepared in details so that they can be play the role of textbooks in regular curriculum. Third, evaluation of developed program was executed by a 5 point Likert scale survey on 13 HE experts on two aspects of program development process and program development results. In the evaluation of development process, mean value was 4.61 and index of content validity was 97.4%. For development results, mean value was 4.37 and index of content validity was 86.9%. These values showed that validity in the development process and results in this study was highly secured and confirmed that PPEP based on HE was appropriate and valid to enhance parent qualifications of high school learners.

An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1 s.21
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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A Study on Perception and Attitudes of Health Workers Towards the Organization and Activities of Urban Health Centers (도시보건소 직원의 보건소 업무에 대한 인식 및 견해)

  • Lee, Jae-Mu;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Cheon-Tae
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.347-365
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    • 1995
  • A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.

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The Empirical Exploration of the Conception on Nursing (간호개념에 대한 기초조사)

  • 백혜자
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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