• Health Policy and Management
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• v.2 no.1
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• pp.17-41
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• 1992

During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.14-21
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• 1996

Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

• Journal of Agricultural Extension & Community Development
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• v.21 no.4
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• pp.1125-1147
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• 2014

This study was conducted to develop the health evaluation indicator of pond wetland in order to enhance the quality of eco-experience in rural area. The methods for development of evaluation indicator were consisted of 3 stages; 1st, the precedent assessment protocol was applied to 10 pond wetlands in farm villages, and eco-experience expert survey was conducted to selection the evaluation item and criteria at 2nd and 3rd stages. In the results of applying the precedent assessment protocol, we found out two problems; 1) the evaluation result of value determination and conservation value were too simple, and 2) the score by evaluation items were nearly the same, because evaluation criteria in not precisely for application in rural area. These results were reflected to expert survey. According to the 1st survey results, they suggested that 4 items should be maintained, and 3 items should be deleted, and 2 items should be modified among a total of 9 times. Therefore, it was modified into the evaluation protocol having a total of 8 items. According to the 2nd survey results, the selected evaluation items were generally proper. With regard to items for assessing the health condition of pond wetland, we selected a total of 8 items; (1) Connectivity to forest, (2) Connectivity between water body and wetland connection, (3) Number of Vegetation, (4) Surround land use, (5) Interspersion of Vegetation, (6) Crossing Structure, (7) Wetland size, and (8) Outlet structure. In addition, it was suggested that accessibility, visibility, and trash were need for utilization of pond wetland as a place for eco-experience. It is expected that the selected evaluation indicator can help to utilize the pond wetland as an eco-experience space in rural area, and maintain the pond wetland as a space for conservation of biodiversity.

• Journal of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Korean Journal of Biological Psychiatry
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• v.20 no.1
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• pp.6-11
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• 2013

Objectives There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. Methods A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. Results The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's ${\alpha}$ = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. Conclusions To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.

• Journal of Agricultural Extension & Community Development
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• v.7 no.1
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• pp.121-136
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• 2000

This study reports on a comparison between the Korean diffusion of agricultural innovation or extension service and the cooperative extension service in the United States of America. It focuses on relevant differences between the two systems and provides recommendation for improvement of the Korean system to insure success in important areas related to the diffusion of agricultural innovations. After a comparative study on diffusion of innovations it is clear that: in order to have a productive agriculture that makes effective and efficient use of natural resources and helps achieve sustainability goals, a mechanism that delivers knowledge to agricultural communities must be established and maintained. This mechanism is clearly an agricultural extension service that is cooperatively funded by federal, state and local governments and that insures participation of constituents in the process of establishing priorities and evaluating achievements. The success of US agriculture, the most productive in the world, is to a large degree to the Cooperative Extension Service. Based on the results of this study and the differences of the United States and Korea, the following recommendations should be emphasized for more effective communication for agricultural innovation and rural development in Korea: 1) In order to insure that extension educators are high caliber professional individuals, it is important to establish a system that nationally recognizes these individuals as such, and that provides a professional development path. 2) The results of the decision of transfer of extension educators to local governments has not yielded positive outcomes, especially in terms of professional status. It is clearly demonstrable that valuable professionals are leaving the service, that local governments do not have the will and resources to implement a successful extension program. 3) Because of the critical importance of diffusing innovations to agricultural producers in order to insure and quality and steady food supply, it is of critical importance that these issues be addressed before the extension service is further deteriorated. Given the cement situation, it is clear that the extension service should become nationally supported again in cooperation with local and state governments and that extension professionals be given appropriate rank at the national level, commesurate with their peers in research and teaching. 4) The common current committee practice of lengthy reporting and short discussion needs to be changed to one that results in char, brief and substantive action oriented goals. Joint participation by researchers, extension educators and farmers should be encouraged in planning, implementation and evaluation of communication for agricultural innovations. Roles and functions of committees for institutional cooperation, and or agricultural extension committees should be enlarged. 5) Extension educators should be encouraged to adopt new communication technologies to improve their diffusion of innovations methods. Agricultural institutions and organizations should be encouraged to adopt farmer-first and or client-oriented approach in agricultural extension and diffusion of agricultural technologies. The number, complexity and rapid change of information in agricultural extension require the development of a computer based information and report system to support agricultural extension. 6) To facilitate and expand the further development of communication for agricultural innovation and rural development, agricultural communication programs in universities especially in colleges of agriculture and life sciences. 7) To strengthening the sense of national and social responsibility communication for agricultural innovation and rural development among students in agricultural colleges and universities through participation in learning activities by proactive recruitment. 8) To establish and reinforce a policy that insures participation in communication for agricultural innovation and regal development activities. 9) To improve further development of communication for agricultural innovation and rural development in Korea, more research activities should be encouraged.

• The Journal of Korean Academic Society of Nursing Education
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• v.3
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• pp.78-98
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• 1997

Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

• Journal of dental hygiene science
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• v.13 no.3
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• pp.271-280
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• 2013

This study aims to analyze the effects of tooth-brushing facilities (TBF) at middle schools that installed TBF in 2012 as part of the oral health project in Seongdong-gu, Seoul. The subjects were the first graders at A middle school that installed TBF previously and B middle school that installed TBF in 2012. The results are as follows: DMFT, DMFS and CPI didn't show significant difference by schools (p>0.05), but code (0) was higher and code (2) was lower in female students than male students (p<0.05). As to PHP index, the students at A school with TBF indicated better oral hygiene (p<0.01). In the research on before and after installing TBF, the oral hygiene was improved significantly more after the installation than before (p <0.01). In the comparison on the oral health-related behavior, the percentage of not brushing after lunch was higher B school than A school and the frequency of toothbrushing after lunch was higher A school than B school (p<0.01). About the reasons why not to brush after lunch, there was difference in 'lack of the place' as A school showed 2.6% while B school without TBF indicated 14.2% (p<0.01). About the changes of the oral health-related behavior before and after TBF installation, the percentage of not brushing after lunch increased from 78.7% to 83.8% after the installation. The average frequency of tooth-brushing after lunch for one week also decreased from 0.50 to 0.34 (p>0.05). Among the reasons why not to brush after lunch, 'lack of the place' significantly reduced, but 'because other friends don't do it' increased greatly after the installation (p <0.05). Only with the improvement of oral health knowledge, we cannot expect either clinical or behavioral significance. Not only schools but policies of governmental agencies and financial support, cooperation of community-related groups for program development and evaluation will contribute altogether to helping teenagers to habitualize proper oral health management.

• Journal of Home Health Care Nursing
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• v.8 no.1
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• pp.5-24
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• 2001

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

• Journal of Korean Home Economics Education Association
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• v.16 no.2
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• pp.13-26
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• 2004

This study tried to suggest teaching and learning activities which can be effectively utilized in Home Economics Education by analyzing and suggesting “The objective and contents of personality education” in Home Economics Area in the curriculum of 7th Technology ＆ Home Economics. As a result, Personality education can be implemented in all areas of Home Economics Education. Especially in Home Economics Education, the following personality education can be implemented. First of all, it can teach the equality among family members by teaching the values of equality and respecting human rights. Secondly, it can teach to recognize and implement various values related to environmental protection. Thirdly, it can teach the ethics related to care which was claimed by Gilligan and other people - in other words, charity, forgiveness, friendship, love, sacrifice, concession, conversation, compromise and etc. Especially these kind of values are extended to also the ethics of care for others, neighborhood, and community not only for family care which was the traditional Home Economics education criticized as family selfishness. On the other hand, personality education in Home Economics Education is different from other subjects. It enables students to act through experiences not just emotion or knowledge by learning actual relationships among family members in daily life. This kind of feature is proving the fact that Home Economics Education can play a very effective role in achieving the objective of moral behavior The results of this study proves that Home Economics Education is an effective subject which can conduct personality education by the objectives and contents that are different from other subjects. This provides the reasonable cause for Home Economics Education to be an required subject in school curricula. Future study should be conducted as an empirical research to develop personality programs(activities for teaching ＆ learning) which can be implemented in Home Economics Education and to accumulate empirical data of such programs.