• 대한간호학회지
• /
• 제28권4호
• /
• pp.1047-1059
• /
• 1998

Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

• 한국유기농업학회지
• /
• 제21권4호
• /
• pp.569-588
• /
• 2013

The organic foods is the terminology calling the organic products, the organic livestock and the organic processing food. The value of organic food may be evaluated as the index of the nutrient content, the safety and the health promotion. The reason why consumers prefer the organic food in the market is because the value of health promotion to be obtained through its consumption is expected to be bigger than the expense according to the purchase of organic food. This study has the significance in developing the direct evaluation model like the human biomonitoring method. The hypothesis for this study is summarized, "If the metabolome of metabolic syndrome of decreases, the exposure of substance of health harm decreases, the number of hospital care decreases and the quality of life shall be improved if the organic food is incepted in the long term and the health care is managed well". The consumer's cooperative and the health consumer's cooperative select the experimental group of 100 persons and the comparative group of 100 persons in 5 areas in the whole country at the same time to verify this hypothesis. Its rate of change is compared and analyzed by measuring the blood and urine of each biomarkers such as the exposed agriculture pesticides, the nitrate in the body at intervals of 2 months for 1 year. Also, by letting participants in the experiment record the major activity such as the dietary intake and the exercise, etc., in the questionnaire and the performance evaluation form, the statistical analysis for the correlation of this with the metabolome, etc., is conducted. The time that is called minimum 1 year and a lot of expense are required to implement this model. Accordingly, the cooperative study by composing the consortium of the interdisciplinary and the interagency is desirable.

• 한국치위생학회지
• /
• 제18권1호
• /
• pp.65-75
• /
• 2018

Objectives: This study aims to contribute to the prevention of dental diseases and health care in the elderly by investigating the relationship among the experiences of chronic diseases, dental health status, and the behaviors in the Korean elderly people. Methods: A total of 2,856 elderly people aged 65 or older were selected as the final analysis subjects using data from the 6th National Health and Nutrition Examination Survey (2013-2014). Chronic diseases were defined as 'cardiocerebrovascular diseases', 'diabetes', 'chronic respiratory diseases', and 'cancer' diagnosed by the doctors. For the statistical analysis, SPSS 21.0 for Windows was used. Descriptive analysis and a Chi-square test were conducted to investigate the relationship among the experiences of chronic diseases, general characteristics, dental health status, and the behaviors in the Korean elderly. Finally, logistic regression analysis was performed to investigate the relationship among the experiences of chronic diseases, dental health status, and the behaviors. Results:The prevalence of Cardiocerebrovascular diseases was significantly higher in the 3-4 group of community periodontal index with the score of 1.36 (95% CI 1.03-1.00) than in the 0-2 group. The prevalence of Cardiocerebrovascular diseases was significantly higher in the group without dental examination during the past one year with the score of 1.29 (95% CI 1.00-1.66). The prevalence of diabetes was significantly higher in the uncomfortable speaking state group with the score 1.46 (95% CI 1.12-1.91). The prevalence of cancer was significantly higher in the partial denture needs group with the score 1.67 (95% CI 0.98-2.83). Conclusions: Regular dental examinations and dental health care for the elderly with chronic diseases showed that periodontal health and residual teeth could be maintained and managed. Therefore, continuous customized dental health services should be implemented for the elderly with chronic diseases.

• 보건교육건강증진학회지
• /
• 제24권4호
• /
• pp.65-85
• /
• 2007

Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.

• 지역사회간호학회지
• /
• 제14권2호
• /
• pp.287-298
• /
• 2003

The purpose of the study was to develop an integrated prevention program to strengthen elders self-care capability and to examine its effectiveness on their psychological condition. This study used one group pre- and post-test design. Subjects were 85 elderly residents (over 65 years of age) who lived alone, and received free basic medical care and social welfare services in a rural community in Korea. Subject eligibility criteria for this study were to an elders who 1) is not currently taking any anti-depressant medication 2) is able to communicate, and 3) agrees to participate in this study. The integrated program was composed of horticulture, reminiscence, and friendship activities. Twelve sessions were provided for 12 weeks in community-based partnerships to achieve better outcomes. The intervention was case-managed by a public health nurse and aided by six volunteers. The main outcome variable was depression, which was assessed by using 15 items selected from the Geriatric Depression Scale-short form Korean version. Socio-demographic characteristics, functional status, and satisfaction with social support were used as covariates. Results showed that there was a significant intervention effect at post-intervention time point compared to pre-intervention time point(E.S. 0.94). Multiple linear regression analysis showed significant interaction effects between intervention and satisfaction with social support. These findings must be interpreted within the context that an effects of an integrated program could be more synergistically increased when social support factor is considered in the program. A community-based integrated prevention program of depression is effective for vulnerable rural elderly. It is suggested that randomized controlled trials within community setting for better methodological strength as well as multi-level outcomes on community need to be conducted in future.

• 한국응급구조학회지
• /
• 제7권1호
• /
• pp.235-246
• /
• 2003

Due to major disasters Korea has been damaged, and they caused lots of casualties: for last ten years natural disasters caused 1288 deaths including missing people; human disasters including industrial disasters brought as many as 4,512.148 casual ties (126,372 deaths with 4,385,400 injuries); and they cost 44.1 trillion property damage. However, even though major disasters have brought about tremendous human loss and property damage, Koreas National Disaster Medical System to rescue casualties is insufficient, and it has not been activated. Fortunately, through major disaster management process, the National Disaster Management System has been developed, increasing its own efficiency, and resulting in to organize an Office of Firefighting and Prevention of Disasters under the central government. Considering the value of human lives, the disaster medical part, in the U.S.A. as well as in Korea, must have an independent organization in the government, not as one sector of the government department. It will have its own organizational structure, such as disaster planning, operation, and logistics, and interact with central and local government or between local government agencies. So each agency will cooperate and supply resources interchangeably. Also, with the system of disaster management and restoration, the disaster medical system must be advanced in keeping step. Its role must be extended due to the possibility of biological terror or SARS around the world, resulting in severe casualties. Korea has the Emergency Medical Service System based on the regulation of emergency medical care, yet it is a part of the National Disaster Management System. It must be managed independently apart from it. As we see the emergency medical technicians playing as the backbone in disaster medical care in the US, we should have legal foundations for Koreas emergency medical technicians, emergency medical providers, to participate in rescue operation actively. At the same time, we need to have a national register system to classify disaster medical resources, and a total plan to place resources according to the impact of disaster, and how to organize teams. We also need to draw up a scheme to activate civil disaster medical resources, as integrating public and private or voluntary organizations.

• 한국의료질향상학회지
• /
• 제7권2호
• /
• pp.244-261
• /
• 2000

Background : In order to cope with changes in the management environment at hospitals, increased interests are drawn in patient foodservice system on Continuous Quality Improvement Activity as the method of approaching a quality food service and effective management. Thus, as a part of this activity, this study was conducted to evaluate job flow improvement that was already performed and the results of that process at the dietetic department of a university hospital, focusing on improving management. Method : On February 15 of 1998. the dietetic department formed a job flow-improvement to decide on the priority of job flow improvement, and prepared specific action strategies and schedule of the priority: after a 5 month process period, job improvement achieved on June 15. 1998. Also, economic achievement of the task was evaluated through labor productivity analysis and cost-benefit analysis. Results : The patient food service system which was managed decentralized at the present hospital was centralized, some steps of the food service process were integrated, and quality of patient food was improved. Also, as a solution of the problems expected when conducting job flow improvement was made on food service equipments and utensils. The result of evaluating the job flow improvement that labor productivity improved by 18.2% compared to before the improvement and the result of the analysis of cost-benefit showed that Benefit-Cost (B/C) ratio was 2.22. showing financial merit on the investment. Conclusions : Continuous Quality Improvement Activity needs to be initiated and conducted in the future in various areas of hospital foodservice system in order to actively adopt to ever changing hospital management environment. In order to achieve this goal, many researches and more efforts need to be put in by people in charge of hospital food service management, and interests and support are needed from hospital policy makers.

• 서비스연구
• /
• 제3권2호
• /
• pp.45-52
• /
• 2013

정보통신기술의 발달과 함께, 인터넷의 사회 경제적 영향력 및 중요성이 급증하고 있으며, 이는 보건의료 분야에서도 다르지 않다. 인터넷상에서 건강정보가 증가하고, 이를 찾고 사용하는 사람들이 증가함에 따라 인터넷에서 제공되는 건강정보는 보건의료전문가, 정보전문가, 건강정보 소비자들의 관심 주제가 되고 있으며, 인터넷에서 제공되는 건강정보의 질 관리 및 올바른 활용을 위하여 건강정보의 질을 보장하거나 판단 시 필요한 기준, 제공시 필요한 기준들이 계속적으로 제시되고 있다. 본 논문은 HON(Health On the Net) Foundation에서 제정하고 있는 HONCODE를 이용하여 현재 국내 인터넷에 정보화 되어 있는 갑상선암에 대한 의료정보를 평가한다. 이를 통하여 갑상선암에 대한 의료정보 제공의 질 제고에 기어코자 한다.

• 보건교육건강증진학회지
• /
• 제7권1호
• /
• pp.54-63
• /
• 1990

This study aims to find out the prevalence of smoking, and to analyze the effect of smoking for health status, and then to emphasize the necessity of stop smoking. The data used in this study are obtained from periodic health care programe at Health Care Center in a suburban hospital, and selected 435 males who have occupation. The independent varibles chosen for the analysis are general charactersitic variables and smoking habit. The dependent variables are designed to cover the health status of individual cases, and include blood pressure, blood cholesterol level with HDL-cholesterol and blood triglyceride level, recent symptoms and recently being managed diseases. The result of this study are summarized as follows. 1) Percentage of smoker by the age groups is highest in 4th decade, being 71.1%. The second and third ranks are 6th and 7th decades, being 53.5% and 44.4%, respectively. 2) In the view of socio-economic levels, smoking rate is higher in the groups who live at rural area and whoes occupation is labor or merchant. Smoking rate is significantly higher in the heavy drinking group. 3) Among the atherosclerotic risk factors, which include hypertension, HDL-cholesterol by total cholesterol ratio lower than 0.2 and triglyceride level higher than 200gm/dl, hypertension was not statistically associated with smoking, but others revealed statistically high association with smoking. 4) The groups who have the symptoms of severe fatigue, gastrointestinal symptoms, pulmonary symptoms, palpitation and chest tightness havepositive association with smoking. 5) The groups who have hypertension with cardiovascular diseases and gastrointestinal diseases showed highly significant association with non-smoking. 6) In relation of the smoking habit to the atherosclerotic risk factor index, smokers have more atherosclerotic risk factors, but that is not statistically significant. 7) In relation of the smoking habit to the recent symptom index, smokers have more symptoms than non-smokers with statistical significance. In conclusion, smokers have worse health status than non-smokers especially in the atherosclerotic risk factors such as hypertension or abnormal blood lipid status and have more symptoms such as severe fatigue, gastrointestinal symptoms, pulmonary symptoms, palpitation and chest tightness. And the campaingn against smoking should direct for the male in 4th decade because they have highest smoking rate.

• 지역사회간호학회지
• /
• 제31권2호
• /
• pp.119-129
• /
• 2020

Purpose: The aim of this qualitative study is to explore the health problems and coping experiences of middle-aged and elderly women in the community. Methods: A total of five focus group interviews were conducted with three groups of middle-aged and two groups of elderly women. All interviews were recorded and transcribed. Data were analyzed using the content analysis method. Results: Health problems were categorized as confusion caused by problems that are difficult to handle alone in the middle-aged group and suffering originated by confronting changes in roles and environment in the elderly group. The health problems included stress, suffering, anxiety and social withdrawal as subcategories for the middle-aged women, and the stress, sense of loss, fear, and limited social activities caused by their life events for the elderly women. Meanwhile, the contents of categories about coping were revealed as the beginning of care for the body and mind for healthy life in the middle-aged group and active practice with insight into a healthy lifestyle in the elderly group. While the middle-aged women focused on themselves, attempted changes and started to take care of themselves, the elderly women interacted with the outside world, hardened their mind, made efforts for a dignified death, and managed health by their own methods. Conclusion: There were differences in the experiences of middle-aged and elderly women in accepting their health problems and coping. Nursing interventions reflecting these findings can help to manage and promote the health of middle-aged and elderly women based on an integrated perspective.