• Title/Summary/Keyword: medical services

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Improvement of Knowledge, Self-Efficacy and Self-Care Behaviors among Diabetic Patients participated in the Education Program of Sejong Center for Hypertension and Diabetes Management (당뇨병 환자 교육에 따른 지식, 자기효능감 및 자기관리행위의 변화: 세종특별자치시 고혈압·당뇨병 등록교육센터 등록자를 중심으로)

  • Jung, Jin-Gyu;Chung, Eun-Young;Kim, A-Ryeon;Park, Hyun-Jin;Kim, Yun-Jung;Ban, Young-Hwa;Kim, Jong-Sung;Yoon, Seok-Joon;Kim, Soon-Young;Ahn, Soon-Ki;Nam, Hae-Sung
    • Journal of agricultural medicine and community health
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    • v.42 no.4
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    • pp.234-243
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    • 2017
  • Objective: This study was aimed to evaluate the effectiveness of the diabetes education program implemented in a community hypertension and diabetes education center. Methods: Participants were thirty nine diabetic patients who received the education program in the center from May 2014 through May 2015. The education program consisted of two sessions for 2 days (45 minutes per session) regarding clinical information, nutrition and exercise for type 2 diabetes patients. Initially, they were assessed for general characteristics, knowledge on diabetes, self-efficacy and self-care behaviors. Reassessment was performed on their knowledge and self-efficacy directly after the program, and on self-care behaviors at 12 weeks after the program. Results: The mean score of diabetes knowledge was significantly increased from $5.27{\pm}2.10$ to $8.21{\pm}1.20$ (p<0.001) between before and after the program. The self-efficacy score was also significantly increased from $6.88{\pm}1.72$ to $8.16{\pm}1.47$ (p<0.001). The self-care behavior score was significantly increased from $3.59{\pm}1.89$ before the program to $4.35{\pm}1.29$ (p<0.001) at 12 weeks after the program. Conclusion: The diabetes education program may be effective on the improvement of knowledge, self-efficacy and self-care behaviors in type 2 diabetic patients.

A Study on the Relationship of School Oral Health Clinics to the Dental Caries Experience of Children (초등학교 내 학교구강보건실 운영 여부에 따른 아동의 치아우식경험도 비교 연구)

  • Lim, Soon-Hwan;Kim, Eung-Kwon;Gwon, Mi-Young
    • Journal of dental hygiene science
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    • v.5 no.4
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    • pp.233-238
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    • 2005
  • The study was intended to investigate elementary schoolers' oral health status according to whether the school have and manage an school oral health clinic or not in order to provide useful information for continuously developing the school oral health clinic 1,163 children in Hwasan elementary school in Hwasung city and 485 children in S elementary school in the same locality were selected as the experimental group and the control group, respectively, and orally examined from May 1st to 30th, 2004. The findings from the oral examination were as follows. 1. DMF rate was higher in the higher grades in both the groups. The rate was lower in the experimental group with 45.1% of the children than in the control group with 65.3% of the children. 2. DMFT rate also were higher as the grades were higher in both the groups. The ratio was lower in the experimental group with 30.4% of the children than in the control group with 44.6% of the children. 3. DMFT index was 1.0 in number in the experimental group and 1.6 in the control group. Index increase from the 1st grade to the sixth grade was also more positive in the experimental group. 4. DT rate was a little higher in the experimental group in the first graders, but comparatively decreased to the grades while increased in the control group. In the sixth graders, the rate was 42.4% in the experimental group and 87.7% in the control group, the former was less than the latter by about 50% point. 5. FT rate was a little higher in the control group for the first graders but increased in the experimental group to the grades. The rate in the sixth graders was higher by more than double in the experimental group. Based on the above findings, the region of the study had better oral health statistics than in other regions. The operation of school oral health clinics that provide dental health care to children at the right time seems to contribute to enhancing their dental health status by preventing against dental diseases and changing their relevant knowledge, attitude and behaviors. In the future, more school oral health clinics should gradually be prepared to push ahead with a sustained, extensive dental health project geared toward school-aged children. To make it happen, dental hygienists who are professional medical personnels should be taken advantage of, and in order to beef up the efficiency of preventive measures and oral health education, the best dental health care services should be offered by harnessing dental hygienists and dentists who work at public dental clinics run by local governments.

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A Study on the Applicability of Social Security Platform to Smart City (사회보장플랫폼과 스마트시티에의 적용가능성에 관한 연구)

  • Jang, Bong-Seok
    • Journal of the Korea Convergence Society
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    • v.11 no.11
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    • pp.321-335
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    • 2020
  • Given that with the development of the 4th industry, interest and desire for smart cities are gradually increasing and related technologies are developed as a way to strengthen urban competitiveness by utilizing big data, information and communication technology, IoT, M2M, and AI, the purpose of this study is to find out how to achieve this goal on the premise of the idea of smart well fair city. In other words, the purpose is to devise a smart well-fair city in the care area, such as health care, medical care, and welfare, and see if it is feasible. With this recognition, the paper aimed to review the concept and scope of smart city, the discussions that have been made so far and the issues or limitations on its connection to social security and social welfare, and based on it, come up with the concept of welfare city. As a method of realizing the smart welfare city, the paper reviewed characteristics and features of a social security platform as well as the applicability of smart city, especially care services. Furthermore, the paper developed discussions on the standardization of the city in terms of political and institutional improvements, utilization of personal information and public data as well as ways of institutional improvement centering on social security information system. This paper highlights the importance of implementing the digitally based community care and smart welfare city that our society is seeking to achieve. With regard to the social security platform based on behavioral design and the 7 principles(6W1H method), the present paper has the limitation of dealing only with smart cities in the fields of healthcare, medicine, and welfare. Therefore, further studies are needed to investigate the effects of smart cities in other fields and to consider the application and utilization of technologies in various aspects and the corresponding impact on our society. It is expected that this paper will suggest the future course and vision not only for smart cities but also for the social security and welfare system and thereby make some contribution to improving the quality of people's lives through the requisite adjustments made in each relevant field.

The Impact of Childhood Cancer on The Korean Family (암 환아 발생이 가족에게 미치는 영향에 관한 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.636-652
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    • 1992
  • This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

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Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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A Study of the Relationship between Personality Traits and Job Satisfaction of Community Health Practitioners in a Rural Area (일부 보건진료원의 성격특성과 직무만족도에 관한 연구)

  • Lee, Soon-Ryae;Park, Sang-Hag
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.331-350
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    • 1999
  • This study was attempted to examine relationship between personality traits and job satisfaction of community health practitioners(CHPs) working in remote rural area in order to suggest some methods to enhance their lob performance and the degrees of job satisfaction. The General Personality Test and the revised version of Job Satisfaction Questionnaire were administered to 200 of 348 CHPs in the Kwangju-Chonnam area and then the percentages, means, standard deviations and Pearson's correlation coefficients of these data were obtained, ANOVA and logistic analysis were used. The results of study were as follows : 1. CHPs without religion were more satisfied with their salary than those with religion. 2. CHPs who hoped for continuous education showed higher scores than the others on necessary job, professional pride and autonomy. Those who chose for independent job showed higher scores than the others on both necessary job and professional pride. Those who hope for long duration showed higher scores than the others on both necessary job and professional pride. Those who were satisfied with the present occupation showed higher scores than the others on pay satisfaction, necessary job, professional pride, interaction, autonomy and demand from organization. 3. Their autonomy scores differed significantly according to work status, both interaction and autonomy scores did so according to the fields of the past job in CHP, and their autonomy scores according to location of clinics. Their interaction scores differed significantly according to the frequency of home visits per mouth, both the degrees of salary satisfaction and professional pride scores did so according to the frequency of counseling education per mouth, and their professional pride scores did so according to total income per year. 4. The levels of their responsibility and self-confidence showed the highest of all personality traits variables. 5. The professional pride score of CHPs showed the highest of all job satisfaction variables. 6. Dominance were mostly correlated with autonomy and responsibility were mostly associated with professional pride. Both emotional stability and self-confidence were mostly related necessary job. In conclusion, religion, location of clinics, clinical experience, opportunity for education, dominance, self-confidence, the duration of services hoped for, satisfaction with the present occupation, the field of past job and administrative affairs were found to be the important factors in the degrees of their job satisfaction. Therefore, the methods to consider these variables will be necessary to develop for enhancing the efficiency of their Job performance and the degrees of job satisfaction.

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A Study on Therapeutic Compliance of Hypertensive Patients in a Rural Health Subcenter (일개 농촌지역 보건지소 고혈압 환자의 치료지속성)

  • Song, Min-Keun
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.155-164
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    • 2002
  • Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

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Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Globalization and Independency of Populist Nations' Welfare Policies: Focusing on the Influences of Multinational Pharmaceutical Companies on the Korean Government's Policy on the Pharmaceutical Industry (세계화와 국민국가의 복지정책 자율성: 다국적 제약자본이 우리나라 제약정책 결정에 미친 영향을 중심으로)

  • Lee, Su-Yun;Kim, Young-Mi
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.5-30
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    • 2005
  • Globalization has conflicting effects on pharmaceutical policies. A change into a 'populist competitive nation' due to globalization strengthens policies to reduce drug manufacturing costs while the WTO's TRIPS Agreement that is affected by multinational pharmaceutical companies increases drug manufacturing costs by bolstering the patent rights on new drugs. Currently, the independency of populist nations' policies to reduce drug manufacturing cost is being compromised because multinational organizations(such as the European Union) which represents the interests of the multinational pharmaceutical companies put restrictions on the pharmaceutical policies of populist nations for purposes of promoting the industrial goals of the multinational companies. Korea is no exception. Up until the late 1990s, the main feature of the pharmaceutical policies in Korea was keeping the drug price at the cost level based on a growth-driven ideology, and this was Korea's unique policy tools as a developing nation. However, the increase in the power of multinational pharmaceutical companies currently infringes on the independency of Korea's pharmaceutical policies. Expensive imported drugs were originally covered by the national health insurance plan, but starting from 1999 such drugs began to be covered by the plan. After separation of medical and pharmaceutical services, the use of expensive drugs was increased, and the Korean government planned to introduce the reference price policy in order to contain the cost of the national health insurance plan. However, due to pressures from the U.S. government as well as multinational pharmaceutical companies, implementation of the policy has been postponed. In addition, due to a pressure from the U.S. government, a working group was created which would affect the health care policy of the Korean government. Discussions so far on globalization was about whether the change into populist competitive nations due to globalization resulted in the reduction of welfare spending. However, this study shows not only the reduction of health care cost through policies to reduce drug manufacturing costs but increase in welfare spending by raising the strengths of multinational pharmaceutical companies that are for-profit providers of welfare service. While focusing on the contradictory effects of globalization on pharmaceutical policies of a nation, this study looked at how these conflicting effects end up promoting the interests of multinational pharmaceutical companies by examining the Korean case.

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The Characteristics of Population Flows in kwangju Metropolitan Area (光州 中心의 人口移動 特性에 관한 硏究)

  • Chouh, Hae-Chong
    • Journal of the Korean Geographical Society
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    • v.28 no.1
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    • pp.40-57
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    • 1993
  • This paper aims to show the various aspects of migration in Kwangju merropolitan area, southwestern Korea, for a period of years 1980-1985. Migratory patterns are spatially extensive in countryside around Kwanfju, and due to high accessibility to the metropolitan area urban implosion emerges in the city. In Chonnam province where Kwangju is loca-ted, all cities and counties except for such in-dustrial areas as Yochon, and Kwangyang are experiencing population losses in terms of net migration by survival rate methods. Kwangju is the exceptionally one of in-migration areas in Chonnam, though its central part(Dong-Gu) is also an out-migrated area. Predominantly in-migration urban areas have high proportions of a student age group between 15-19 years, and that reflects the importance of the educational factor in migration analysis. The municipal authorities of Kwangju are planning to block the way of the middle sxhool students who live in the outskirts of Kwangju to entrance to high school in the city. Thant may stir up migrations into Kwangju for the elementary and middle school students, because the city id expected to provide educational opportunities higher and better than remaining Chonnam areas. Population of Kwangju would, therefore, grow as the students migrate into the city. The findings on the residential intra-city movement in selected 5 Dongs indicate that implications of a short-distance movement re noteworthy; neighbour to neighbour, and the nearest stop in the way from the outer Kwangju as well. Trends in a short-distance movement are in accord with Ravensteins's "law of migra-tion". But in casw of the inter-provincial migra-tion to Kwangju, the number of in-migrants from remoter Seoul is more than that from nearer Chonbuk province. Therefore it supports the fact that the movement between capital region and far off local cities overcomes a distance barrier. The temporary mobility for a day has been increased as the standard of living has improved and it reaches a peak on weekend or on con-secutive holidays. The number of temporal movers to Kwangju from capital region and Yongnam area, southeastern Korea has a greatincrease in terms of the frequency of the passengers' mobility, in particular on Myongjol(the ethnic and traditional festival day) in com-parison with on weekdays. By comparison with two largest Myongjols, the number of movers is more on Chusok(The Full Moon festival on lunar August) than on Sol (lunar new year's day). Annual peak point of weekday movers appears in August because of summer vacation. But the lowest one appears in June, which is related to the busy farming season. A patients' move for medical services in on the increase with a change of living conditions. It is especially true in the industrial counties such as Kwangyang and Yochon. By way of conclusion, it should be pointed out that one of the problems we face in survey of migration volume by the survival rate method is that the survival rate somtimes exceeds the value 1.0, in normal states of which should be under 1.0. it may be due to the shortcoming from the census statistics. We should not give therefore too much stress on the importance of migrations or moves as an element of changes in spatial pattern. In cinclusion, the results of the study show some geographic facts as the followings: 1. One of the outstanding phenomena in all types of movement is the seletivity of ages. The most important factors are related to education and employment. 2. Short-distance movement is carried out in accordance with Ravenstein's law, but in case long-distance movement, in-migration from capital region is prominent in spite of remoten-ces. The gravity between large cities such as Kwangju and Seoul, which has a frequent human movenent, causes urban implosion of small cities between those cities. 3. The temporary mobility for a day, in con-trast to that of permanent movement, is more related to transportation, and its volumes and annual variations are a large-scale. 4. Passengers' mobility is high in industrial cities. And the scope of patients' mobility is narrower than passengers'.

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