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Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)

  • Lee, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.176-192
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    • 1991
  • School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

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Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease- (가정산소치료의 보험급여 실시 이후 처방 실태: 다기관 조사 -만성기도폐쇄성질환 임상연구센터 제3세부과제 만성기도폐쇄성질환 진료지침 개발/보급 연구-)

  • Park, Myung Jae;Yoo, Jee-Hong;Choi, Cheon Woong;Kim, Young Kyoon;Yoon, Hyoung-Kyu;Kang, Kyung Ho;Lee, Sung Yong;Choi, Hye Sook;Lee, Kwan Ho;Lee, Jin Hwa;Lim, Sung-Chul;Kim, Yu-Il;Shin, Dong Ho;Kim, Tae Hyun;Jung, Ki-Suck;Park, Yong Bum
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.88-94
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    • 2009
  • Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

Measurement of Environmental Radiation Using Medical Scintillation Detector in Well Counter System (의료용 우물형 섬광계수기를 이용한 환경 방사선 측정)

  • Lyu, Kwang Yeul;Park, Yeon-joon;Kim, Min-jeong;Ham, Eun-hye;Yoon, Ji-yeol;Kim, Hyun-jin;Min, Jung Hwan;Park, Hoon-Hee
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.337-345
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    • 2015
  • After the Fukushima nuclear accident in 2011, concerns about radiation by people are increasing rapidly. If people could know how much they will be exposed by radiation, it may help them avoiding it and understand what exactly radiation is. By doing this, we were helping to reduce the anxiety of radiation contamination. In this study, we have researched figures of radioactivity with 'Captus-3000 thyroid uptake measurement systems' in well counter detector system. The materials were measured with Briquette, Shiitake, Pollock, Button type battery, Alkaline battery, Topsoil, Asphalt, Gasoline, Milk powder, Pine, Basalt stone, Pencil lead, Wasabi, Coarse salt, Tuna(can) Cigar, Beer, and then we categorized those samples into Land resources, Water resources, Foodstuff and Etc (Beer classified as a water resources has been categorized into Foodstuff). Also, we selected the standard radiation source linear 137Cs to measure the sensitivity of well counter detector. After that, we took cpm(counter per minute) for the well counter detector of thyroid uptake system's sensitivity. Then we compared the results of each material's cpm and converted those results to Bq/kg unit. There were a little limitation with the measurement equipment because it has less sensitivity than other professional equipment like 'High purity germanium radiation detector'. Moreover, We didn't have many choices to decide the materials. As a result, there are macroscopic differences among the rates of material's spectrum. Therefore, it had meaningful results that showed how much each material had emitted radiation. To compare the material's cpm with BKG, we've compounded their spectrums. By doing that, we were able to detect some differences among the spectrums at specific peak section. Lastly, Button type battery, Alkaline Battery, Briquette, Asphalt and Topsoil showed high value. There were classified emitting high radiation Group A and emitted lower radiation Group B. The Group A, alkaline battery showed higher rate of radiation by 7.67 %, and Button type battery was yield 4.65 % higher rate than BKG. Additionally, Asphalt (8.03 %), Topsoil (3.76 %), Briquette (7.46 %) were yield for higher values. Several samples of the daily supplies were yield little higher, but it seems safe to use in daily lives. In the case of the 'Foodstuff', all of the samples were safe and they were under the radiation limits of the Ministry of Food and Drug Safety for Food; thus, we highly recommend this study to you as a reference of common daily routine.

Gait Analysis of a Pediatric-Patient with Femoral Nerve Injury : A Case Study (대퇴신경 손상 환아의 보행분석 : 사례연구)

  • Hwang, S.H.;Park, S.W.;Son, J.S.;Park, J.M.;Kwon, S.J.;Choi, I.S.;Kim, Y.H.
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.165-176
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    • 2011
  • The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

A Study on Hospital Infection Management of Radiological Technologist (방사선사의 병원감염관리에 대한 연구)

  • Jeong, Bong-Jae
    • Journal of the Korean Society of Radiology
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    • v.12 no.6
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    • pp.727-735
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    • 2018
  • Targeting the radiological technologists working in Gyoungsangnam province, this study was performed to obtain the fundamental data to improve the competency and right awareness of the hospital infection management, and to educate infection management of radiological technologists by analyzing the status, awareness, and performance of the hospital infection management. During April 1, 2018 to April 31, 2015, after we sent out a total of 400 questionnaires for the survey to radiological technologists working at the clinic located in Gyoungsangnam province, 320 questionnaires suitable for research were analysis by using SPSS 18.0 statistical analysis software. As the hospital infection management factors, 5 items for hospital infection and 60 items of the awareness and performance for the hospital infection management were used. 60 items of the awareness and performance for the hospital infection management were consisted hand hygiene, personal hygiene and clothing, medical equipment and supplies, cleaning and waste, examination and environment. And as the sociodemographic characteristics, the gender, marriage, age, level of education, working organization, working period, and working department were used. Consequentially, the awareness for the hospital infection management($4.19{\pm}.60$) and the performance($4.22{\pm}.52$) were confirmed as high level. Using these results, the hospital infection management level of the radiological technologists working in Gyoungsangnam province was found to be high in arareness and performance of hospital infection management. There was a significant correlation between the degree of awareness and performance of radiological technologists for hospital infection management. Furthermore, in the multiple regression analysis of cognitive factors on performance, it was found that 66.1% explanatory power had a significant positive influence. In order to improve the awareness of hospital infection management of radiological technologist working in various departments, the infection management education and improvement of hospital work environment are necessary. And also, It is important to participate actively in hospital infection management and preventive education and to play a pivotal role in securing expertise in hospital infection management.

Problems in the Korean National Family Planning Program (한국가족계획사업(韓國家族計劃事業)의 문제점(問題點))

  • Hong, Jong-Kwan
    • Clinical and Experimental Reproductive Medicine
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    • v.2 no.2
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    • pp.27-36
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    • 1975
  • The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

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