• 한국농촌간호학회지
• /
• 제4권1호
• /
• pp.51-57
• /
• 2009

Purpose: This study was done to learn from the development of rural health nursing in developed countries. Method: A literature search was done using keywords such as "rural and nursing" or "rural and health" from the database CHINAL and website of institutions related to rural health and nursing. Results: In Australia, the type of rural health institution was categorized according to the population size and nursing service was done differently according to area. It is unique to Canada to have the Canadian Association of Rural and Remote Nursing, which published the survey report "the Nature of Nursing Practice in Rural and Remote Canada". In the U.S., the role of nurse practitioners in rural communities was relatively well developed and a diverse nursing care model was demonstrated. To improve health care access in rural communities, financial and political support by the governments has been part of long-term plans in the three countries. Conclusion: It is very informative to identity the difference and similarity in rural health nursing in three developed countries. For the future development of Korean rural nursing, suggestion can be made in terms of research, education and policy development.

• 대한치과마취과학회지
• /
• 제11권1호
• /
• pp.27-31
• /
• 2011

We report two cases of accidental overdoses of intramuscular midazolam used for a conscious sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The pedodontist prescribed midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 2 ml (2 mg) by verbal order to hygienist. The hygienist instead of the pedodontist wrote a prescription for midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 2 ml (10 mg). The inexperienced nurse gave an injection to his buttock as prescription. The child fell into a deep sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The inexperienced pedodontist gave an injection to his buttock midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 3 ml (15 mg) instead of midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 3 ml (3 mg). The child fell into a deep sedation. Both cases had no complications, but the accidents happened as a result of the inexperienced dental staffs. The five times midazoalm instead of the intended doses was inadvertently given intramuscularly, fortunately caused no harm in our cases. However, the situations suggest that we should carefully check the dosage and review the correct procedures, even when using a drug that is considered to be familiar with most practitioners.

• 중환자간호학회지
• /
• 제15권2호
• /
• pp.27-38
• /
• 2022

Purpose : The purpose of this study was to identify the mediating effect of role clarity in the relationship between clinical decision-making abilities and job stress among advanced practice nurses at tertiary hospitals. Methods : The participants were 137 advanced practice nurses. The assessment tools were clinical decision-making in nursing scale, role ambiguity scale, and Korean occupational stress scale (KOSS-26). Data were analyzed with the SPSS/24.0 program and mediation analysis was performed according to the Baron and Kenny methods. Results : There were significant relationships between clinical decision-making abilities and job stress (r=-.33, p<.001), and role clarity and job stress (r=-.29, p=.001). Role clarity showed partial mediating effects in the relationship between clinical decision-making abilities and job stress (Z=2.02, p=.043). Conclusion : Therefore, to reduce advanced practice nurses' job stress, it is necessary to develop a program and strategies to increase their clinical decision-making abilities.

• 임상간호연구
• /
• 제16권3호
• /
• pp.25-37
• /
• 2010

Purpose: The purpose of this study was to examine potential factors related to the management of cancer pain, that is, hospital institutional factors as well as personal aspects of nurses. Methods: This study was a descriptive research study in which 229 RNs working in 2 tertiary medical institutions in Seoul and 4 secondary medical institutions in Seoul, Incheon and Gyeonggi were surveyed. Results: It was found that nurses' knowledge about pain intervention, their working division and their knowledge about the use of analgesics had different effects on their pharmacologic interventions. These 3 variables explained 14.5% of the variance regarding pharmacologic interventions. On the other hand, nurses' knowledge about pain interventions and nursing organization were variables affecting non-pharmacologic interventions by the nurses. These two variables explained 22.1% of the variance regarding non-pharmacologic interventions by the nurses. Conclusion: The findings indicate that nursing organization, one of hospital institutional factors, had significant effects on non-pharmacologic interventions. Therefore, to increase effective pain management by nurses, an organizational system should be established such as placement of nurse practitioners, improvement of nurses' autonomy in pain management, and development and distribution of standardized guidelines.

• 대한간호학회지
• /
• 제25권4호
• /
• pp.751-773
• /
• 1995

We, clinical nurse specialists practising and guiding student practice in a Community health nursing clinic, wanted to develop a family pattern appraisal consistent with Rogers' conceptual system, the nursing model guiding our practice. We use Rogers' model because it is harmonious with the traditional Korean view of the one human, natural and cosmic world. The purpose of our research was to contribute to science - based nursing practice, not only, one helpful model, but also a model of how to use, in guiding practice, a conceptual system which reflects nurse practitioners' philosophy of nursing, is intellectually satisfying, and enriches meaning in daily nursing life. The research objectives were to review the literature on Rogers' model and analyse it according to Kim's five - level analytical framework, to explore Rogers' definition of family, to review appraisals based on Rogers' model, and to develop a family appraisal which is culturally appropriate for use in our community. This work including the use of the appraisal and its refinement with families in our practice which was done during 1994 and 1995, in Seoul, in the Capital of the Republic of Korea. At the highest level of analysis, Rogers conceptual system emphasizes acausality and multidimentional meaning ; the world view is characterized by process, movement and wholeness. The epistemology Is one of holism and the knowledge base includes all forms of experience, from sensory to mystical, objective, and subjective. At the metaparadigm level, nursing focuses on the unitary human being and the environment. At the level of nursing philosophy, the model identifies human being, nursing, nurse, and illness and health. At the paradigm level the model assumes the irriducibility of the human to parts, noncausality and continual change. Rogers' practice methodology consists of pattern manifestation appraisal and deliberative mutual patterning. Under-standing patterns and patterning of people is the key to helping them achieve their potential. At the theory level, the basic assumptions, key concepts, and homeodynamic principles were identified. Rogers states the family energy field is an undividable, four-dimensional negentropic energy field which is in a larger envircinmental field show-ing such characteristics as cannot be predicted by knowledge of individual family members. Based on the word of Rogers scholars, we chose Rogers' correlates of patterning to understand the family unit as a whole-frequency, rhythms, motion, time perception, sleeping-waking beyond waking, pragmatic -imaginative-visionary to develop the appraisal. We, also used some of Barrel's (1988) criteria including interpersonal network and professional health care access and use, and Cordon's (1982) criteria including self perception - self concept modified to fit the family. Our family Pattern appraisal included 1. Influencirg data, 2. Professional health care access and use, 3. Family self perception-self concept, 4. Family interpersonal network, 5. Sleep-wake-be-yond waking, 6. Pragmatic-imaginary-visionary, 7. Family frequency and rhythm, 8. Family motion, 9. Family time perception. The appraisal was used with four families and modified to eliminate overlap and to make it possible for the family member to express themselves more easily. We plan to gain more experience with the appraisal toward further development of the tool.

• 지역사회간호학회지
• /
• 제13권4호
• /
• pp.757-766
• /
• 2002

Purpose: Recently there have been many changes in health care environments in Korea. To perform public health programs effectively and efficiently, it is necessary to analyze and identify the demand and supply for the public health nurses. Method: The study analyzed experts' opinions regarding the supply of public health nurses, as well as national and foreign statistical data on workforce supply of public health nurses. Two methods for estimating the amount of demand for public health nurses were used: one was applying the indicators of developed countries for public health nurses based on population: the other was to refer to regulations and/or recommended guidelines in Korea. Result: 1) The number of public health centers, public health sub-centers, and primary health care posts have decreased between 1990 and 2001, from 260 to 242, 1318 to 1270, 2038 to 1907, respectively. 2) Between 1997 and 2002, the number of public health nurses has also decreased from 5572 to 5112. 3) In the case of applying regulations, the number (5112) of existing public health nurses falls shortly by 942. 4) In 2001, the Korean population per one public health nurse was 9262. 5) In the case of applying regulations, the number of public health nurses required to meet the demand for health services in 2001 and 2020 is estimated at 5932 and 6347, respectively. 6) In the case of applying the indicators of developed countries, the number of public health nurses required to meet the demand for health service in 2001 and 2020 is estimated at 9.469 and 10.310, respectively. Conclusion and suggestions: Because of the importance of public health industry, public health nurses have been approved as a field specialist and specialized nurse practitioner by the newly revised legal regulation, there have been absence of approval of their role differentiation and capability. In addition, organizational activity and insufficient number of the public health nurses have contributed to the inactive utilization of them. As community public health is focused on caring individuals as well as organizations, it requires more autonomy and special skills than other fields. Therefore, public health nurses need to enhance the capability as health educator, consultant, and information management persons through advanced education course for public health nurses. Public health nurses need to be prepared as advanced nurse practitioners by receiving advanced education courses and field experiences.

• 농촌의학ㆍ지역보건
• /
• 제17권1호
• /
• pp.34-45
• /
• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• 보건교육건강증진학회지
• /
• 제27권5호
• /
• pp.41-50
• /
• 2010

목적: 한국 농촌지역에 있는 보건진료소에서 수행하고 있는 고혈압 예방 및 관리 사업 평가도구를 개발하고, 이를 활용하여 현장에서 수행되고 있는 프로그램을 평가하고자 한다. 방법: 문헌고찰, 현장방문과 보건진료소에서 근무하는 보건진료원과의 심층면담을 통해 예비문항을 작성하고, 전문가(중앙기관의 업무행정담당자 5인, 보건진료원 6인, 이론과 연구전문가 5인)집단을 통해 2회 내용타당도 검정을 실시하였다. 전문가들에 의해 80%이상 동의한 항목만을 선정한 결과, 4개 영역, 12개 항목, 41개 세부평가 항목으로 구성된 평가도구가 완성되었다. 4개 영역은 고혈압 예방사업, 고혈압 관리사업, 사업여건조성, 자체평가로 분류되었고. 고혈압 예방사업 영역은 보건교육, 고혈압환자 조기발견 항목이 포함되었고, 고혈압 관리사업 영역은 고혈압환자 등록 및 관리사업, 교육 및 상담, 고혈압환자 치료 및 추구관리 항목이 포함되었다. 사업여건조성 영역은 지역주민의 접근성, 보건교육자료의 비치, 홍보 항목이 있고, 자체평가는 사업계획서 수립, 중간평가, 결과평가 항목으로 구성하였다. 영역별 가중치는 전문가타당도 검정을 통해 각기 다르게 설정하였으며, 연구대상은 전국 보건진료소를 모집단으로 비례층화추출법에 의해 700개소를 선정하였다. 연구의 윤리적인 측면을 고려하여 설문지 표지에 연구에 대한 구체적인 소개, 익명성보장과 자발성을 제시하고 자가 보고식의 우편설문조사를 실시하였다. 최종적으로 215개의 설문지를 자료 분석에 활용하였다. 결과: 영역별 평가결과에 의하면 고혈압 관리 사업이 평균 28.81점(72%), 고혈압 예방사업은 평균 23.44점(67%), 사업여건조성이 평균 4.29점(43%), 자체평가 5.10점(34%) 순으로 나타났다. 항목별 평가에서 가장 낮은 결과를 보인 것은 보건교육을 위한 교육매체 보유, 공식적인 연계망, 고혈압사업의 여건조성을 위한 물리적 환경조성과 사업결과로 나타났다. 결론: 보건진료소에서 실시하고 있는 고혈압 예방 및 관리 사업을 좀 더 효과적으로 수행하기 위해서는 사업여건 조성과 자체평가 영역을 향상시켜야 할 것으로 사료된다.

• 농촌의학ㆍ지역보건
• /
• 제18권2호
• /
• pp.105-119
• /
• 1993

The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.

• 대한간호학회지
• /
• 제30권5호
• /
• pp.1195-1206
• /
• 2000

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.