• Korean Journal of Social Welfare Studies
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• v.48 no.3
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• pp.171-208
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• 2017

The purpose of this study is to classify the underlying and parsimonious types of child maltreatment and examine whether the effects of risk factors on child maltreatment recurrence differ by type of maltreatment. We utilized the multiyear national administrative data from the National Child Maltreatment Information System collected by Child Protection Agency in Korea. Of 26,921 child maltreatment victims reported and substantiated on or after January 1, 2012, 1,447 children who had recurrence of child maltreatment until December 31, 2015 were selected as maltreatment recurrence group and 4,580 children who had not experienced maltreatment since first substantiation were assigned as maltreatment non-recurrence group. Latent class analysis(LCA) and latent transition analysis(LTA) were used to group children with similar maltreatment subtypes into discrete classes of child maltreatment recurrence. Logistic regression is employed to examine the association between the child maltreatment predominant types and risk factors for recurrence. Results of LCA and LTA showed four latent classes representing predominant type of child maltreatment: 'physical abuse predominant type', 'emotional abuse predominant type', 'sexual abuse predominant type', and 'neglect type'. Significant differences in the effect of risk factors among latent classes were found in child's age and gender, perpetrator's gender, family poverty, biological parent as the perpetrator, domestic violence toward partner, perpetrator's alcoholic problem, insufficient parenting skills, and out-of-home care service, Based on these findings, results suggested how the typology can be used to guide decision about who to target in prevention and intervention programs, and which features of risk factors to target. Practice and policy implications as well as further research tasks were discussed in the lights of searching for useful and important strategies to prevent recurrence of child maltreatment.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.141-158
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• 1994

To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

• The Korean Nurse
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• v.36 no.1
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• pp.77-96
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• 1997

The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

• Journal of Nutrition and Health
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• v.10 no.4
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• pp.43-58
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• 1977

Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.