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Study on the Multilevel Effects of Integrated Crisis Intervention Model for the Prevention of Elderly Suicide: Focusing on Suicidal Ideation and Depression (노인자살예방을 위한 통합적 위기개입모델 다층효과 연구: 자살생각·우울을 중심으로)

  • Kim, Eun Joo;Yook, Sung Pil
    • 한국노년학
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    • v.37 no.1
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    • pp.173-200
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    • 2017
  • This study is designed to verify the actual effect on the prevention of the elderly suicide of the integrated crisis intervention service which has been widely provided across all local communities in Gyeonggi-province focusing on the integrated crisis intervention model developed for the prevention of elderly suicide. The integrated crisis intervention model for the local communities and its manual were developed for the prevention of elderly suicide by integrating the crisis intervention theory which contains local community's integrated system approach and the stress vulnerability theory. For the analysis of the effect, the geriatric depression and suicidal ideation scale was adopted and the data was collected as follows; The data was collected from 258 people in the first preliminary test. Then, it was collected from the secondary test of 184 people after the integrated crisis intervention service was performed for 6 months. The third collection of data was made from 124 people after 2 or 3 years later using the backward tracing method. As for the analysis, the researcher used the R Statistics computing to conduct the test equating, and the vertical scaling between measuring points. Then, the researcher conducted descriptive statistics analysis and univariate analysis of variance, and performed multi-level modeling analysis using Bayesian estimation. As a result of the study, it was found out that the integrated crisis intervention model which has been developed for the elderly suicide prevention has a statistically significant effect on the reduction of elderly suicide in terms of elderly depression and suicide ideation in the follow-up measurement after the implementation of crisis intervention rather than in the first preliminary scores. The integrated crisis intervention model for the prevention of elderly suicide was found to be effective to the extent of 0.56 for the reduction of depression and 0.39 for the reduction of suicidal ideation. However, it was found out in the backward tracing test conducted 2-3 years after the first crisis intervention that the improved values returned to its original state, thus showing that the effect of the intervention is not maintained for long. Multilevel analysis was conducted to find out the factors such as the service type(professional counseling, medication, peer counseling), characteristics of the client (sex, age), the characteristics of the counselor(age, career, major) and the interaction between the characteristics of the counselor and intervention which affect depression and suicidal ideation. It was found that only medication can significantly reduce suicidal ideation and that if the counselor's major is counseling, it significantly further reduces suicidal ideation by interacting with professional counseling. Furthermore, as the characteristics of the suicide prevention experts are found to regulate the intervention effect on elderly suicide prevention in applying integrated crisis intervention model, the primary consideration should be given to the counseling ability of these experts.

Householder's Working Type and Household Saving: A Perspective of the Precautionary Saving Behavior Theory (가구주 근로유형과 가계저축: 예비적 저축행동 이론의 관점)

  • Shim, Young
    • Journal of Consumption Culture
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    • v.15 no.1
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    • pp.93-118
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    • 2012
  • The purpose of this study was to examine the effect of a householder's working type on household saving from the perspective of precautionary saving behavior theory and the determinants of household saving by householder's working type. The data for this study was from the 2009 year of the Korea Welfare Panel Survey (KOWEPS), consisting of 2,463 households with householders whose working type was regular or non-regular employment(temporary, daily or public work). OLS regression analyses and Chow-tests were performed. In the regression analyses, the dependent variables for household saving were precautionary saving and precautionary asset. Precautionary saving was operationalized with the amount of average monthly saving and the ratio of average monthly saving to average monthly disposable income, and precautionary asset was operationalized with the amount of financial assets and the ratio of financial assets to net assets. The independent variables were household income, household assets, householder's working type(regular, non-regular), householder's age, sex, education level and marriage status, income level, the number of household members, housing type, debt, and public transfer income. Monthly average total consumption expenditures for household income, and net assets for household assets, the existence of spouse for marriage status, poverty for income level were used. Public transfer income was classified into three, social insurance, basic assistance and government assistance. For the analyses, Stata 11.0 version was used. The results are as follows: Householder's working type was significantly related to the precautionary saving behavior of a household. However, the precautionary saving and the precautionary asset of a household with a householder in non-regular working type was lower than those of a household with a householder in regular working type. This result is not consistent with the expectation from the perspective of precautionary saving behavior that the saving of a household with a householder in non-regular working type is expected to be higher than that of a household with a householder in regular working type. According to the analyses of the determinants for precautionary saving behavior by householder's working type, monthly average total consumption expenditures, debt, net assets, poverty, the number of household members, basic assistance were statistically significant variables. The positive relation of basic assistance to precautionary saving(the amount of average monthly saving and the ratio of average monthly saving)is a noteworthy result in the analyses of the determinants for household saving by householder's working type. The above results suggest the followings. First, it is easy to predict the unstability of economic life of a household with a householder in non-regular working type because of relatively low precautionary saving and precautionary asset. The reason for the low precautionary saving and the low precautionary asset may be a low current income of the household in spite of its willingness to save. If this reasoning is possible, it suggests that policies are needed for households with householders in non-regular working type to save. Second, the relatively low precautionary saving and precautionary asset of a household with a householder in non-regular working type suggest also their long-term economic stability. This suggests they need to try a long-term financial planning even though they have limitations to save for future because of their low current income. It is necessary to develop the financial planning for the households with unstable incomes. Third, the determinants for precautionary saving behavior by householder's working type were mostly the ones which reflect the economic condition of a household. This suggests that the economic condition of a household is a core factor for household saving. Consequently, it emphasizes the efforts for a household to acquire the adequate level of income for saving. Forth, the positive relation of basic assistance to precautionary saving(the amount of average monthly saving and the ratio of average monthly saving) suggests the possibility for a household to accumulate the precautionary saving and the precautionary asset in the channel of basic assistance.

An Empirical Analysis of The Determinants and Long-term Projections for The Demand and Supply of Labor force (노동력수급의 요인분석과 전망)

  • 김중수
    • Korea journal of population studies
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    • v.9 no.1
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    • pp.41-53
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    • 1986
  • The purpose of this paper is two-fold. One is to investigate the determinants of the demand supply of labor, and another is to project long-term demand and supply of labor. The paper consists of three parts. In the first part, theoretical models and important hypotheses are discussed: for the case of a labor supply model, issues regarding discouraged worker model, permanent wage hypothesis, and relative wage hypothesis are examined and for the case of a demand model, issues regarding estimating an employment demand equation within the framework of an inverted short-run produc- tion function are inspected. Particularly, a theoretical justification for introducing a demographic cohort variable in a labor supply equation is also investigated. In the second part, empirical results of the estimated supply and demand equations are analyzed. Supply equations are specified differently between primary and secondary labor force. That is, for the case of primary labor force groups including males aged 25 and over, attempts are made to explain the variations in participation behavior within the framework of a neo-classical economics oriented permanent wage hypothesis. On the other hand, for the case of females and young male labor force, variations in participation rates are explained in terms of a relative wage hypothesis. In other words, the participation behavior of primary labor force is related to short-rum business fluctuations, while that of secondary labor force is associated with intermediate swings of business cycles and demographic changes in the age structure of population. Some major findings arc summarized as follows. (1) For the case of males aged 14~19 and 2O~24 groups and females aged 14∼19, the effect of schhool enrollment rate is dominant and thus it plays a key role in explaining the recent declining trend of participation rates of these groups. (2) Except for females aged 20∼24, a demographic cohort variable, which captures the impact of changes in the age structure on participation behavior, turns out to show positive and significant coefficients for secondary labor force groups. (3) A cyclical variable produce significant coefficients for prime-age males and females reflecting that as compared to other groups the labor supply behavior of these groups is more closely related to short-run cyclical variations (4) The wage variable, which represents a labor-leisure trade-off turns out to yield significant coefficients only for older age groups (6O and over) for both males and females. This result reveals that unlike the experiences of other higer-income nations, the participation decision of the labor force of our nation is not highly sensitive with respect to wage changes. (5)The estimated result of the employment demand equation displays that given that the level of GNP remains constant the ability of the economy to absord labor force has been declining;that is, the elasticity of GNP with respect to labor absorption decreasre over time. In the third part, the results of long-term projections (for the period of 1986 and 1995) for age-sex specific participation rates are discussed. The participation rate of total males is anticipated to increase slightly, which is contrary to the recent trend of declining participation rates of this group. For the groups aged 25 and below, the participation rates are forecast to decline although the magnitude of decrease is likely to shrink. On the other hand, the participation rate of prime- age males (25 to 59 years old) is predicted to increase slightly during 1985 and 1990. For the case of females, except for 20∼24 and 25∼34 age groups, the participation rates are projected to decrease: the participation rates of 25∼34 age group is likely to remain at its current level, while the participation rate of 20∼24 age group is expected to increase considerably in the future (specifi- cally, from 55% in 1985 to 61% in 1990 and to 69% in 1995). In conclusion, while the number of an excess supply of labor will increase in absolute magnitude, its size as a ratio of total labor force is not likely to increase. However, the age composition of labor force is predicted to change; that is, the proportion of prime-age male and female labor force is projected to increase.

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A Study on the Motive and Evaluation of the Job for a Special Private Security Tasks (특수경비원의 직업선택동기와 직업평가에 관한 연구)

  • An, Hwang-Gwon
    • Korean Security Journal
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    • no.12
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    • pp.225-243
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    • 2006
  • This study is focused on the relation in the motive and the evaluation for the job in a special private security field. The supplement of the outstanding human resources is one of most important matter to improve the private security industry. For it the applicant's motive and evaluation of whose quality should be screened to recruit proper and oustanding human resources into the industry. For the study the follow elements would be considered. First, What is the real motive to apply the job and how prospect on the job the applicant will be taken. Second, what is different point of view to the job between male and female. Third, what relationship is in achieving the job performance between the temporary motive and the planed motive. Forth, what effects are on the job satisfaction and the planed motive for the job. With the above elements the survey was taken based on each sex for the study and the results are out as below. a) Male is in higher than female in taking with unplaned job motive and for job satisfaction is much higher in 1-20 age range. b) In general, the expectation on the job is much higher than the current job status, the male are in the expextation on the job and the female are in the the current job status. c) The job satisfaction is on positive effect to the planed taken job but the unplaned taken job is on negative. From the Research the most concerning element on the recruiting new employee is applicant's positive attitude on the job he/she will be taken.

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Influence of the Hoping Number of Children, the Policy of Childbirth, and the Causes of Reduced Childbirth to the Perception of Childbirth in Health-Line College Students (일 지역 보건계열 대학생을 대상으로 한 희망자녀수, 출산정책, 출산저하 원인이 출산인식에 미치는 영향)

  • Jung, Sang-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5031-5041
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    • 2014
  • Purpose: The influence of the hoping number of children, the policy of childbirth, and the causes of reduced childbirth to the perception of childbirth, which will be the subject of future childbirth, was surveyed by health-line college students. Results: In terms of the attitude to the perception of childbirth, the quality of personal life, childcare, insufficient support of childbirth, and breeding of descendants had the largest influence on childbirth, and in terms of the attitude to the hoping number of children, economic reasons, childcare expenses, and education expenses had the largest influences. Second, when the causes of social demographic properties influencing childbirth was analyzed, sex showed significance to all the factors on the hoping number of children in terms of growing areas, to all the factors excluding childbirth policy in terms of the economic level, and hoping number of children in terms of the parents' jobs. Third, when the correlation was analyzed, a correlation was found in every area excluding the hoping number of children in terms of the causes of childbirth reduction and economy, childbirth policy in terms of the personal causes, personal factor in terms of the causes of childbirth policy, and family factor in terms of the causes of childbirth reduction and economy. Fourth, when the influences of the causes of hoping number of children, childbirth policy, and childbirth reduction to perception of childbirth were analyzed, the case hoping no or one child, the case hoping 2 or more children, childbirth policy, and childbirth reduction had a positive significant influence on the perception of childbirth. Conclusion: The childbirth rate will be improved if the following occur: childbirth policy and laws are established at the level of government, education programs are developed and operated for the formation of the value of perception of childbirth, and a new support policy is established after analyzing the current childbirth support policies. To change the perception of childbirth in college students who are future subjects of childbirth, successive studies will be needed to verify the effect of aforesaid measures.

A Study on Women's Casino Security Employees (여성 카지노 시큐리티 종사원에 관한 연구)

  • Kim, Hyeong-seok
    • Korean Security Journal
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    • no.62
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    • pp.135-158
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    • 2020
  • In casinos, security personnel who manage the safety of customers and employees play a very important role. In particular, there is a high percentage of female employees in casinos, and because the ratio of female and male employees is similar, the probability of female customers or female employees experiencing accidents may be similar to or higher than that of males. Women's security agents who handle women's case accidents can provide female customers and employees with a security service that only women can do. However, most of the agents doing security work at casinos are male, and the proportion of women is very low. Therefore, this research is about employees who are currently working as women in casinos and conducted qualitative research to find out about various experiences they experienced while working in the casino. A total of five study participants were interviewed three times to analyze and categorize the data collected. The first question is the professor's recommendation, his personal information search and his acquaintance's recommendation. The second question, the factors behind the necessary skills at work, are various athletic skills, good physical conditions and foreign language skills. In the third question, the satisfaction factors of the task are the scarcity value of the work, the satisfaction of the pay, the suitability of the individual and the expectation of the future, and the unsatisfactory factors of the work are the risk of the work, the stress on the customer, the discrimination against the sex, the gaze around, the tiredness of the shift work. In the fourth question, factors on the need for female casino security agents are providing differentiated services to female customers, protecting female employees and providing opportunities for women in related majors. The results of this study were interviewed by an expert of more than 20 years in the casino security business, and female casino security agents said that since it is a necessary requirement, they should seek a direction for development through institutional and cognitive improvement.

The Study about Popularization of Gardening and Its Development Process in the UK - Focused on the Royal Horticultural Society in the 19th Century - (영국 정원문화의 대중화 전개 양상에 대한 연구 - 19세기 왕립원예협회(RHS)의 활동을 중심으로 -)

  • Cho, Hye-Ryeong;Sung, Jong-Sang
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.3
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    • pp.47-55
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    • 2016
  • RHS is a core organization with huge influences on the expansion of the base for the garden culture and industry. This study aimed to examine the meaning and value of the professional charity's role through the appearance background and developmental process of RHS. The passion for plant collection in the Victorian Age of the $19^{th}$ century became the background of establishing the society. Such background of the times and the root of the society are deeply related to the British civil garden culture. The consideration of the forming process of RHS and the study can be summarized as below. First, the professional introduction of exotic plants by plant hunters was developed into an organization supporting professional plant research through collection, sampling, and records, which led to the development of horticulture techniques, growth of plant nursery businesses and established the foundation of the civil garden culture in the UK. Second, after John Loudon was involved in RHS, inspired by the press editing more practical information contents, middle-class and women became new patrons to gardening. Therefore, the care of gardens became a source of agreeable domestic recreation, especially to the female sex. Third, $19^{th}$ century plant collection and exhibition was seen in the Chelsea Flower Show which a key role beyond the UK garden culture. Fourth, those acts of RHS and modernity in $19^{th}$ developed British middle-class domestic gardens which have the character of the ordinary and national garden style in the UK. Such history and activities of RHS are connected to the national status as a country of gardens, which suggests clues to practical measures and values we should aim for in order to settle citizen-centered garden culture.

A Statistical Study of the Foreign Bodies in the Food and Air Passages for past 4 years and 5 months (과거 4년 5개월간 본교실에서 취급한 식도 및 기도이물의 통계적 고찰)

  • 전지일;김성일;조현상;김정원;최태규;김진구;최병익;임현준;김영학
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.87.4-88
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    • 1976
  • The statistcal study was done on 81 cases of the foreign bodies in the food passages (73 cases) and air passages (8 cases), who had visited the Dept. of Otolaryngology of Kyung Hee Medical Center and treated endoscopically, from Nov. 1971 to Mar 1976. The results were as follows, 1) The incidence of esophageal foreign bodies (73 cases) in order of frequency was coin (61 cases; 83.6%), bone (6 cases; 8.2%), food particles (3 cases; 4.1%), discs (2 cases), and other metals (l case). The incidence of foreign bodies in the air passages (8 cases) was food particles (3 cases; 37.5%), pointed metal (2 cases; 25%), plastic pencil cap (l case), plastic ring (1 case), and wood piece (1 case) in order. 2) In sex distribution, 51 cases (62.9%) were males and 30 cases (37.1%) were females, and the ratio between males and females was about 1.7 : 1.3. In the age incidence, 69 cases (82.5%) of all foreign bodies were under 5 years of age, and especially, coin cases were 59 cases (96.7%) and the highest was 8 years of age, lowest was 11 months of age. 7 cases (87.5%) of all airway foreign bodies were under 10 years of age. 4) The ratio between the food passages(73 cases) and the air passages (8 cases) was about 9 : 1. In the location of the foreign bodies of the food passages, 66 cases (90.4%) were in the first esophageal narrowing, 5 cases (6.9%) in the second narrowing, and 2 cases (2.7%) in the third narrowing. In the air passages, the frequent sites were trachea (5 cases; 62.5%), larynx (2 cases), and bronchus (1 case) in order. 5) In duration of lodgement, 63 cases (86. 3%) of esophageal foreign bodies were removed within 24 hours, and one case was removed within 16 days. The number of cases lodged within 24 hours were 4 cases (50%). in the air passages and one case was removed within 18 days. 6) In treatment, 37 cases (50.7%) of esophageal foreign bodies were extracted by modified upper esophagoscopy, 33 cases (42.5%) by esophagoscopy under the local anesthesia, 3 cases (4.1%) by esophagoscopy under the general anesthesia. 8 cases of the coin cases were passed into the stomach during the endoscopic examination. Laryngeal foreign bodies (2 cases; 25%) were extracted by laryngoscopy under the local anesthesia. 2 cases (40%) of tracheal foreign bodies by Bronchoscopy with tracheotomy under the local anesthesia, 3 cases (60%) by Bronchoscopy under the general anesthesia, and bronchial foreign body (1 case) by open thoracotomy under the general anesthesia, at the Dept. of Chest surgery.

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COMPARATIVE STUDY UPON THE CHARACTERISTICS OF WRITING BETWEEN THE PATIENTS WITH WRITING DISABILITIES AND NORMAL ELEMENTARY SCHOOL STUDENTS (쓰기 장애 환자와 정상 초등학교 학생의 쓰기 특성 비교)

  • Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.51-70
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    • 2001
  • Characteristics of handwriting were investigated and compared between the patients with writing disabilities and normal elementary school pupils. Generally, the heights of the letters of the patients were significantly larger than those of normal children, and letters of the patients were more sparsely distributed than those of controls. The distance between the words were significantly reduced in the patients’ writings, which indicated that patients had much more problems of space-leaving than normal pupils. Letter heights differences were significant across all grades in the patients and normal controls. The heights of the letters decreased as they grew older, and the slope of the decrements were more steeper in normal girls(r=-0.45) than girls with writing disabilities(r=-0.16). Sex differences were found in the letter spacings in low grades(grades 1, 2), that is, the distances between the letters were significantly narrower in the male patients than normal boys in these grades, and the differences were almost indiscriminating in grades 3 through 5, and finally, in sixth grade, letter spacings were signifycantly broader in normal boys than male dysgraphics. In girls, letter spacings were significantly broader in the patients across all grades. These findings supports the hypothesis that male and female writings were qualitatively different and that distinct mechanisms served in boys and girls dysgraphics. Across all grades and sexes, spaces between the words of the patients were significantly broader than normal pupils, which suggested that space-leaving between the words was important in Korean writings. There was trend that letter spacings and word spacings decreased across grades, but in girls, no correlations between the letter spacings and grades were found. Correlation analyses revealed that letter heights and letter spacings had mild correlation(r=0.11-0.15), and that letter spacings and word spacings had robust correlation(r=0.99). Phonological errors were mostly found in last phoneme(Jong-seong), especially double-phoneme(ㄳ, ㄵ, ㄶ, ㄺ, ㄻ, ㄼ, ㄾ, ㄿ, ㅀ, ㅄ), and in the case the sound values changed due to assimilations of phonemes. Semantic errors were rare in both groups. Space-leaving errors were correlated with phonological errors, and more frequent in boys than girls. In conclusion, significant differences existed in the letter heights, letter spacings, word spacings, and frequencies of phonological errors and spaceleaving errors between the patients with writing disabilities and normal pupils. The characteristics of writings changed across grades and the developmental profiles were somewhat quantitatively different between the groups. The differences became obvious from the second-third grades.

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A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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