• 여성건강간호학회지
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• 제6권2호
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• 디지털융복합연구
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• 제19권2호
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• pp.307-314
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• 2021

본 연구는 척추·관절질환 환자 만족도와 병원 추천 의향을 분석하고 만족도에 영향을 미치는 요인을 확인하기 위해 수행되었다. 이에 2019년 서울지역 소재 척추·관절 전문병원에서 환자 만족도와 추천 의향을 조사하였고, 인구·사회적 특성과 환자 만족도와의 관련성, 만족도 영향요인 및 추천 의향 등을 분석하였다. 분석 결과 외래의 경우 직원 용모·복장의 단정함과 청결도, 직원 친절도, 시설환경 쾌적성에서 환자 만족도가 높게 나타났고, 대기시간 관련 문항에서 환자 만족도가 낮게 나타났다. 입원의 경우 간호 영역과 병원환경 영역에서 여성의 만족도가 높았다. 하위 영역별로는 간호 영역 중 고객 존중 및 예의, 고객 경청, 담당 간호사에서 환자 만족도가 높게 나타났고, 병원환경 영역은 전반적인 병원 청결도와 안전 문항에서 만족도가 높았다. 환자 만족도와 주변에 해당 병원을 추천할 의향이 있는지를 묻는 문항 간 상관관계 분석에서는 환자 만족도와 병원 추천 의향은 양의 상관관계가 있는 것으로 나타났다. 척추·관절 질환 환자 만족도와 추천 의향 평가 결과는 척추·관절 전문병원에서 의료서비스 질 향상과 병원경영 전략 수립을 위한 기초 자료로 활용될 수 있을 것이다.

• 지역사회간호학회지
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• 제7권2호
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• pp.384-399
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• 1996

The concept of parish nursing began in the late 1960s in the United States when increasing numbers of churches employed registered nurses (RNs) to provide holistic, preventive health care to the members of their congregations. Parish nursing role was developed in 1983 by Lutheran chaplain Granger Westberg, and provides care to a variety of church congregation of various denominations. The parish nurse functions as health educator, counselor, group facilitator, client advocate, and liaison to community resources. Since these activities are complementary to the population-focused practice of community health' CNSs, parish nurses either have a strong public health background or work directly with both baccalaureate-prepared public health nurses and CNSs. In a Midwest community in U.S.A., the Healthy People 2000(1991) objectives are being addressed in health ministries through a coalition between public health nurses and parish nurses. Parish nursing is in the beginning state in Korea and up untill now, there has been no research was conducted on concrete role of korean parish nurses. The main purpose of this study was to identify, classify and analyze activities of parish nurses. The other important objective of this study was to establish an effective approach and direction for parish nursing and provide a database for korean parish nursing model through analysis and' classification of the content of the nursing record which included nursing activities. This study was a descriptive survey research. The parish nurses were working in churches where the demonstration project developed on parish nursing. The study was done on all nursing records which were working in churches where the demonstration project developed on parish nursing. The study was done on all nursing records which were documented by parish nurses in three churches from March, 1995 to February, 1996. Namsan, Taegu Jeei and Nedang presbyterian churches in Taegu and Keimyung nursing college incooperated together for the parish nursing demonstration project. The data analysis procedure was as follows: First, a record analysis tool was developed and second, the data was collected, coded and analyzed, the classification for nursing activities was developed through a literature review, from which the basic analysis tool was produced and cotent validity review was also done. The classification of the activities of parish nurses showed 7 activitity categories. 7 activity categories consisted of visitation nursing, health check-ups, health education, referring, attending staff meetings, attending inservices and seminar, volunteers coordinating. The percentage of activities were as follows: Visitation nursing(A: 51.6%, B: 55%, C: 42.6%) Health check-ups(A: 13.5%, B: 12.1%, C: 22.3%) Health education(A: 13.5%, B: 13.2%, C: 18.2%) Referring(A: 1.4%, B: 4.2%, C: 2.4%) Attending staff meeting(A: 18.8%, B: 13.0%, C: 12.2%) Attending inservices and seminar(A: 1.5%, B: 2.2%, C: 2.1%) Volunteers coordinating(A: 0.3%, B: 0.4%, C: 0.0%) To establish and develope parish nursing delivery network in Korea, parish nurses role, activities and boundaries of practice should be continuously monitored and refined every 2 years. Also, It is needed to develope effective nursing recording system based on the need assessment research data of various congregation members. role, activities and boundaries of practice and arrangement of the working structure, continuing education, cooperation with community resources and structuring and organizing parish nursing delivery network. Also, It is needed to develope effective nursing recording system based on the need assessment research data of various congregation members.

• 부모자녀건강학회지
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• 제5권2호
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• pp.145-160
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• 2002

The primary purpose of this study was to suggest midwife education programs which could be recognized and exchanged internationally by examining and analyzing both domestic and foreign midwife education programs. The secondary purpose of this study was to offer a plan to raise the level of national examination. Specific aims of this study were as follows: 1) to identify the international standard of the education and practices of midwives 2) to analyze both domestic and foreign midwife education programs 3) to offer a new curriculum for educating midwives 4) to suggest a prerequisite to raise the standards of the national examination 5) to suggest subjects for the national examination The results of this research were as follows: 1. The concept of midwife and midwifery practices recognized internationally by WHO and ICM(International Confederation of Midwives) was identified. In addition, Core Competencies for Basic Midwifery Practice suggested by ACNM(American College of Nurse-Midwives) of the U.S.A. were examined. 2. Midwife education programs of the U.S.A., Sweden, Australia, and Japan were investigated and analyzed. In addition, the midwife education program stated in the public health related law of this country as well as curriculums of institutions for midwife education were also investigated and analyzed. 3. As for the midwife education system, both a graduate program for midwife education in the college of nursing sciences and a postgraduate professional midwife education program centered medical institutions were suggested. 4. A new curriculum that could promote more international exchanges and extend the role of midwives was suggested after studying both domestic and foreign midwife education programs. 5. A prerequisite to raise the level of national examination for midwives was suggested. In addition, subjects for the examination which could evaluate the applicant's comprehensive thinking ability were presented with its respective range and ratio. A midwife is a medical professional who has a nursing license and is licensed nationally as a midwife with an additional year of education. An effort to extend a midwife' role and to improve its service is imperative. The laws related midwives should be revised in regard to education, service, and the national examination to the level of developed countries so that international recognition can take place. In addition, midwife curriculum and its service should be evaluated periodically. A system must be established to renew midwife licences.

• 지역사회간호학회지
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• 제10권1호
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• pp.5-18
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• 1999

The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

• 한국임상약학회지
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• 제25권4호
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• pp.223-230
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• 2015

Background: 8,000 children in North Korea died before they reached the 1 year after births in 2013. The high mortality rate of children under five years of age is mainly caused by infectious diseases and malnutrition. The need for national pediatric immunization and supply of vaccines will be vital when the abrupt reunification occurs. Objective: The purpose of this study is to scrutinize the pediatric immunization coverage of North Korea. Additionally it is to estimate the amount and the costs needed to vaccinate. Methods: The target population is the children of North Korea. The method is based on a pre-survey and an interview of North Korea defectors. The target interviewees searched for are as follows; doctors, teachers, and others. The interview includes questions on mortality rates and immunization coverage. The analysis is largely based on the statements of the health care providers within the selected group. Results: The interviewees are 8; 7 female and 1 male. The birth years range from 1956 to 1982. 3 out of 8 are former health care providers; a doctor, a pharmacist, and a nurse. The morbidity rate of infectious diseases exceeds the data from WHO. The immunization coverage is nearly 0% after 1980s. In order to ensure the welfare of North Korean children, at least 8,234,000 vaccine doses, requiring over 105 million U.S. dollars, are needed. Conclusion: The morbidity rate of infectious disease in North Korea is conspicuous. The preparation for supply and expenditure of vaccines is vital.

• 지역사회간호학회지
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• 제18권2호
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• pp.310-319
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• 2007

Purpose: This study intends to investigate gender role identity and egalitarianism consciousness among adolescents and to determine the relationship between the two factors. Method: Data were collected from 376 middle and high school students in U City. Tools used were the Korean Sexual Role Identity (Kim, J. H., 2005) and the Gender Egalitarianism Consciousness among Adolescents (Kim, 2002). Data were analyzed using SPSS 12.0 for t-test, one-way ANOVA and Pearson correlation coefficient. Results: There was no significant difference between boys and girls in sender role identity. Boys' gender role identity was different according to school grade (t=-3.19, p= .00), frequency of mother's hugging (t=-2.28, p= .02) and girls' according to religion (t=-2.24, p= .03) mother's job (F=3.59, p= .02), father's education level (F=3.20, p= .04), mother's education level (F=3.24, p= .04), family harmony (F=7.28, p= .00), and frequency of mother's hugging (t=-2.41. p= .02). There was significant difference in egalitarianism consciousness according to sender (t=-12.70. p= .00) Boys' egalitarianism consciousness was different according to school type (t= .02, p= .00) and father's education level (F=4.97, p= .02), and girls' according to school grade (t=-4.21 p= .00), school type (t=-3.12, p= .00), father's level of education (F=3.78. p= .02), decision maker of important domestic matter (F=4.95, p= .00) and frequency of mother's hugging (t=2.53, p= .01). In Girls, sexual role identity and sender egalitarianism consciousness were significantly correlated with each other (r= .01, p= .04). Conclusion: Through the study, it was found that boys' concern for sexual equality of was remarkably lower than girls. Therefore, it is necessary to offer curriculums for boys and to start social education for parents.

• 지역사회간호학회지
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• 제13권2호
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• pp.239-248
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• 2002

Objectives: The purpose of this study was to evaluate the effects of assertiveness training on assertiveness behavior, problem solving ability, and interpersonal relationships of nursing college students. Methods: A nonequivalent pre- and post-test experimental design was used. This study included 15 subjects in the experimental group, and 15 subjects in the control group, who were sophomore nursing students recruited from Gachon Nursing School located in Inchon City. The experimental group received 8 series of a ready planned and reorganized assertiveness training course, while the control group did not receive any training. The 120 minute training session was held on a weekly basis. The Maan-Whitney U Test was done to identify the changes in scores of assertiveness behavior, problem solving ability, and interpersonal relationships between the experimental and the control groups, after the assertiveness training. The data were collected before and after each part of the assertiveness training. The data collection period was from May 7 to July 10, 2001. Results: 1) The assertiveness behavior scores of the nursing students who participated in the assertiveness training were higher than those of the nursing students who did not participate in the assertiveness training. 2) The self problem solving evaluation scores of the nursing students who received assertiveness training were higher than those of the nursing students who did not receive the training. 3) The interpersonal relationship scores of the nursing students who participated in the assertiveness training were higher than those of the nursing students who did not participate in the assertiveness training. Conclusion: The study results showed that the assertiveness training was effective in promoting assertiveness behavior, problem solving ability, and changes in interpersonal relationships in nursing college students. It is suggested that well designed strategies are needed in the further studies in order to expand and apply the assertiveness training to other nursing student and nurse cohorts.

• 가정∙방문간호학회지
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• 제11권1호
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• pp.33-43
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• 2004

Purpose: This study is a descriptive research conducted for looking into the role awareness level. role conflicts, and job satisfaction among professional home care nurses in the field of hospital based home care nursing service. Method: 154 specialized home care nurses in 63 hospitals and clinics that are implementing home care programs were subject to the study. Result: 1. The level of role awareness among professional home care nurses was $4.47\pm0.41$ on average out of 5. 2. The average score for role conflicts was $3.87\pm0.61$ out of 5. 3. In terms of job satisfaction level. $3.33\pm0.71$ was scored out of 5. 4. It has been discovered that there are statistically significant positive correlations among role awareness level, role conflicts(r= .224, P= .005), and job satisfaction level(r= .166, P=.040), while a negative correlation was detected between role conflicts and job satisfaction level(r=-.210, P= .009). Conclusion: The level of role awareness among professional home care nurses in the field of hospital based home care nursing service was very high and job satisfaction level was high when the level of home care nursing antecedents was high and the organization structure of working place was independent. But the level of role conflicts coming out of the weakness of job-supporting system was high. So the realistic alternative such as the improvement of working environment by administrative, institutional support, is required to make up for this problem in the future.

• 치위생과학회지
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• 제1권1호
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• pp.46-52
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• 2001

2001년 3월 29일부터 2001년 5월 9일까지 서울 경기지역 건강사회를 위한 치과의사회에 소속되어 있는 치과의원과 치과병원에 근무하는 치과위생사 78명과 치과조무사 50명을 대상으로 설문조사를 실시하였다. 조사 내용은 일반적 특성, 자가 건강관리, 개인방호의 실천, 치과진료기구의 취급, 손 씻기에 관한 사항으로 구성되어 있다. 일반적 특성과 요인들간의 관계를 비교 관찰한 연구결과는 다음과 같다. 1. 병원 근무 전 건강검진을 받은 경우는 근무년수 5-7년 미만이 71.4%로 가장 많았고, 병원 근무 후 건강검진을 받은 경우는 근무년수 9년 이상이 61.5%로 가장 높았음을 알 수 있었다(P<0.05). 2. 병원 근무 후 B형 간염예방접종을 받은 경우는 연령별로는 35세 이상이 71.4%로 가장 많았고, 근무년수별로는 9년 이상이 57.7%로 가장 많게 나타나 연령과 근무년수에 따라 차이를 보였다(P<0.05). 3. 개인방호실천은 치과위생사와 치과조무사 사이에 유의한 차이는 없었다(P>0.05). 그러나 개인방호 실천도를 3점 만점으로 할 때 마스크 착용 2.40과 장갑착용 1.96에 비해 진료용 보안경 착용 1.48로 낮게 사용되고 있음을 알 수 있었다. 4. 사용하고 남은 마취제의 관리는 1회 사용 후 버리는 경우가 치과위생사는 89.7%, 치과조무사 70.0%로 치과위생사에서 높게 나타났다(P<0.05). 5. 손 세정제로 항균용 액체비누를 쓰는 치과위생사가 19.3%, 치과조무사 10.0%로 매우 낮았으며, 손 건조 방법으로 1회용 종이수건을 사용하는 치과위생사 37.2%, 치과조무사 36.0%로 낮게 나타났다(P>0.05).