• Health Policy and Management
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• v.12 no.3
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• pp.1-22
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• 2002

Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.331-336
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• 2018

Oral health is an essential requirement for maintaining and promoting health and quality of life while aging. It is known that there is a deep connection with hygienic management of dentures. However, despite the emphasis on the importance of clean management of dentures, there is a lack of quantitative research on denture-related detergents. Therefore, the purpose of this study is to evaluate food stain removal performance of three denture cleansers containing proteolytic enzymes. In addition, this study provides basic data on self-cleaning methods using detergents and suggests ways to improve effective treatment for oral health of elders in domiciliary care. In order to obtain quantitative data concerning food stain removal performance of each proteinase denture cleaner, the test evaluation method proposed by the Korean Consumer Agency, ISO 20795, was used. A total of 18 specimens were discolored for 48 hours in water dissolved with turmeric, and then washed with each denture cleaner for 24 hours. The cleaned denture specimens were measured quantitatively using a spectrophotometer to measure the color values of the denture specimens before the discoloration as well as the color values of the discolored specimens after cleaning with the denture cleanser. The experimental values were analyzed through one-way ANOVA with post-hoc Tukey's test, and statistically significant differences were found among the experimental groups. It was found that C had statistically significant stain removal performance compared with A and B(p<.05). All experiments were conducted for a total of 21 days, from July 3- 23, 2017. This study confirms that denture cleansers is a beneficial self-denture management method for domiciliary seniors. Therefore, it is necessary to extend accessibility for denture cleansers in order to to optimize domiciliary care for elderly oral hygiene and health.

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.603-620
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• 2015

The National Pension of Korea is a public social security system designed to alleviate social risks and poverty that has had a major impact on the quality of life for the aging population. However, a rapidly aging population and low fertility threaten the sustainability of national pension in Korea. The National Pension Research Institute publishes a nancial projection every ve years; consequently, the government has lowered the entitlements for the sustainability of national pension based on the projection results. The current reform of the pension system that arbitrarily reduces the entitlements might detract from the income security role of the national pension for pensioners without accounting for the highest elderly poverty rate in the OECD countries. We first discuss methods for the financial projection of the national pension in terms of population, subscribers, and pensioner projections in order to estimate the pension reserve fund and the financial depletion year. We also conduct a sensitivity analysis for population variables, institutional variables, and economic variables based on pension reserves and the financial depletion year. We evaluate intergenerational fairness between the income hierarchy by conducting a money's worth analysis. Finally, we investigate the possibility of the sustainability of national pension by adjusting pension contributions and entitlements (income replacement rate). A new dependency ratio shows that a simple reform of the national pension does not secure the sustainability of the national pension without adapting a pay-as-you-go system.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.293-309
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• 1998

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community in Kwangju. The results are followed : 1) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that : Community elderly were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, 1.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables related to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality of life, new approaches considering the characteristics of both group, institutional and community living elderly, are needed.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.332-344
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• 2000

The subjects of this study were 100 elderly people who were over 60 years of age and had chronic pain. The study examined the matter of quality of life and self-efficacy of elderly patients with chronic pain including the influence of related factors on these variables. Also, by examining their relation, it provides basic data for the development of efficient nursing interventions for the elderly patients with chronic pain. The tools were the general self-efficacy scale by Sherer & Maddux(1982) and a specific self-efficacy Scale(Lorig et al, 1989) modified to better suit the subjects of this study. The quality of life scale by You-Ja Ro(1988) modified to better suit the subjects of this study was used. The data were collected from August to October 1999. Four researchers and two research assistants developed a data collection protocol subjected to a pilot study for confirmation of validity. In this study, the research assistants read the questionaire to the subjects and recorded the responses themselves. The interviews lasted 40-50 minutes on an average. The data thus collected were analyzed in terms of t-test, ANOVA, Pearson's correlation coefficient, using the SAS PC program. The major findings are as follows: 1) For self-efficacy it was found that males had higher self-efficacy than females for specific self-efficacy. But for general efficacy, males and females showed similar results. The the quality of life was found to be higher for males than females. 2) A positive correlation was identified between the specific self-efficacy, general self-efficacy and quality of life. 3) The general characteristics affecting the self-efficacy of elderly patients with chronic pain were employment, age, level of education, spouse, economic status and income. Self-efficacy was higher among those who were employed, aged between 66-70, well-educated, married and rich or having their own income. 4) The general characteristics affecting the quality of life of elderly patients with chronic pain were lodging with children, religion, level of education and economic status. The quality of life was higher among those who lived with their children and were Buddhists, were well-educated and rich.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2005.09a
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• pp.3-32
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• 2005

정부의 건강증진사업은 국민의 건강수명 연장과 삶의 질 향상에 궁극적인 목적이 있다. 이는 건강 지지적인 환경을 조성하고 질병을 예방${\cdot}$관리하며 평생 건강서비스를 제공하고 건강한 생활양식을 형성하도록 함으로써 달성될 수 있는 것이다. 건강증진사업을 위한 기반으로 연구와 개발 강화, 법과 규칙의 조정, 기금과 인력과 같은 자원 확보는 필수적이다. 정부의 건강증진전략은 첫째 자원할당의 우선순위를 확보하는 것으로 건강증진, 질병 및 손상의 예방, 재활관련 사업에 더욱 많은 자원을 할당하는 것이며, 둘째로 국가차원의 건강증진 프로그램을 개발하여 실행하는 것이다. 포괄적인 생애주기별 건강증진 프로그램(건강증진종합계획)과 모아보건, 학교보건, 산업보건, 그리고 만성질환예방프로그램 등이 포함된 포괄적인 프로그램을 개발하여 실행하는 것이다. 셋째로, 건강증진기금을 공공보건을 위한 하부기반과 건강증진 프로그램에 투자함으로써 사업의 하부기반을 정비하는 것이다. 건강증진사업을 위한 하부기반으로는 정책과 위임사항을 들 수 있는데, 국민건강증진법과 국민건강증진종합계획, 2005년 6월에 서울시 의회를 통과한 건강도시추진위원회를 들 수 있다. 정부의 건강증진사업의 법적 기반은 1995년에 제정된 국민건강증진법이다. 국민건강증진법은 국민들이 건강에 대한 가치를 인식하고 책임의식을 함양하며, 올바른 건강지식을 갖고, 국민들이 건강한 생활양식을 실천할 수 있는 환경 조성을 목적으로 하고 있다. 건강증진사업은 대중을 위한 보건교육과 건강상담, 영양관리, 구강보건관리, 질병의 조기발견과 치료를 위한 건강검진, 지역사회 건강문제에 관한 조사와 연구, 담배소비 감소와 건강증진부담금 부과를 통한 국민건강상태의 향상을 위한 사업이다. 훈련과정으로는 보건복지부에서 2005년부터 수행하고 있는 시와 지역을 위한 현장관리 프로그램과 서울시가 수행예정인 지역수준의 지도자 훈련과정이 있다. 건강증진사업의 원활한 진행을 위한 기금조성은 건강증진기금이 담배세로부터 조성되고 있으며 2004년 12월 31일 현재 담배 한 갑 당 500원으로 인상되어 부과되고 있다. 기금의 관리와 운용은 보건복지부가 담당하며, 기금은 건강한 생활양식형성에 대한 지원활동, 국민을 위한 보건교육과 교육자료 개발, 건강증진과 만성질환에 대한 연구, 질병의 조기발견을 위한 건강검진, 구강보건관리활동에 사용되고 있다. 향후 건강증진사업 투자계획은 1단계 (98-02년)에는 사업기반조성기, 2단계(03-06년) 보건소사업발전기, 3단계(07-11년)통합사업정착기로 구성되고 2단계의 인프라구축에 사용될 투자 비율은 30%에서 3단계에 15%로 감소될 예정이며, 사업실행 영역은 50%에서 65%로 확대될 계획이다. 2005년 건강증진사업의 중점목표는 건강증진사업의 지방 분산화, 건강증진사업의 근거마련, 사회적 형평성의 달성에 있다. 건강증진사업의 지방분산화를 위해서는 중앙에 관리센터가 설치되어 기획과 평가, 연구와 개발, 현장관리 훈련을 담당하게 되고, 지역관리센터에서는 자치적인 보건소 중심 건강증진사업의 수행과 평가를 진행하게 된다. 건강증진사업의 근거마련을 위해서 효과가 입증된 사업에 우선순위를 두며, 기획과 평가위원회를 설치하고, 건강증진사업의 평가결과를 환류 할 수 있는 체계를 마련하는 것이다. 또한 건강증진포럼을 구성하며 현 건강조사 체계를 수정한다. 한편 형평성 제고의 측면에서는 저소득층, 노인, 장애인들과 같은 취약계층의 건강상태 향상을 위한 중앙정부와 지방자치단체의 역할을 강화하고, 지역간${\cdot}$사회적 집단 간의 건강증진사업관련 형평성을 제고한다.

• Korean Journal of Health Education and Promotion
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• v.17 no.2
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• pp.183-205
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• 2000

This research was designed to compare the health condition and the quality of life of the elderly inpatients with those of the normal elderly people. The subjects of study were 482 elderly inpatients and 304 normal elderly people. The research was conducted in July and August using the instrument WHOQOL. The results of the research are as follows: For the level of health, it was recognized that male was healthier than female, having higher the education, living in the city rather than in the rural, keeping the normal life than being in the hospital. There were little difference in the past medical histories of the elderly inpatients and the normal elderly people. As to the diseases currently under the treatment, there were some difference between the elderly inpatients and the normal elderly people but the tendency was similar in the kinds and the frequencies. As to the recognition for the quality of life between the elderly inpatients and the normal elderly people based on the records reflected on each of the domains of WHOQOL, the normal elderly people more positively recognized in the overall quality of life and the following domains: physical, psychological, level of independence, and spirituality/religion/personal beliefs. The normal elderly people more positively recognized especially in the level of independence domain (mobility, activities of daily living, dependence on medication or treatments, working capacity). In the social relationships domain only the sexual activity was significant and the normal elderly people more positively recognized. The elderly inpatients showed the correlation of over 0.5 in the overall quality of life and the following domains: environment, social relationships, physical, psychological, level of independence. It was over 0.6 in the physical domain and the domains of psychological and level of independence. and the psychological domains of level of independence and social relationships. For the points of overall quality of life, it had no correlation with hospitalization but the health condition, residential district, occupation, and taste exerted a significant effect. As a result of separate analyses of the elderly inpatients and the normal elderly people, the health condition and the age only were the common variable which would exercise a significant effect. Besides, the primary factors which would exercise the quality of life were the occupation and taste for the elderly inpatients, and the residential district and source of income for the normal elderly people. In conclusion, it is first and foremost important to improve the standard of health for the overall quality of life for the elderly people, regardless of hospitalization. Therefore, a plan must be urgently drawn up for revitalization of the health promoting projects for the elderly people and the public health projects for the elderly people, and the investment must be increased for settlement of health problems of the elderly people.

• Journal of Technologic Dentistry
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• v.34 no.3
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• pp.273-281
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• 2012

Purpose: This study conducted a survey on the elderly of 65 years and over with physical debilities and ones capable of living at home residing in Jeju Special Self-Government Province to compare and analyze demo-sociological characteristics and factors influencing on oral health related living quality. And also this study intended to provide basic data for developing effective public medical policies and health promotion programs to increase oral health related living quality of the elder. Methods: The elderly of 65 years and over living in Jeju Special Self-Government Province were interviewed individually from 7 February 2011 to 18 April and interview results of a total of 220 subjects were analysed for this study. Results: Current status of the elderly including ones with & without physical debilities influenced functional limitation and behavioral aspects of GOHAI criteria used in this study. The elderly with physical debilities experienced less limitation in food chewing and swallowing, and pronunciation than ones capable of living at home. On the analogy of the previous study(by Park, N. G., 2010) in which oral health related quality and satisfaction of life of the elderly with physical debilities were different due to their physical, circumstantial and psychological limitations, the former's oral health conditions are worse than the ones capable of living at home and because of medical care accessability limitation they suffer from deteriorated oral condition. By the comparison of factors influencing on the living quality relating to the oral health of the elderly with physical debilities and ones capable of living at home, 2 factors, age and living area, were meaningful factors commonly influencing on the oral health related living qualities of both. The elderly of 75 years and over were more affected by psychological and behavioral aspects of oral health related living quality than the ones of 65-74 years, and the ones living in country suffered from functional limitations, pains and discomfort more than ones in city. Additionally, being different from the elderly capable of living at home, the ones with physical debilities were influenced by the factors of average monthly income and medical security type. Conclusion: Improvement of programs and systems to increase oral health related quality of life needs to be carried out preferentially for the elderly of 75 years and over, and dwelling in country. Also this study suggests that the policy of paying the denture insurance allowance in 2012 need effective planning considering the elderly's current status, age, living area, medical security type.

• Korean Journal of Social Welfare Studies
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• v.45 no.2
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• pp.31-63
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• 2014

Recently interest in civic engagement and civic service is increasing. However, in Korea, few studies have focused on civic service. This might be on account of general awareness that civic service is fundamentally different from the basic spirit of voluntary work, while interest in paid volunteer work is on the rise. Thus, it is necessary to examine whether civic service is the real antipode of volunteer work. Under this kind of critical viewpoint, this study aims to analyze civic service based on the attributes of voluntary work and civic service. The major findings are as follows. Firstly, contrary to common belief, civic service has not been established to go beyond the principle of voluntary and unpaid characteristics of volunteer work. Rather, some voluntary work has broken out of principle of voluntary activities. Secondly, civic service and volunteer work might be characterized as different not due to spontaneity and unpaid service but the structural characteristics of the goal, continuity and formality. Furthermore, the reason for the soft landing of civic service in the United States is not because they have supported the reimbursement of expenses and the provision of stipends. Rather, it is because their long-term activities have promoted real community development for the purpose of finding solutions to social problems, and they have derived a sense of pride and satisfaction from social recognition and rewards for their contributions.