• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.212-217
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• 2011

Purpose: Since 2005, the Ministry of Health & Welfare has provided financial support to promote palliative care for terminal cancer patients. We analyzed how palliative care facilities used the funding between 2006 and 2010. Methods: Frequency analysis was conducted by the item of expenditure based on fiscal reports of the palliative care facilities. Linear regression analysis was performed to examine a trend over time. Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare expenditure items, the number of provision of financial support and type of palliative care units. Results: About a half of the fund was spent to pay care givers salary, improve facilities and purchase equipment regardless of the year, the number of financial support provided or facility type. By year, the operation cost for palliative care program and the education cost for health care workers have significantly increased in linear regression analysis (P<0.01). However, the amount of financial support for the low income group has decreased over years (P=0.024). This trend was affected by evaluation criteria and weight. Conclusion: The government aid for palliative care units has been used to improve facilities and equipment. Moreover, desirable changes were noted such as a higher portion of expenses for program operation and care giver training to enhance the quality of care. However, the evaluation criteria need to be adjusted to prevent any further decrease in the support provided to the low income group.

• Women's Health Nursing
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• v.6 no.3
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• pp.439-452
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• 2000

This study sought to figure out women's needs during early postpartum for developing adequate nursing intervention toward postpartal women's healthy adaptation. A convenience sample of 89 women who are in the early postpartal period and admitted in a university hospital located in Seoul, Korea was studied from July 1, 1999 to August 13. 1999. 1. The age group of 26-30 years was 52.8% and the level of education above high school 91%. 67.6% of women had no job, 62.9% had experienced one time of delivery, and 52.8% had no experience of abortion. 2. 31.5% of women received prenatal education, 44.9% only postpartal education. 77.5% of women planned breast-feeding, and 53.9% of women had an experience of breast-feeding during hospital stay. For the feeling of confidence related to the self-care, 27% only expressed 'yes. I have' and 59.5% 'just a little bit'. For the feeling of confidence related to the baby rearing, 29.2% only expressed 'yes. I have' and 60.7% 'just a little bit'. 3. The rate of postpartal women's mother as a preferred non-professional care giver was the highest, 75.3%. The rate of the style of Sanhujori highly preferred and planned at this time was at postpartal women's maiden home or her home with mother, 58.4%, 47.7% respectively. It shows that women still wish to have traditional Sanhuiori at home. 4. The mean of nursing need of postpartal women was 4.25% and it means that universally the degree of nursing need during postpartum is still high. General nursing need (4.29) was higher than that of traditional Sanhujori (4.09), however, the need of Sanhujori is still high. 5. Specifically, the degree of nursing need according to the category of needs was 'educational need for baby rearing,' 4.43; 'emotional-psychological care', 4.41; 'environmental care,' 4.31; 'self-care,' 4.14; and 'physical care,' 3.85 in rank. The educational need core of the specific method about Sanhuiori (4.35) was second to the highest among 15 items of self-care. 6. The related factors to the degree of nursing need were age to physical care; educational level, plan of breast feeding and experience of breast feeding during hospital stay to emotional-psychological care; and the feeling of confidence in baby rearing to environmental care. 7. There was highly positive correlation between the degree of traditional Sanhujori need and general care need(r=.77). This result strongly reflects that there is a necessity of professional care givers' capability to consider the integrative care reflecting the socio-cultural need for women's healthy adaptation during postpartum. It provides a challenge to the professional care givers to research further on the effects of Sanhuiori on the health status, health recovery after abortion or delivery from the various aspects through the cross-sectional and longitudinal research for the refinement of the reality of Sanhuiori not only as cultural phenomenon but as an inseparable factor influencing on women's postpartal healthy adaptation and for the appropriateness of intervention and quality of care for desirable health outcome.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.479-489
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• 1998

This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.

• Journal of Digital Convergence
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• v.17 no.6
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• pp.267-277
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• 2019

The purpose of this study is to investigate the burden of caring for the care-givers of the elderly in Korea by using an integrated literature review method. A total of 23 studies were analyzed using a search database. When care-givers had higher sense of filial and guilt or more than two diseases, they showed high level of feeling of burden. Also, they had high level of feeling of physical burden by their oldness, service period (especially at the period of 1-3 years). In the feeling of economic burden, they had high level of feeling of burden by their oldness, or elderly's disease periods. The feeling of burden by psychological condition was found in elderly in aged and the beginning of admission of nursing home. The feeling of burden by environment situation was found when the functional status of the elderly was bad. Therefore, we need to concern care-givers's feeling of burden with elderly people in the nursing home. In the future, I believe that the findings of this study will be helpful for development of the intervention program for alleviate burden for the care-giver.

• Journal of Korean Academy of Nursing
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• v.28 no.4
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• pp.1047-1059
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• 1998

Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.145-153
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• 2007

Purpose: This study was to analyze the research trend centering on the theses to hospice released in Korea. Methods: The researcher collected the academic degrees and theses published on the book of the academic society from 1991 to 2004, and examined 110 domestic papers of hospice. Results: 1) The number of articles increased 3 years after 1997, 52 (47%) theses were published in $2000{\sim}2002$. 97 (88%) articles were quantitative studies, and 13 (12%) were qualitative studies. 2) As for the subject, the results were: patients with end stage 44 (40%), nurse 18 (16%), hospice care system, facilities, and literature review 12 (10%). 3) As for main concepts of correlational studies 15 (13%), the results were: quality of life, activities of volunteers, suffering experience of nurse, and so on. 4) The subjects and contents of survey, the results were: pain control and need for nursing care in patients, need for spiritual and physical care in family, and so on. 5) The treatment of experimental research, the results were: hospice nursing, educational program, informational support, spiritual nursing, supportive nursing intervention, home hospice care, information services for control of cancer pain, and so on. 6) In the theme of the qualitative studies, the results were: experience of dying patients, perceive of hospice care and death, experience of family of terminal ill patients, meaning of dying in Korean. 7) In the instrument in studies, the results were: MQOL, EQOL, QOL, NIC, Need Scale, Spiritual Well-being Scale, Spiritual Perspective Scale, Coping for Grief Scale, K-CPAT, VAS, BPI, Depression Scale, Strait-anxiety Scale, Care-giver Burden Inventory, Burnout Inventory, Mental quality. Conclusion: More research needs to be encouraged in experimental and qualitative research fields. Researches should be conducted for the establishment of the basis of practical and theoretical framework and hospice polices.

• Journal of The Korea Institute of Healthcare Architecture
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• v.18 no.4
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• pp.39-51
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• 2012

Purpose: Hospitals for patients and their guardians can, from the concept of healing, be removed from just gaining profits, but suggest a future-oriented direction for the hospital. Accordingly, there have been studies related to the selection of hospitals, but most were related to preference and satisfaction, and only recently did research from the concept of tradeoffs of factors for selection began to grow rapidly. Methods: From this context, this study evaluates the level of importance for factors of selecting hospitals using the analytical hierarchy process, and identifies the correlation with users, gender, age group, and outpatient features in order to identify the difference of awareness among different groups for selecting hospitals. In the factors for selection 26 factors in six categories were set through studies of preceding research, and after surveying 144 people, the following results were attained. Results: 1) The overall analysis results were found in the order of medical level, medical service, and fame, and low for facilities, which is similar to the cases of preceding studies. 2) For user analysis, it was similar between patients and guardians, but there was a slight difference in awareness among nurses, who are also medical service providers. Nurses showed relatively high level of importance in direct factors such as medical technologies and medical services, while guardians of patients showed higher importance in indirect factors such as facility environments and convenience. 3) Women showed higher assessments of importance levels in environmental factors, while men in physical factors. 4) The older the age group, the lower level importance there was on medical level, while the importance on fame reduced the further the commute to the hospital was.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.853-867
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• 1996

This study was designed and undertaken to identify the degree of burden and depression in family caregivers of patients with stroke and to determine whether burden was directly related to depression. The data were collected from October 23th to November 20th, 1995. The subjects in this study were 80 caregivers, that is, one family member and 80 patients with stroke who were hospitalized in one oriental medicine hospital located in Taejon City. The questionnaires consisted of questions regarding burden(13 item, 6 point scale) and depression(20 item, 4 point scale). Data were analyzed using percentages, means, t-test, ANOVA and Peason-correlation coefficients, done with the SAS program. The results of this study are as follows : 1. The score for family caregiver's burden was higher than the mid level for the 13 items. 2. The score for of family caregiver's depression was relatively low. 3. The relationship between burden and depression showed a significant inverse correlation. 4. In the relationships between total burden and general characteristics of the family caregivers : there were no significant differences. But, in the relationship between objective burden and general characteristics of the family caregivers ; age and education had statistically significant differences. That is, the 40's group felt more objective burden than any other age group and the high education group more than the illiterate group. 5. In the relationship between depression and general characteristics of the family caregivers ; sex, education and monthly income had statistically significant differences. That is, female caregivers felt more depression than males, and the lower the level of education and the lower the monthly income, the higher the degree of depression. 6. In the relationships between burden and general charateristics of the stroke patients, only subjective burden according to the patients' sex was significantly different. That is, caregivers felt more subjective burden when caring for male patients than for female patients. 7. In the relationships between depression and general charateristics of the stroke patients, only the patients' economic status showed a statistically significant difference. That is, caregivers felt more depression in case of patients' low economic status.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.183-190
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• 2001

Objective : To estimate the annual economic costs attributable to cigarette smoking in Korea. Methods : The costs were classified as being direct medical and non-medical costs, indirect costs and others. We focused on those costs related that are incurred in the treatment of selected diseases (cardiovascular diseases, respiratory diseases, and cancers), which have been proven to be caused by smoking. In addition to the basic costs of treatment, the additional amount of costs occurred due to smoking was obtained by computing the population attributable risk (PAR%) caused by smoking. To compute the PAR%, relative risks of smoking to the number of outpatient visits, hospitalizations, and the death were estimated using the Cox proportional hazard model, respectively. Our major data source was the 'Korea Medical Insurance Corporation (KMIC) cohort study,' which was composed of a total of 115,682 male and 67,932 female beneficiaries who had complete records of their smoking histories in the year of 1992. Results : The annual costs that could be attributable to smoking were estimated to be in the range of 2,847,500 million Won to 3,959,100 million Won. The maximum estimate of 3,959,100 million Won includes 233,100 million Won for medical costs, 5,100 million Won for transportation costs, 27,600 million Won for care giver's economic costs, 69,100 million Won in productivity loss, 3,435,000 million Won lost because of premature death, 172,100 million Won in costs resulting from passive smoke inhalation and 17,100 million Won for costs that resulted from fires that were caused by careless smoking. Conclusion : Our study confirms that the magnitude of the economic burden of smoking to Korean society is substantial. Therefore, this study provides strong evidence that there is a strong need for a national policy of tobacco control in Korea.

• Child Health Nursing Research
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• v.4 no.1
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• pp.31-44
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• 1998

In our time the parent's role is changing from sexually differentiated to androgynous pattern. Mother's interction with infant includes caring and father's interaction especially have play. Father and mother share the caring and play because they have complementary nature. Infants have a tendency to show more positive responses to their fathers than mothers in play situations. For that reason we can help the promotion of father's interaction with his infant through ascertaining patterns of father-infant play interaction. This study was to find out patterns of father-infant play interaction in order to improve the Interaction between father and infant. Data was video-taped from 6 fathers and infants who were healthy and first-timed and 7-11 weeks old in their houses. I used Father-Infant Play Interaction Scale that was applied to father instead of mother as a care-giver. The scale was checked up by experts in this field for content validity and the reliability was 0.95 in this study. The results were as follows : 1. Father's play behaviors were the patterns of responses about infant's cue. The mean score was 33.16(SD, 9.11), This means they come up to the standard level of responses about infant's cue. 2. Infant's play behaviors were the patterns of responses about father's cue. The mean score was 7.00(SD,3.10). This means they get the higher level of responses about father's cue. 3. The patterns of simultaneous responses occured together between father and infant. The mean score was 9.58 (SD, 3.96). This means they reach the standard level of simultaneous responses between father and infant. 4. The patterns of interactional behaviors occured interpersonally between father and infant. The mean score was 49.75(SD, 15.80). This means they interact on the standard level of play interaction. In view of the results father's play interaction seems to reveal an average level and play patterns are similar to mother's. In order to ascertain definitely patterns of father-infant play interaction we need further research which has more subjects and variables to have important effects.