• Clinical and Experimental Pediatrics
• /
• v.51 no.7
• /
• pp.671-689
• /
• 2008

The economic recession of North Korea has been prolonged, the need for humanitarian assistance for the women and children of DPRK has been raised. In March 2006, South Korean government signed MOU with World Health Organization (WHO) to financially support "Improving Women's and Children's Health in DPRK (IWCH)" project. The assistance projects through UNICEF and the non-government organizations of South Korea were also followed. IWCH project consists of three parts; nutrition, disease management, children and maternity care. The first term (2006-2007) of the project leading by WHO was finished, and the second term (2008-2010) is just begun. The projects driven by NGOs have relatively been delayed due to difficulties in negotiating on project contents and places with North Korea. Recently, however, re-modeling processes of an obstetric/gynecology hospital and a children hospital in Nampo were started. Up to recently, South Korean government has played only a limited role in the humanitarian assistance for North Korea. IWCH project is, however, a full-scale initiative driven by government based on a systematic review of need and priorities. A significant amount of budget and relatively long term (five year) project compare to the previous short term and small size programs were expected to make more meaningful achievement. Despite these positive aspects, the project remains a list of unsolved problems a lack of mutual trust, a different decision making process between South and North Korea, a lack of conflict management process, and unpredictability and complexity of international politics. In spite of such kind of political uncertainty, the health care sector will be a leading area in the process of improving relationship between South and North Korea, particularly, humanitarian assistance for women and children will play a crucial role in the process. The successful implementation of IWCH project, therefore, will contribute to provide the reference model in developing the mutually constructive relationship between South and North

• Journal of Oral Medicine and Pain
• /
• v.36 no.4
• /
• pp.225-234
• /
• 2011

Tobacco smoking is a major risk factor of systemic health and also impairs oral health, which is related to development of oral cancers, periodontitis, delayed wound healing, tooth loss, failure of implant, etc. Aside from smoking, many other risk factors can be related to oral health and long-term effects of smoking on salivary flow and taste threshold are still in controversy. Authors considered dental students to be an appropriate group with good oral hygiene for a long-term study to reveal effects of smoking on oral health. This study was performed to compare smoking patterns and current oral health conditions between smokers and nonsmokers in dental students prior to long-term evaluation. 192 volunteers (85.7%) of 224 male dental students in Dankook University were evaluated through questionnaires and clinical examination in 2010. Questionnaires included smoking pattern, alcohol use, nicotine dependence, preventive care, psychological profile and clinical examinations comprised assessment of teeth or periodontal status, nicotine pigmentation, salivary flow, electrical taste thresholds and halitosis. From the study, (current) smokers were older, and drank more frequently with more alcohol intake compared to former smokers and nonsmokers(p<0.05). There was no significant difference among them in salivary flow rate, halitosis and electrical taste threshold. However, there was significant difference in DMFT rate, periodontal treatment need, nicotinic pigmentation between smokers and nonsmokers(p<0.05), irrespective of their levels of preventive care. The smokers in this study, who are young dental students with relatively shorter duration of smoking, less use of cigarettes and low level of nicotine dependence, did not reveal significant impairment of oral health. However, their oral health was found to be relatively impaired compared to nonsmokers', which suggests negative effect of smoking on the oral health and a need of smoking cessation.

• Journal of Hospice and Palliative Care
• /
• v.5 no.2
• /
• pp.136-145
• /
• 2002

Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

• Journal of Korean Academy of Nursing Administration
• /
• v.1 no.1
• /
• pp.97-111
• /
• 1995

In our society today, a variety of medical caring system, along with a scientific development in the area of oriental medical science plus national demand, has increased the augmentation and the opening of oriental wards and hospitals (Han Bang), which has come to create an additional requirement of nursing activity at oriental medicine wards should be different from that of the general wards or the same as the other. In view of this, various studies need to be made in this connection. The purpose of this study is to comprehend the number of nurses who want to work at oriental medicine wards and measure job satisfaction in nursing as compared with those working at general wards so as to provide basic materials for future assignment and supplementary training for the nurses. An attempt was made to contribute toward nursing administration on the one hand improving nursing training course on the other hand. A total of 72 nurses currently working at two oriental medicine hospitals available in Seoul and 82 general nurses were selected for this study using the questionaire from December 1993 to January 1994. An instrument for the study was based on the measurement of work satisfaction developed by Paula L. Stamps including 37 questions complemented by Kim for revision (1993) and 14 questions regarding general characteristics and oriental medicine wards. The instrument to test dependability showed Cronbach's=0.7711. The collected data have been processed by computer package SPSS. General characteristics of the two groups and the matters involved in oriental medicine wards were calculated into real figure and percentage an similarities between the two groups were analyzed by t-test and F-test according to the characteristics of variables. The comparative test on work satisfaction among the two groups including general characteristics and work factors were conducted by t-test and F-test. The major findings as a result of the study are as follows : 1. As general characteristics, age group of $26{\sim}30$ years are more than any segment of age. As to marital status, the number of those in single status is slightly higher than the married. Approximately 80% of them are graduates of nursing schools and nursing colleges. They are mostly in service for one to three years. There is no significant difference between the two groups. 2. The number of those who want to work at oriental medicine wards represents 40.3% against 58.4%, being in favor of general wards. 3. The reason for service at oriental medicine wards is that "there is room for potential research" which happened to rank first, followed by "easy job," "good working atmosphere" and "growing interest in oriental medicine." 4. Work satisfactions among nurses who work at oriental medicine wards prove greater than that of nurses who work at general wards. 5. Work satisfaction between the two groups by work factors is reflected with significant difference statistically on task requirement, interaction and doctor-nurse relationships. 6. The general charcateristics and the work satisfaction by work factors prove that there are significant difference in age, marital status, education and the period of work. They tend to be more satisfied with the work as they grow in age. Significant differneces are found in the work factors such as autonomy, adiministration and professional job in the relationship with doctor-nurse. As to marital status, the married are more satisfied than the unmarried. There are significant differneces in the factors respecting administration and doctor-nurse college graduates are highly satisfied with task requirement. However, satisfaction with the professional level has proven the highest degree for those having master degree. The period of work and satisfaction : There are significant differneces in task requirement, administration, interactions, professional level and doctor-nurse relationships. As a general rule, the degree of satisfactions is in proportion to the lengrh of service. The following conclusions are drawn based on the fndings mentioned above. Even though the work satisfaction of the nurse who work at oriental medicine ward is relatively high, it is desired that personal consultation be given as to disposition of nurses when they are assigned to oriental medicine wards. It is also recommended that lectures on oriental medicine be conducted through supplementary training and/or basic nursing course in order that they may be motivated for ingenious activities with an increasing sense of self-esteem which will eventually enhance positive changes for the patients who are in need of oriental medicine nursing and for the medical teams. In addition, joint reseaches involvingclinical care and education should be in constant process for unique and scientific development for those who are subject to oriental medicine nursing care.

• Journal of Korean Academy of Nursing
• /
• v.24 no.1
• /
• pp.18-32
• /
• 1994

It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2％). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.211-221
• /
• 2024

Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.

• Korea Journal of Hospital Management
• /
• v.8 no.3
• /
• pp.32-48
• /
• 2003

Korea is to open its medical markets to foreign hospitals starting in the year 2006 regardless of our will(DDA, Doha Development Agenda). To accurately understand the characteristics of Korean medical users, their detailed and various needs, their attitudes toward the opening of Korean medical markets, and factors affecting these users in choosing foreign medical service providers would be first step needs to be taken by the Korean medical facilities that need to survive and develope through the fiercely competitive era coming with the opening of Korean medical markets to foreign medical service providers and would be very important in hospital management. The subjects of this study were 500 patients randomly selected from the outpatients who visited one of university hospitals in Seoul on the 14th-16th days of April 2003, and conducted a self-completion questionnaire. The answers of 463 respondents among the selected patients(93% of a responding rate)were analyzed through the Excel and statistics programs. The attitudes on the opening of the medical markets were shown in agreement 56.5%(247 persons), disagreement 6.9%(30 persons), and no idea 36.6%(160 persons). In consideration of only the answers as agreement and disagreement exclusive of the answer as no idea, 89.2% of the respondents agreed to the opening of the medical markets while 10.8% objected to the opening. The approval rate was higher with the higher education and income levels. Moreover, The approval rate for the opening of the medical markets was relatively high regardless of the satisfaction in the medical service, and the most important reason of the agreement was the guarantee of the patients(national)option. The main reason of the disagreement was high medical fee(50.5%), and the other reasons showing low rates were outflow of the domestic fund to the foreign countries(13.6%), damage of medical influences on the public(11.4%), lack of competition of the domestic medical industry(9.1%)and so on. As for the factors of selecting the foreign hospitals in the opening of the medical markets, the patients considered the authority(competency)of doctors firstly, and the other principal factors were worldwide fame and reliance, specific explanation of doctors, modernized medical instruments, convenient consultation procedure, etc. The patients agreed to the opening of the medical markets at a high rate regardless of the satisfaction in the medical service, and the most principal reason of the agreement was the guarantee of the patients(national)option for the medical care. Connected with the factors to select the hospitals, the approval reasons for the opening of the medical markets were the authority(competency)of the doctors as the first one, and then fame and tradition, reliance, overall diagnosis and modernized medical instruments, doctors specific explanation, and so on. However, these factors are actually associated with the Quality of the medical care, and consequently the approval reasons for the opening of the medical markets are connected with the security of the medical care. Accordingly, the guarantee of the patients(national)option answered as the main reason of the agreement can be also understood as the awareness of the right to have a variety of options for the security of the medical quality.

• Quality Improvement in Health Care
• /
• v.7 no.1
• /
• pp.118-131
• /
• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.11
• /
• pp.526-535
• /
• 2017

This study was conducted to identify the effects of a comprehensive health care program for elderly living alone on blood pressure, fasting glucose, body composition, and depression at a senior welfare center in M city. The study employed a one-group, pre-posttest design. The comprehensive health care program lasted for three months, from March to June in 2015, and consisted of open health education, exercise class, health consulting and personal education, nutritional consultation, and a self-support group. The sample elements of this study were individuals over 65-years-old with hypertension or diabetes mellitus, living near a welfare center in M city. A total of 34 participants were initially selected, but five subjects who were attended less than five times were excluded; therefore, a total of 29 individuals were included. The t-test and Pearson's correlation were used to analyze the data. The characteristics of subjects were 19 male(65.52%) and 10 female(34.48%). The most common age was 70 (16 subjects;55.17%). Additionally, 14 subjects were suffering from hypertension and diabetes mellitus (48.27%), which were occupied in the largest number in this study. The average attendance number of health programs was 10.28 times(${\pm}4.17$). In this study of subjects were significantly lower systolic blood pressure(t=3.275, p=0.004), body weight(t=3.878, p=0.001), depression(t=3.308, p=0.004) compared to pre-test. As the elderly population has increased, the number of individuals living alone has also increased. Accordingly, then need for physical and psycho-social health programs targeting the elderly is greater.

• Journal of Hospice and Palliative Care
• /
• v.8 no.2
• /
• pp.131-142
• /
• 2005

Purpose: The purpose of this study was to survey the knowledge and needs of hospice for inpatients' family. Methods: This study was carried out with 277 inpatients' families at J General Hospital located in J city, Korea during the period from March to May, 2004. The data were collected through a self-reporting questionnaire constructed by the authors. The data were analyzed by descriptive statistics and $x^2-test$ with SPSSWIN 10.0. Results: 83.8% of the respondents heard about hospice mostly through mass communication. 76.9% of the respondents recognized hospice to be helpful and to provide comfort during the remainder of life and to confront the moment of death. Most of the respondents responded positively to the necessity of hospice service, and would receive hospice if necessary. 76.5% of them would consider arranging preparation for death if he/she were to be diagnosed with a terminal illness. 63.9% of the respondents wanted only to be with their family members, 31.4% wanted both the family and hospice members at the moment of death. They named the best helper among the hospice members to be the nurse. 81.6% of the respondents wanted a hospice institution to be established, 23.8% of them report that the most adequate hospice management institution would be the hospice ward in hospital. Conclusion: Consequently, most respondents wanted hospice services. So Korean society is in need of developing adequate teaching and care programs for hospice according to local needs.