• Title/Summary/Keyword: Care system

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Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City (1차 의료기관의 엑스선 발생장치 정도관리에 관한 현황조사:광주광역시 지역을 중심으로)

  • Dong, Kyung-Rae;Lee, Seun-Joo;Kweon, Dae-Cheol;Goo, Eun-Hoe;Jung, Jae-Eun;Lee, Kyu-Su
    • Journal of Radiation Protection and Research
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    • v.35 no.1
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    • pp.34-42
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    • 2010
  • With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.

The Comparative Study on Health Promoting Behaviors by Shift Pattern of Duties of Women Workers in workplace (산업장 여성근로자의 근무형태에 따른 건강증진행위 비교)

  • Jang, Hee Jung;Park, Kyung Min
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.22-41
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    • 1999
  • This study intended to analyze the health promoting behaviors, compare their factors according to the shift pattern of duties of women workers who were working in the industrial workplace and present basic data in planning systematic and effective programs of health promotion for three-shift system and day-duty. Using Quota Sampling, 219 women workers were selected as subjects from 5 workshops which had 50 settled workers up to 300 and 10 factories which had more than 300 located in Taegu and Kyung-Book Province. Data were collected by means of questionnaire from September 12 to September 30, 1998. As the instruments of the study were used Health Promotion Lifestyle Profile(HPLP) which was adapted and adjusted by Seo, Y. O. for health promoting behavior, the one developed by Moon, J. S. (1990) for health-belief, the one developed by Sherer et al.(1982) and then adapted by Oh, H. S. for self-efficacy, and the one developed by Park, J. W. (1985) for social support. The analysis of data were performed with Cronbach's ${\chi}^2$-test, t-test, ANCOVA, Kendal tau, Pearson correlation, Stepwise Multiple Regression test using SPSS program. The results of the study are as follows : 1. There was a significant difference in age(${\chi}^2=32.46$, p=0.000), career (${\chi}^2=18.47$, p=0.000), working day(t=-3.18, p=0.000) by the shift pattern of duties in terms of socio-demographic characteristics. 2. There was a statistically significant difference between the two groups on the health promoting behaviors (t=2,52, p=0.012). The score of three-shift group on health promoting behaviors was 2.27, showing that it was lower by .13 than that of day-duty group(2.40). 3. ANCOVA involving age, career and working day as covariables, which had revealed significant difference before, showed that health promoting behaviors by the shift patterns of duties was significantly different(F=4.88, p=0.028). 4. In consideration of variables that have an influence on health promoting behavior by the shift pattern of duties, social support occupied 19.4% of health promoting behavior in the three-shift group and 22.5% including the sense of self-efficacy. In the day-duty group, social support occupied 34.4% of health promoting behavior. 5. The score of three-shift group(2.94) was significantly lower than that of day-duty group(3.12) in the perceived benefit of health-belief(t= -3.29, p=0.001), while the score of three-shift group (2.48) was significantly higher than that of day-duty group(2.24) in the perceived barrier (t=4.22, p=0.000). In the sense of self-efficacy(t=-4.20, p=0.000), the score of three-shift group(3.24) was significantly lower than that of day-duty group(3.53) while in social support(t=-4.56, p=0.000) the one of three-shift group(2.64) was significantly lower than that of day-duty group(2.88). The suggestions are as follows on the basis of the results of this study : 1. It is required to develop health promoting program that takes the shift pattern of duties of women workers into consideration. In addition, there are special demands on developing nursing strategies for health promoting behavior of three-shift workers. 2. It is required to develop specific strategies for social support which is the most significant factor to the health promoting behavior for women workers. 3. It is necessary to develop some programs for improving the sense of self-efficacy, social support, and health-belief of three-shift workers. To achieve these tasks, industrial nurses should play an active role and improve the ability of self-health care of women workers.

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The Etiological Role of Legionella Pneumophila in Patients with Community-Acquired Pneumonia in Korea (입원한 지역사회획득 폐렴 환자에서 요중 레지오넬라항원 검사를 통해 본 Legionella Pneumophila 감염의 비중)

  • Song, Hong-Seok;Suh, Ji-Hyeon;Ahn, Jong-Ho;Yoon, Byeong-In;Lee, Seung-Joon;Lee, Myung-Goo;Jun, Man-Jo;Kang, Min-Jong;Lee, Jae-Myung;Kim, Dong-Gyu;Son, Jee-Woong;Park, Myung-Jae;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.409-414
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    • 2001
  • Background : Legionella pneumophila has been recognized as an important cause of community-acquired pneumonia(CAP) requiring hospitalization. However, epidemiological data on the occurrence of legionella-related pneumonia is unavailable in Korea. The purpose of this study was to evaluate the etiological importance of legionella pneumophila serogroup 1 in patients hospitalized with CAP. Method : The CAP patients over 16 year-old were recruited from July 1999 to June 2000 at the Chunchon Sacred Heart Hospital. Fifty four patients (male 29, female 25, average age $63.8{\pm}15.3$) were included in this study. A diagnosis of a legionella pneumophila infection was based on a urinary antigen test using the Binax Company enzyme immunoassay. The severity of pneumonia was assessed using the Fine's PORT scoring system. Result : The average Fine's PORT score was 99.7(${\pm}44.9$). According to the risk classification proposed by the Infectious Disease Society of America, the number of patients in each class(from class I to class V) were 6(11.1%), 13(24.1%), 9(16.7%), 14(25.8%), and 12(22.2%), respectively. Thirty two patients(59.3%) were initially admitted to the intensive care unit. The mortality rate was 16.7%(9 in 54). In all patients, urinary antigens to Legionella pnewnophila serogroup 1 were not detected. Conclusion : Legionella pnewnophila may play little role in causing adult CAP in Korea. Therefore, the routine use of macrolide in the empirical treatment of the CAP patients based upon the ATS guidelines(1993) in Korea should be reevaluated.

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Clinical analysis of pediatric patients who visited Masan Samsung Emergency Center (일개 종합병원 응급의료센터에 내원한 소아청소년 환자에 대한 임상 분석)

  • Yoo, Jae Wook;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.314-322
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    • 2010
  • Purpose : Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. Methods : We reviewed the medical records of 14,065 pediatric patients below 19 years of age. Results : The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%). The peak month was May (10.0%), the peak day of the week was Sunday (24.7%), and the peak time of day was 20:00-0:59 (8.5%). There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog) or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD)-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding) (31.5%), and the most common symptom was fever (13.1%). Final outcomes were discharged (73.8%), admitted (25.7%), transferred (0.4%), and expired (0.1%). In adolescent patients aged 15-9 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%); the most common symptom was abdominal pain (9.6%). Conclusion : Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

A study on simple nursing activities for the registered nurses and nurse aides in the hospital (단순간호활동에 관한 간호사 및 간호조무사의 태도조사연구)

  • Lee Jung-Hee
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.37-55
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    • 1990
  • Every country in the world has been trying to expand the basic health right for the peoples as W.H.O has established the goal 'health for AU' by the year of 2000. Related to this goal, our government authority has establish the policy 'the insurance of health for all' into effect from July 198\). Recently hospitalshave been making a ceaseless effort for the plan for the rationalization of its management the academic World is making it a subject of discussion by doing the secure of manpower at a resonable level and the increase of productivity by the manpower. As a result of the efforts the study was established to secure the numbers of nursing manpower at a resonable level and use the unskilled persons at the utilizing field and seek the possible area of their activity for more efficient service through the investigation of ablity of simple nursing activities of regiestered nurses and nurse aides for rational function according to the educational levels and talents. The method of study was established by the registered nurses and nurse and nurse aides(R.N 229, N.A 226) who are working in 15 hospitals with over 200 beds. This surrey was conducted from Mar 29, 1989 to April 8, 1989. The method to test the degree of importance, difficulties, and the abillity of performance of a simple nursing activities was classified into 35 activities on the basis of references on this field. The degree of importance was composed from point l(Not so important) to 5(Very important). the degree of difficulties. was composed as follows; very easy - Point 1 very difficult and complicated - Point 5. and the ability of performance was composed from point 1 to 5. The materials gathered through the survey were analyzed with frequency, mean standard deviation, percentage. t-test, Anova, pearson's coefficient of correlation, stepwise multiple regression. factor analysis, discriminant analysis. The obtained results are summarized as follows: 1. The recognition values of the simple nursing activities of each group of registered nurse and nurse aides show; The degree of importance; 4.04 and 4.26 The degree of difficulties; 2.72 and 2.94 The ability of performance; 2.07 and 2.38 The brief summary shows there are little differences between who two groups the simple nursing activities turned out to be easy and simple work. 2. Regardless of the degree of importance, and difficulties, the ability of performance the important in fluencing of the degree of the simple nursing activities between the registered nurses and nurse aides was the order of educational level, hospital career, working career in wards and ages of the registered nurses and ages and hospital creer of nurse aides. The result was that the simple nursing activities could easily be familiar through the training of their working environment and period of experience. 3. Among the 35 simple nursing activities the items capable of resonable entrusting to the nurse aides are 5 that is helping bed-bathing, 8itz Bath, using bed pan, care while delivering patient, accompaying patient when visitor's check. There wasn't and differences between RN and nurse aides in performing the above 5 items. In anywhere. so we can say obviosuly that this nursing activities should be performed under the nursing system of which chief of nurse are supposed to supervise nurse aides as a possible function to be entrusted. In view of the above mentioned results, therefore, this partial functional job of the simple nursing activities can able be entrusted to the nurse aides through the regular training course. In case of these functional activities could be entrusted under, the responsibility of registered nurse, we can able suggest to for that there are the following advantages: 1.. In the nursing activities-affairs, the qualified guarantee of the nursing services can be kept and increased or promotoed with accommodation of the required nursing service and roles being expanded presently. 2. In the productivity of the hospital manpower, therefore, we have comt to view and consider in favourly that when an automational administration times would be come in the near future time to hospital affairs as a reality, to utilize the existing nures aides is better rather than investing so as to develop the other source manpowers or seek its for the efficient business management in the operational strategy or its policy.

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Effects Of Environmental Factors And Individual Traits On Work Stress And Ethical Decision Making (간호사의 환경적 요소와 개인적 특성이 직무스트레스와 윤리적 의사결정에 미치는 영향)

  • Kim, Sang Mi L.;Shake ketefian
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.417-430
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    • 1993
  • 이 연구는 환경적 요소(간호사의 자율성, 조직의 표준화)와 개인의 특성(통제위, 나이, 경험. 간호역할개념, 도덕성), 직무 스트레스, 윤리적 의사결정 사이의 관계를 이론적 틀을 구성하여 테스트함으로써 그 인과관계를 탐구하였다. 본 연구를 위해 개발된 모형은 1) Katz와 Kahn의 조직에 대한 개방체계 이론(open systems theory of organization) ; 2) Kahn. Wolfe, Quinn, Snoek의 스트레스 이론 (theory of stress) : 3) Kohlberg의 도덕발달 이론(theory of moral develop-ment): 그리고 4) 여러 문헌고찰을 기초로 하였다. 본 연구의 모형은 2가지의 주요 종속변수(직무 스트레스, 윤리적 간호행위), 2가지 매개변수(간호 역할개념, 도덕성 발달정도) 그리고 여러 독립변수들(조직의 표준화, 자율성, 통제위, 교육, 나이, 경험 등)로 구성되었다. 간단히 말해, 간호사의 스트레스와 윤리적 간호행위 를 개인 자신과 환경이라는 두 요소의 결과로 간주한 것이다. 미국(2개주)의 여러 건강관리기관에 근무하는 224명의 정규 간호사를 대상으로 하였고. 가설 검증을 위하여 1) 변수간의 인과관계를 조사하기 위한 Linear Structural Relationships(LISREL)기법과 2) 나이, 경험, 교육이 변수간의 관계에 미치는 중간역할을 알아보기 위해 상관분석을 이용하였다. LISREL결과를 보면 제시된 모델이 각 내재 변수에 상당한 설명력을 가지면서 자료에 잘 맞는 것으로 나타났다. 이 연구에서 가장 뚜렷한 점으로 나타난 것은 개인의 특성보다 환경적 요소로서의 자율성이 직무스트레스와 윤리적 의사결정을 예견하는데 훨씬 중요한 변수로 부각되었다는 점이다. 또한 간호사의 전문적 역할개념과 봉사적 역할개념이 간호사의 윤리적 의사결정을 예견하는 가장 중요한 요소로 나타났다. 중간영향(moderation effect)을 보면, 젊고 경험이 적은 간호사일수록 나이가 많고 경험있는 간호사보다 환경적 요소(자율성)에 더 큰 영향을 받는다는 것을 암시하고 있다. 또한 4년제 대학 이상을 졸업한 간호사의 윤리 적 간호행 위 는 2, 3년제 를 졸업 한 간호사 보다 환경적 요소에 의해 덜 영향을 받는 것으로 나타났다. 한편 자율성의 부족은 2, 3년제 졸업 간호사보다 4년제 졸업 간호사에게 더 심한 스트레스가 되고 있음을 시사하였다. 이 연구의 결과로부터 적어도 다음과 같은 두 가지 실제적인 제언을 도출할 수 있다. 첫째, 이 연구는 환경적요소로서의 자율성이 다른 어떤 개인적인 요소보다 직무 스트레스를 예견하는 데 중요한 요소라는 것을 제시하였다. 이것은 간호행정가들에게, 간호사의 직무 스트레스를 감소시키기 위해선 “자율성”이 아주 중요히 다루어져야 한다는 것을 의미한다. 만일 간호사들의 직무스트레스가 그 개인의 복지에 큰 해가 되고 환자를 간호하는 데 직접적으로 관계된다면, 간호행정가는 그 조직의 직무체계를 다시 평가해서 일에 대한 새로운 설계가 필요한지를 파악해야 한다. 또한 이 연구는 직무를 다시 설계할 경우, 누구에게 먼저 촛점을 두고 시작해야 하는지를 밝혀주고 있다. 즉, 젊고 경험이 미숙한 간호사들에게 촛점을 두고 시작해야 하며, 작업환경의 가장 중요한 차원중의 하나인 사회적 지원(social support)을 조심스럽게 고려해 보아야 한다. 둘째, 간호사의 윤리적 간호행위를 높히기 위해 전문적 역할개념과 봉사적 역할개념이 재강조될 필요가 있다. 이 두 역할개념 들을 교육을 통하여 효과적으로 가르칠 필요가 있다고 본다. 이 두 개념들이 간호사의 바람직한 간호행 위에 영향을 미치는 가장 중요한 요소로 나타났기 때문이다. 또한, 본 연구결과에 따르면, 경험이 많을수록 일에 싫증을 느껴 바람직한 윤리적 간호행위가 감소되는 경향이 있었다. 따라서, 건강관리체제 (health care system) 안에서의 간호사의 역할이-전문직으로서의, 그리고 환자를 위한 옹호자로서의-학교와 임상에서 효과적으로 교육되어져야 한다고 본다. 간호사들의 역할에 대한 계속적인 교육이 학생은 물론 임상 간호사들에게도 실시되어져야 할 것이다. 미래연구의 방향을 제시해 보면 첫째로 연구의 일반화를 높히기 위해 더 많은 대상자를 포함시켜야 한다. 이는 여러 종류의 표본을 반드시 한번에 전부 포함시켜야 한다는 것을 의미하는 것이 아니고, 특정한 여러 표본들을 연속적으로 연구함으로서 이 목표를 성취할 수 있다고 생각한다. 둘째는 여러 construct들(윤리적 간호행위, 직무 스트레스, 간호 역할개념 등)에 대한 적절한 측정도구를 개발해야 한다. 측정도구를 개발하기 위해서는 풍부하고 세세한 통찰력을 제공하는 질적인 정보를 얻는 것이 선행되어야 한다. 셋째, 윤리적 간호행위와 직무 스트레스에 관한 연구를 증진시키기 위해 실험설계 및 종단적 연구(expel-imental, longitudinal design)가 시도될 필요가 있다. 마지막으로, 윤리적 간호행위와 직무 스트레스를 예견할 수 있는 이론적 탐구(theoretical exploration), 즉 이론정립을 위하여, 환경적 요소와 개인의 특성에 대한 자세한 정보를 제공해 줄 수 있는 질적 연구들이 요구된다.

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Outcomes in Relation to Time of Tracheostomy in Patients with Mechanical Ventilation (기계호흡환자의 기관절개 시행 시기에 따른 결과 분석)

  • Shin, Jeong-Eun;Shin, Tae-Rim;Park, Young-Mi;Nam, Jun-Sik;Cheon, Seon-Hee;Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.365-373
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    • 1999
  • Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.

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Supercargo and Temporary Passengers (화물관리인과 임시승선자)

  • Choi, Suk-Yoon;Hong, Sung-Hwa;Ha, Chang-Woo
    • Proceedings of the Korean Institute of Navigation and Port Research Conference
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    • 2018.11a
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    • pp.225-227
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    • 2018
  • This research paper examines the history and present of 'temporary passengers' prescribed in Paragraph 9 of Article 5 of the Ships Safety Act Enforcement Regulations and suggests improvement plans referring to the examples of legislation of other countries. In 2015, Ministry of Ocean and Fisheries made authoritative interpretation that Paragraph 9 of Article 5 of the Ships Safety Act Enforcement Regulations, which prescribes special cargo drivers such as agricultural, marine or livestock vehicles as temporary passengers, is applied only to passenger ships and not to cargo ships such including Ro-Ro cargo ships. As the authoritative interpretation of the Ministry does not agree with not only the traditional interpretational methodology but also the interpretational methodology that are commonly used today, it lacks logical basis and looks unpersuasive. Paragraph 9 of Article 5 of the Ships Safety Act Enforcement Regulations can be applied not only on passenger ships but also on cargo ships. Also in case of Ro-Ro cargo ships, it is logically contradictory and against fairness not to acknowledge special cargo vehicle drivers as temporary passengers when there is no problem with safe navigation and safety of passengers on board even when the sailor, the sailor's family and the ship owner may be acknowledged as temporary passengers. To avoid unnecessary disputes and lawsuits, improvement plans using theory of legislation through statutory reform is more desirable. Therefore, the P aragraph should be amended to "Supercargo who deals with cargo that requires special care due to the characteristics of the cargo, such as transportation vehicles for agricultural products, marine products, livestock, explosives or flammable materials (drivers can serve as supercargos)" to reflect the distinct characteristics of cargo and ship navigation in Korea including the current distribution system, while setting an objective standard based on common sense of ordinary people and not on arbitrary interpretation.

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A Need Assessment on Establishment of Oriental Health Promotion Center (한방건강증진센터 설립에 대한 인식 및 요구조사)

  • Lee, Hyang-Yeon;Kim, Kwuy-Bun;Cho, Kyoul-Ja;Shin, Hye-Sook;Kim, Kwang-Joo;Moon, Heui-Ja;Park, Shin-Ae;Kim, Yoon-Hee;Kang, Hyun-Sook
    • Journal of East-West Nursing Research
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    • v.5 no.1
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    • pp.90-101
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    • 2000
  • The study attempts to examine the degree of cognition and demand on health promotion center of oriental nursing. It puts unique nursing intervention using traditional health promotion connected with oriental medicine to practical use for residents' health promotion and prevention of disease. With the study design of cross-sectional descriptive study, 516 residents who live in 26 Dongs, Dongdaemoon-gu were selected. The tool of study consists of 30 questions which the study team made for the degree of cognition and demand on health promotion center of oriental nursing. Cronbach's $\alpha$ in the degree of cognition was .8028. Collection of research data had been done from October 1 to October 30, 1999 with help of Dongdaemoon-gu office after pretest from 20 residents. Collected data were analyzed into the number and percentage in the characteristic of a subject and connected with demand on the establishment of center, the mean and the standard deviation in the degree of cognition and F-tests in the difference of the degree of cognition by characteristics. The results were as follow; 1) The characteristic of subject of this study was male 50.6%, and average age was 38.5 years old and 30-39 years old occupied the highest percentage with 31.6%. The married were 71.8%, over high school graduates was 85.6%, monthly income from 500 thousand won to 2 million won was 86.1%. 50.8% was the type living with parents, children and sibling. 2) When they were sick, the institution which residents used at first was a pharmacy(69.2%) and hospital(27.5%), but oriental medicine hospital was just 1.4%. As for subjective health condition, 82.5% answered over average, and 28.7% answered that they had chronic illness such as arthritis, chronic digestion problem, hypertension and so on. As for information collection on health, mass communication(34.9%) and medically concerned people(28.1%) occupied relatively high rate. Free health diagnosis system(36.8%) and establishment of health promotion center(31.5%) among welfare programs that residents want to enjoy were high ranked. The rate using a special institution for health was 17.8%, and among these institutions, the rate using aerobic exercises, health center(7.0%) and steamed room(5.4%) was high. Besides, other institutions such as breathing at the abdomen, finger-pressure therapy, meridian massage, foot massage, and so on were being used. 3) As the average of the degree of cognition on health promotion center of oriental medicine was 2.92, the degree of cognition was medium. The description, "health promotion center of oriental medicine is necessary for health keeping of healthy people, including people who have a problem in health" showed the highest degree of cognition(3.04, ${\pm}0.64$). 4) As for the intention on using health promotion center of oriental nursing, 61.4% said "yes", "no" was just 1.4%. The services that people relatively high wanted to be served from the center were measures reducing stress(68.0%) (relaxation therapy, meditation, breathing at the abdomen and so on), acupuncture(66.5%), finger-pressure(61.6%), moxibustion(57.6%), meridian massage(44.2%), postpartum care(40.3%) and so on. 5) As for the degree of cognition on the establishment of health promotion center of oriental nursing by characteristics of subject, there was significant difference(F=4.03, p=.046) between male(3.01) and female(2.91). But there was no significant difference by age, marital status, level of educational achievement and monthly income. As the above result, cognition on the establishment of health promotion center of oriental nursing was relatively low because people were not familiar with about the health promotion center of oriental nursing yet. However once the center will be established, the degree of demand on the center will be relatively high. So positive advertisement will be necessary, and the management of useful programs will be also required in order to make people recognize the advantage when they actually will use the center. On the other hand, as the subject of the study consists of many young people of below 30, the health problem came to be low. And in the case of sampling, the study using random sampling that can represent population will be required.

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Application and Effectiveness of a Preceptorship for the Improvement of Clinical Education (임상실습 교육개선을 위한 일 실습지도자 활용모델 (preceptorship model)의 적용 및 효과에 관한 연구 -암센타, 재활센타, 중환자실 실습을 중심으로-)

  • 이원희;김소선;한신희;이소연;김기연
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.581-596
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    • 1995
  • Clinical practice in nursing education provides an opportunity for students, through the process of ap-plying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide ad-vice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the preceptorship, the three - tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et ai was also used to measure student competencies. The results of this study are as follows 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t=-5.l3, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that : 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse(student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their bur-den. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to up-grade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

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