• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.13-29
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• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• Journal of Oriental Neuropsychiatry
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• v.26 no.1
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• pp.39-48
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• 2015

Objectives: This study was conducted to analyze the hwa-byung, self-perceived health, life-stress, social support, depression, and factors affecting on suicidal ideation in community dwelling elders. Methods: This study was a cross-sectional descriptive study. The subjects were 165 elderly in I city. The data was collected from November $21^{st}$ to December $5^{th}$ of 2014 by using structured questionnaire. T-test, Pearson's correlation coefficients, and stepwise multiple regression were performed by SPSS/PC 17.0. Results: There were more females than males in hwa-byung (t=.-3.068, p=.003). In the visit parent, more than once a month was a significantly higher in social support (t=.3.333, p=.001). Hwa-byung (t=.-2.577, p=.011), life-stress (t=.-3.800, p=.001), depression (t=.-2.776, p=.006), and suicidal ideation (t=.-4.316, p<.001) were shown to be high in the elders with lower level of living. Subjects with health insurance had high self-perceived health (t=-3.800, p=.001) and low hwa-byung (t=-4.102, p<.001), life-stress (t=-4.482, p<.001), depression (t=-5.296, p<.001), and suicidal ideation (t=.-2.152, p=.036), according to the type of insurance. In the correlation, sleeping hours (r=-.180, p=.020), self-perceived health (r=-.364, p,.001), and suicidal ideation had negative correlation; hwa-byung (r=.404, p<.001), life-stress (r=.300, p<.001), social support (r=-.310, p<.001), depression (r=.423, p<.001) and suicidal ideation had positive correlation. Factors affecting the suicidal ideation in community dwelling elders were depression (${\beta}$=.42, p<.001), hwa-byung (${\beta}$=.23, p=.004), social support (${\beta}$=-.18, p=.012), and level of living (${\beta}$=.24, p=.001). Discussion: For the prevention of elderly suicide, it is necessary to care for psychosocial status and solve economic difficulties through social support.

• Journal of Home Health Care Nursing
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• v.5
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• Journal of East-West Nursing Research
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• v.18 no.1
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• pp.25-30
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• 2012

Purpose: The purpose of this study was to verify the influence of health point system on the lifestyle among the patients with chronic diseases listed in iCDMS, a project of the Incheon Metropolitan Center for Chronic Disease Control and Prevention. Methods: The data were collected 1,000 persons among the patients listed in iCDMS from March 16, 2009 to December 21, 2010 by telephone survey. The data were analyzed by descriptive statistics, ${\chi}^2$-test, odds ratio and logistic regression with the SPSS 18.0 program. Results: The higher the percentage of the accumulation of the points of necessary medical examinations they have, the better the lifestyle the participants practice moderation in drinking, exercise, and diet (p<.05). Also the higher the percentage e accumulative points of education and visit, the stronger the intention to improve the lifestyle such as for example, receiving the guidance of no smoking, giving up drinking, or being conscious of nutrition and obesity (p<.05). Conclusion: This study suggests that the motivation through an incentive system can increase self-care make an effect on the care of patients with chronic diseases.

• Journal of Home Health Care Nursing
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• v.2
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• Korean Journal of Health Education and Promotion
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• v.23 no.1
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• pp.23-43
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• 2006

Objectives: To investigate the drinking behavior and related factors of community residents in G city. Methods: Examination was executed with questionnaire to 1973 adults. Data were collected from October 1, 2005 to November 16, 2005. Drinking behavior involves rate of drinking, frequency of drinking, age of starting drinking, drinking amount, rate of attempts to drink moderately and reasons for reducing drinking. Related factors involves the general characteristics, the habits of health behaviors. This was analyzed with frequency, percentage, mean, standard deviation, x2-test, t-test, ANOVA and logistic regression. Results: The drinking rate of the respondents was 67.4%, that rate of male was 83.1%, while that rate of female was 52.5%. The drinking rate was higher in groups of younger aged and highly educated people than that rate of the other groups. The highest level of drinking frequency was ones or twice a week. The drinking frequency of those who drank more than three times weekly was higher in the groups of male, old aged, married people, low educated people, rural residents, farmers or fisherman or laborers and those who unemployed or who did not exercise frequently and control their body weight. These individuals also preferred salty food and meat and fish, dined out frequently, did not visit dental clinic regularly, and tend to be smokers. The mean of the age of starting drinking was 21.17 year-old, that of males was 19.94 year-old, that of females was 22.82 year-old. The mean of the age of starting drinking was lower in groups of male, young aged, unmarried, college educated, rural residents, clerks, high monthly income, healthy and no illness, and smokers than that of the other group. The average of the drinking amount was 5.77 pack, that of males was 7.41 pack, and that of females was 3.31 pack. The drinking amount is much more in groups of males, fifties, unmarried, college educated, rural residents, self-employed, healthy people, and smoker than the other. 33.4% of the respondents attempted to drink moderately. According to the reasons of trying to drink moderately, the rate of prevention illness was highest. Conclusions: The variables of influencing drinking were sex, marital status, education, smoking, monthly income, health status, and stress.

• Journal of Home Health Care Nursing
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• v.8 no.1
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• pp.5-24
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• 2001

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

• Journal of agricultural medicine and community health
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• v.34 no.2
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• pp.234-243
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• 2009

Objectives: The aim of this study was to establish the basic data for adolescents' mental health states in a community. Methods: 466 middle school and high school students were analyzed by visit-survey with an organized questionnaire from March to June 2008. K-YSR for measurement of mental health was used. Results: The score of total behavior (p<0.01), anxious/depressed (p<0.05), though problems (p<0.001), attention problems (p<0.001), aggressive behavior (p<0.01) and internalizing problems (p<0.05) in girls appeared significantly higher as compare to those the boys. Also, total competence (p<0.05) in high school students appeared significantly lower as compare to those middle school students. Withdrawn (p<0.01) in high school students appeared significantly higher as compare to those middle school students. The though problems (p<0.001) and aggressive behavior (p<0.05) in middle school students appeared significantly higher as compare to those high school students. The distribution of clinical group was school 93.8%, total competence 32.6%, attention problems 8.8%, total behavior problems 8.6%, anxious/depressed 7.7%, aggressive behavior 6.4% et. al. The social (p<0.05), anxious/depressed (p<0.05), attention problems (p<0.01), internalizing problems (p<0.05) and externalizing problems (p<0.05) in girls of clinical group were more frequent significantly as compared to those the boys of clinical group. Also, the social (p<0.01) in middle school students of clinical group was more frequent significantly as compared to those the high school students of clinical group. Conclusions: This study result will be significant in that it can provide basic data for the school mental health services.

• Research in Community and Public Health Nursing
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• v.6 no.1
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• pp.34-54
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• 1995

Occupational health services in Korea have been operated as dual types: one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative. health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area: 154 places (39.4%) managed by designated. health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation due to the characterstics of each variable and analyzed for impacting factors with relation to the using multiple regression analysis using SPSS PC program, especially using t -test method in order to compare each type of health care management. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. The common sickness management is the most accomplished item in health care area of occupational health care services, while the preventive care and control for the workers who have serious health problems are insufficient in workers health care area. 3. An insufficient accomplishment of overall health education has been shown because it is difficult to perform health education due to almost no chance of the direct introduction at workplaces. Therefore a strong support system for making and supplying the media is necessary in order to activate indirect health education by means of media. 4. Because health care managers and the agencies managers where take the workplaces for this study are almost nurses who have been comparatively high work site rounding rate about an environmental management at the workplaces, that non-profession can also do it, the activities about the professional area not enough. Therefore, an appropriate referral system should be established in order to complement professional area. 5. Two factors which have an effect on the coverage rate of occupational health care services are : one is those from the workplaces such as type of services, the number of workers, the number of harzadous factors and safety & health committee, the other from health care organization about whether there is its own manager or not.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.155-169
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• 2003

Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.