• 지역사회간호학회지
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• 제14권2호
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• pp.299-311
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• 2003

Purpose: This is a phenomenological study to describe the experiences of nursing students on home visiting nursing service as a community nursing practice. Method: Individual interviews were conducted on subjective experiences of 17 nursing students. Data were analyzed through Colaizzi's method in which meaningful statements were extracted and these were clustered into 6 themes. Result: The nursing students started practice with anxiety and expectation at the same time. They were frightened at the clients' inferior environment and their level of loneliness. They also felt pity and experienced complicated feelings for the clients. However, the home visiting practice was a chance for them to discard prejudice on the clients. Positive experiences on visiting nursing practice reported by the nursing students included lively interactions between nurses and the clients, and variable provision of primary nursing care. However, facts such as much limited visiting time, non-professional and limited scope of practice were reported as negative experiences. They felt both worthiness of the home visit service and restricted self-capability at the same time through the practice. They also felt sorry for the clients because the home visit services were carried out during limited time period. Regardless of this, the home visit experience provided them an opportunity of self-growth. This self-growth includes increased awareness of issues for elderly, building of self-identity as a nursing student, self-reflection, and realization of the value of family. Conclusion: This study may provide data for better understanding of nursing students experiences of home visiting nursing services. However, more study on the barriers of their community health practice is needed in the future. Moreover, it is needed to establish desirable practice environment through the collaborative relationships between the university and staffs in the public health center.

• 보건행정학회지
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• 제19권3호
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• 보건교육건강증진학회지
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• 제15권2호
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• pp.199-215
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• 1998

The health care environment exerts tremendous influence on community health practices. Here the author mention several major factors that will influence the future plan for health service and health education; that is, economic problem, the issues of decrement of infectious disease, increment of chronic degenerative disease due to natural increase of the elderly, increased frequency of traffic and industrial accidents and the issues of medical-technological advances etc. Therefore, special efforts by health personnel should be made to develop health education and health promotion strategies on a community-wide basis. Accordingly, the flexible accessibility, convenient availability, guaranteed medical service, sufficient supply of health information, and rapidly available medicaid service for special population such as the elderly, the handicapped, the disabled and the poor are considered. Also, the financial support from the central government and local self-government and active participation of health consumer to health service are needed in Korea, The role of the health personnel is to elicit, facilitate and maintain health promoting behavior with his and her assurance for health consumers being competent and supported in the voluntary choice of their health promoting activities. The health promoting activities such as the above mentioned will be produce escalation of their life Quality among Koreans.

• 한국간호교육학회지
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• 제3권2호
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• pp.163-192
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• 1997

As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

• 한국의료질향상학회지
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• 제22권1호
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• pp.29-37
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• 2016

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

• 농촌지도와개발
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• 제17권4호
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• pp.685-716
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• 2010

The purposes of this study were to exploring the rural residents' satisfaction of living environment and social service. For these purpose we collected the data from the residents in rural area(1,000). The major findings of this study were as follows : First, the total satisfaction score is 58.9. The highest score group is housing and environment(69.9). And the lowest score group is cultural life and leisure environment. Various welfare services have been carried out for low income people, disabled people, old people, children and rural women within the social service system. But many respondents did not have chances to use social service because it was not efficiently provided many social services. So most of the residents in village wanted more welfare services. Second, the qualitative enhancement is more important than physical infrastructure expansion in order to improve rural settlement condition(housing quality, water supply and drainage, road and traffic system, medical care etc.)

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.353-377
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• 2000

보건진료소의 보건의료환경 및 근무여건, 업무현황과 개선에 대한 보건진료원의 의견을 파악하여 향후 보건진료소의 발전 방안을 제시하는데 도움을 주고자 경상북도 소재 보건진료소(1996년 330개소, 1999년 313개소)의 운영상황보고서에 의한 업무 변화량을 분석하였으며, 보건진료원 280명의 설문자료를 분석하였다. 운영상황보고서에 의한 보건진료소의 관할인구 추이는 1996년에 비해 1999년에 전반적으로 감소하였으나 노인인구는 증가하였다. 운영상황보고서에 의한 보건진료소의 업무 활동상황은 1996년도에 비해 전반적으로 증가하였고, 진찰 및 투약관리, 검사, 성인병 및 만성질환관리, 노인건강, 가정방문이 특히 증가하였으며, 전염병 관리와 결핵관리에서 부분적인 감소를 보였다. 재정운영상태는 50.4%가 운영이 잘된다고 하였고, 1.4%만이 운영하기 곤란하다고 하였는데, 현 근무지 근무연수가 많을수록(p<0.05), 그리고 도시근교일수확, 인구가 많을수록, 진찰 및 투약건수가 많을수록(p<0.01) 운영이 잘 된다고 하였다. 보건진료원의 직업적 긍지는 전반적으로 긍정적이었는데, 그 중 하는 일의 중요함이 94.6%로 가장 긍정적이었고, 역할과 임무에 대한 만족정도는 현 근무지 근무연수에 따라 차이가 있었다(p<0.05). 보건진료원들의 보건기관과 민간의료기관과의 협조정도는 대체로 긍정적이었는데, 보건소와 협조정도는 연령이 많을수록, 근무 경력이 길수록 긍정적인 응답률이 유의하게 높았으며(p<0.01), 현 근무지 근무연수에 따라 차이가 있었다(p<0.05). 보건진료원들은 운영협의회, 마을건강원, 지역사회조직과도 협조적이다는 응답이 모두 70% 이상이었다. 보건진료소 사업계획서는 96.4%가 적성하였으며, 제2기 지역보건의료계획서 작성에는 11.4%만이 참여하였다. 관할지역주민의 혈압과 흡연여부를 70% 이상 파악하고 있는 보건 진료원은 각각 88.2%, 63.9% 였는데, 혈압파악률은 보건진료원의 연령이 많을수록(p<0.01), 교육정도가 전문대학 이하인 경우(p<0.05)에서 높았다. 보건진료원의 지난 3년 동안에 보수교육외 교육 참여율, 연구사업 참여율은 각각 27.5%로 저조했으며, 보건진료소 수입으로 주민환원 사업을 실시한 경우는 65.4%였다. 보건진료원들이 생각하는 보건진료소의 필요 정도는 국가적 측면, 소속시군 측면, 관할지역 측면에서 모두 95% 이상이 매우 필요 또는 필요하다고 하였으며, 53.9%가 보건진료소의 역할이 증대되어야 한다고 하였다. 지금까지 폐쇄 및 폐쇄 예정된 보건진료소에 대하여 보건진료원은 담당 부서의 보건진료소 업무에 대한 인식부족 및 행정편의, 보건진료원의 신분이 법률로 보장되지 않은 별정직이어서, 단체장의 의지 등을 주된 이유로 제시하였다. 보건진료원은 향후 보건진료소에 대한 평가기준에 대해 노인 및 만성질환자 등의 보건의료서비스 대상자수, 주민의 의견, 인구 규모, 일상생활권을 고려한 교통상황 등의 순으로 제시하였으며, 보건진료원에 대한 평가기준으로는 보건사업실적, 주민과의 유대정도, 진료실적, 행정 및 업무처리 능력 등의 순으로 제시하였다. 객관적인 평가 후 일정기준이하의 보건진료소에 대한 향후 대처 방안에 대해서 보건진료원은 현 구조 유지하면서 업무개선, 도시 의료취약지역으로의 보건진료소 위치 조정 등을 많이 제시하였다. 보건진료소의 가장 필요한 개선부문으로는 절반 이상인 52.5%가 보건진료원의 업무조정이라고 하였으며, 향후 보건진료소가 중점적으로 추진하여야 한 사업으로는 당뇨 및 고혈압 관리, 방문보건사업, 노인보건사업 등이 중요하다고 하였다. 향후 보건진료소가 일차보건의료의 가치체계를 잘 반영하는 조직이 되기 위하여는 지역사회 보건의료요구에 부합하는 업무개선이 이루어져야 하겠으며, 만성질환관리사업, 방문보건사업, 노인보건사업 등이 활성화 되어야 하겠다.

• 지역사회간호학회지
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• 제15권3호
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• pp.376-384
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• 2004

Purpose: The CHP program has been evaluated as one of the most successful program in the public health area in Korea. The objects of this study were as follows: 1) to evaluate the job activities of the CHP program, using service contents analysis. 2) to figure out personal factors and the outcome of CHP's activities. Method: Data were collected by sending questionnaires to 130 subjects through the mail from May to December 2003. The response rate was 48.0%. The Data were analyzed by the SPSS WIN program with t test and Pearson correlation coefficient. In using these methods. independent variables are CHP's personal factors (age, experience, certification of specialty) and regional factors (geographical classification, aged population, village workers, cooperation of community leaders, work-conditions), and a dependent variable is the outcome of CHP's job activities. Result: The results of t test analysis show that regional differences between factors are influential in the welfare service, the routine job, and the consultation. As a whole, this is shown that CHPs represent experience, the number of village workers and CHPs living condition of work and most of the categories of jobs that influenced over statistical meaning of differences (t=2.417, p=1.043, t=6.123, p=.004, t=4.309, p=.000). There is a significant positive relation between the routine job and the consultation(r=.455, p=.000), the consultation and the education(r=.461, p=.000). Conclusion: Finally, according to the results of this study, the CHP program should be developed and continue to meet the basic health care needs of the residents in accordance with the philosophy of their own primary health care.

• 보건행정학회지
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• 제32권1호
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• pp.3-13
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• 2022

Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

• 한국노년학
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• 제27권2호
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• pp.445-458
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• 2007

본 연구는 재가노인의 문제를 해결하는 데 있어서, 지역사회가 중심이 된 다양한 자원에 접근하기 위한 기초자료를 제공하기 위해 노인의 지역사회 거주의사와 이에 영향을 미치는 요인들을 알아보고자 하였다. 이를 위해 <2005년 부산광역시의 사회복지 욕구 조사> 데이터를 이차자료로 활용하여 분석하였다. 조사대상은 부산광역시에 거주하는 65세 이상의 노인이 포함된 1,673가구이고, 이 가구의 노인이 해당 설문에 직접 응답하였다. 자료 분석방법은 로지스틱회귀분석을 이용하였다. 이를 통해 나타난 연구결과는 다음과 같다. 첫째, 노인의 80%가 지역사회에 거주하고자 하였고, 자녀가 없는 경우(55.2%)는 배우자가 없는 경우(76.4%)보다 지역사회거주의사가 낮은 것으로 나타났다. 둘째, 지역사회 거주의사에 건강할 때에는 자가유무, 자녀유무, 배우자유무, 지역사회자원지각정도, 만성질환수가 적은 경우가 유의미한 영향요인으로 나타났고, 병약할 때에는 교육정도, 기초생활수급유무, 직업유무, 일상생활수행정도, 만성질환수, 자녀유무, 배우자유무가 유의미한 영향요인으로 나타났다. 특히 병약할 때에는 자가유무, 국민기초생활수급유무와 같은 사회경제적 변수가 가족변수보다 더 큰 영향을 미치는 것으로 나타났다. 셋째, 지역사회 거주의사를 가진 노인들의 재가복지서비스이용의사욕구는 낮은 편이었다. 마지막으로 본 연구결과를 통한 정책적 제언과 제한점이 논의되었다.