• 제목/요약/키워드: Comprehensive nursing service

검색결과 150건 처리시간 0.027초

보건진료소 가족계획 및 모자보건사업(1980년~2009년) (Family Planning and Maternal-Child Health Services that Disciplined Itself in Primary Health Care Post from 1980 to 2009)

  • 손계순
    • 한국농촌간호학회지
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    • 제3권2호
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    • pp.104-115
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    • 2008
  • Purpose: A study of the family planning and Maternal-Child Health Services that disciplined itself in primary health care post form 1980 to 2009. Method: Investigation studies family planning in primary health care post and a change process of a Maternal-Child Health Services into case by case until 2009 from 1980. Results: Our country family planning business began at economic development dimensions in order to solve a poverty issue. This business goal were childbirth decrease of pregnancy possibility couple aged 19~49 and improve to mother and child health. For this goal, all kinds of health education included sex education and contraception education, contraception service, comprehensive maternal and child health service that management of front and back of childbirth etc. are provided. According to fail down a birthrate from 6.0(1962) to 1.25(2009), the nation reached to a dilemma called childbirth encouragement policy. Conclusions: Decrease of labor supply by low birthrate, decrease numerical an employed person by aging was brought a labor shortage and decrease of productivity of labor of industrial manpower. Deterioration phenomenon of financial income and expenditure by consumption and investment contraction caused decrease of slowdown of economic growth and potential growth rate, and a social cost burden is increased by deterioration financial old man support burden increase by this and pensions and health insurance, a sharp increase of social welfare cost etc. Now, in order to solve a low birth issue, the government establishes a whole nation forwarding system and establishes basic plan social low birth and advanced age, and to prepare for childbirth fault factors removal and advanced age society shall endeavor.

일 대학 병원의 가정간호시범사업 서비스 내용 및 만족도에 대한 조사연구 (A study on Hospital based Home Health Care Service and the Level of Client Satisfaction)

  • 김정남;권영숙;고효정;김명애;박청자;신영희;이병숙;이경희;서향숙
    • 한국보건간호학회지
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    • 제14권2호
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    • pp.246-259
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    • 2000
  • The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

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조산교육의 국제 표준화 및 국가시험의 수준향상을 위한 연구 (A Study for International Standards of Midwife Education and Improvement of the Level of the National Examination)

  • 이경혜
    • 부모자녀건강학회지
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    • 제5권2호
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    • pp.145-160
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    • 2002
  • The primary purpose of this study was to suggest midwife education programs which could be recognized and exchanged internationally by examining and analyzing both domestic and foreign midwife education programs. The secondary purpose of this study was to offer a plan to raise the level of national examination. Specific aims of this study were as follows: 1) to identify the international standard of the education and practices of midwives 2) to analyze both domestic and foreign midwife education programs 3) to offer a new curriculum for educating midwives 4) to suggest a prerequisite to raise the standards of the national examination 5) to suggest subjects for the national examination The results of this research were as follows: 1. The concept of midwife and midwifery practices recognized internationally by WHO and ICM(International Confederation of Midwives) was identified. In addition, Core Competencies for Basic Midwifery Practice suggested by ACNM(American College of Nurse-Midwives) of the U.S.A. were examined. 2. Midwife education programs of the U.S.A., Sweden, Australia, and Japan were investigated and analyzed. In addition, the midwife education program stated in the public health related law of this country as well as curriculums of institutions for midwife education were also investigated and analyzed. 3. As for the midwife education system, both a graduate program for midwife education in the college of nursing sciences and a postgraduate professional midwife education program centered medical institutions were suggested. 4. A new curriculum that could promote more international exchanges and extend the role of midwives was suggested after studying both domestic and foreign midwife education programs. 5. A prerequisite to raise the level of national examination for midwives was suggested. In addition, subjects for the examination which could evaluate the applicant's comprehensive thinking ability were presented with its respective range and ratio. A midwife is a medical professional who has a nursing license and is licensed nationally as a midwife with an additional year of education. An effort to extend a midwife' role and to improve its service is imperative. The laws related midwives should be revised in regard to education, service, and the national examination to the level of developed countries so that international recognition can take place. In addition, midwife curriculum and its service should be evaluated periodically. A system must be established to renew midwife licences.

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당뇨병 적정관리를 위한 교육 실태 분석: 우리나라 보건소를 중심으로 (Focused on Diabetes Education Practice of Community Health Centers in Korea)

  • 최은진
    • 보건교육건강증진학회지
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    • 제31권4호
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    • pp.11-24
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    • 2014
  • Objectives: The purpose of this article was to investigate the current practice of diabetes education along with the specific interventions, process, and outcomes in community health centers in Korea. Methods: Data were collected by a mail questionnaire from September 20, 2012 to December 20, 2012. Among 253, a total of 161 responded, constituting a 63.3% return rate. Results: Primary staff of diabetes education was the nurse and respondents recognized their role largely as a director. More than half of respondents provided education to people with type 2 diabetes by group. Most common service offered was nutrition therapy and the majority of respondents used printed materials. Among 4 criteria of outcomes, eating (nutrition), knowledge scores, blood pressure, and patients' survey on satisfaction were collected most frequently. Nearly three quarters of respondents were not participated in activities for quality improvement and outcomes were not reported properly. Conclusions: The results are able to draw ideas for organizing diabetes education programs and evaluating outcomes in community heath centers. This article has significance that it is the first comprehensive survey of diabetes education practice in community health centers and provides a baseline for establishing national standards of diabetes self-management education.

산업재해 장애인의 일상생활 수행능력, 우울 및 삶의 질 (Ability of Daily Living, Depression and Quality of Life of the Industrial Accident Disabled)

  • 현혜진;오진주;최정명;이현주;윤순녕
    • 한국직업건강간호학회지
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    • 제12권2호
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    • pp.164-170
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    • 2003
  • The purpose of this study is to Identify the amount of ability of daily living, depression and quality of life and to examin the relationship among ability of daily living, depression and quality of life of the Indestrial Accident Disabled. Three hundred and forty five industrial accident disabled were randomly selected among who have stayed in Seoul, Incheon, and Gyeonggi area and who were confirmed as the disabled classified according to its severity from the first to fourteenth grade between January, 1998 to December, 2000. Data were collected for one month between August 1, 2001 to August 31, 2001. Each study team was consisted of two members of researcher among 20 members and interviewed the disabled individually by visiting their home. Collected data were analyzed from the frequency, percentages, Correlation, etc. The mean score of ability of daily living was 136.3 out of possible 147. The mean score of depression was 31.5 out of possible 64. The mean score of quality of life was 20.1 out of possible 32. The relationship between ability of daily living and depression was significantly correlated and between depression and quality of life was significantly correlated and between ability of daily living and quality of life was significantly correlated. The industrial accident disabled had been in bad health or faced by difficulties in daily activities even after the completion of therapy for the disability. Especially, they are depressed and perceive lowly their quality of life. So, the rehabilitation program for the disabled should be psychosocial oriented program and a comprehensive service.

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간호개념에 대한 기초조사 (The Empirical Exploration of the Conception on Nursing)

  • 백혜자
    • 대한간호학회지
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    • 제11권1호
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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외래 의료서비스 질적 수준의 결정요소 (Determinants of Quality in Outpatient Medical Service)

  • 박숙희;김석범;강복수
    • 한국의료질향상학회지
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    • 제5권2호
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    • pp.176-189
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    • 1998
  • This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

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토픽 모델링과 동시출현 단어 분석을 활용한 환자안전 관련 사회적 이슈의 변화 (An Analysis of Changes in Social Issues Related to Patient Safety Using Topic Modeling and Word Co-occurrence Analysis)

  • 김나리;이남주
    • 한국콘텐츠학회논문지
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    • 제21권1호
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    • pp.92-104
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    • 2021
  • 본 연구의 목적은 온라인 뉴스 기사를 분석하여 환자안전에 대한 사회적 이슈를 확인하고, 환자안전법 시행 이전과 시행 이후 사회적 이슈의 변화를 확인하기 위함이다. R 프로그램을 이용하여 2010년 1월 1일부터 2020년 3월 5일까지 총 7600건의 온라인 뉴스 기사를 수집하였으며, 키워드 분석, 토픽 모델링, 동시출현 네트워크 분석을 시행하였다. 2609개의 키워드는 다음의 8가지 주제로 범주화되었다 : "의료행위", "의료인력", "감염 및 시설", "간호·간병통합서비스", "의약품", "개선을 위한 시스템 개발 및 구축", "환자안전법", "의료기관 인증". 그리고 환자안전법 시행 이전에는 환자안전 인식, 감염관리, 의료기관 인증 등의 키워드가 등장하였으나 시행 이후에는 환자안전 문화, 투약 등의 키워드가 등장하였으며 간호의 중요도 순위가 상승하였다. 의료계뿐 아니라 대중에게도 환자안전에 관한 관심은 높아지고 있으며, 환자안전 향상에 간호의 역할은 중요하다. 따라서 환자안전을 간호의 핵심 역량으로 삼고 지속적인 교육을 해나가야 할 것이다.

노인장기요양보험 급여이용이 기능상태 변화에 미치는 영향 (Effects on the Functional Status Changes of LTC(Long-Term-Care) Services)

  • 현경래;이선미
    • 한국노년학
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    • 제32권2호
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    • pp.593-609
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    • 2012
  • 이 연구는 노인장기요양보험 시행 4주년을 맞이하는 현 시점에서 노인장기요양보험 수급자의 기능상태 변화와 그 관련요인을 파악하고자 수행되었다. 이를 위해 2008년 8~9월 당시 장기요양 등급(1~3등급)을 받은 수급자 가운데 1년 후인 2009년 8~9월에도 장기요양 인정조사를 받은 17,652명을 대상으로 분석을 실시하였다. 연구결과, 2009년의 기능상태가 2008년과 비교해 전체 항목에서 개선되었으며, 특히 일상생활기능, 행동변화, 재활, 수단적 일상생활기능, 인지기능, 그리고 간호처치 항목 순으로 개선 정도가 큰 것으로 나타났다. 분석대상자의 기능상태 변동요인을 분석한 결과에서는 먼저 시설서비스를 이용한 경우 1등급에서는 재활, 2등급에서는 일상생활기능 항목의 기능상태가 유의하게 개선된 것으로 나타났다. 다음으로 재가서비스 중 방문요양 급여를 이용한 경우 1등급에서는 일상생활기능, 2등급에서는 일상생활기능과 재활, 3등급에서는 일상생활기능, 인지기능, 행동변화 항목에서 기능상태가 유의하게 개선되었다. 또한 주·야간보호 급여를 이용한 경우는 1등급에서 일상생활기능, 수단적 일상생활기능, 행동변화, 재활, 2등급에서는 행동변화, 그리고 3등급에서는 인지기능, 행동변화 항목에서 기능상태가 유의하게 개선되었다. 끝으로 단기보호 급여를 이용한 경우는 3등급에서만 행동변화 항목의 기능상태가 유의하게 개선된 것으로 나타났다. 이상을 통해 노인장기요양보험 수급자는 그들의 등급과 이용하는 장기요양 서비스에 따라 기능상태 개선 효과에 차이가 있음을 알 수 있다. 따라서 향후 노인장기요양보험 수급자들의 실질적인 기능상태 개선을 위해서는 수급자의 건강 및 기능상태 등에 대한 객관적이고 포괄적인 이해를 바탕으로 한 맞춤형 서비스제공체계로의 개선이 필요하다. 또한 이를 위해서는 표준급여모형의 급여종류를 수급자의 종합적인 상황을 반영할 수 있도록 개선하는 것은 물론, 표준장기요양이용계획서에 수급자의 다양한 특성을 반영할 수 있도록 작성인력의 전문성 등이 강화되어야 할 것이다.

Service Quality beyond Access: A Multilevel Analysis of Neonatal, Infant, and Under-Five Child Mortality Using the Indian Demographic and Health Survey 2015~2016

  • Kim, Rockli;Choi, Narshil;Subramanian, S.V.;Oh, Juhwan
    • Perspectives in Nursing Science
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    • 제15권2호
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    • pp.49-69
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    • 2018
  • Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.