• Clinical Nutrition Research
• /
• v.13 no.2
• /
• pp.108-120
• /
• 2024

The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

• Journal of the Korean Crystal Growth and Crystal Technology
• /
• v.27 no.4
• /
• pp.196-205
• /
• 2017

In recent years, the service design in the medical sector evolves through practical service research and development that can visualize both intangible and intangible service elements in an integrative way and derive innovative solutions to help customers feel the service more important value. With the improvement of personal income, interest in medical welfare and well-being is increasing day by day, and the focus of the medical sector shifts from the concept of treatment of diseases and illness to preventive medicine. In response to this trend, research and development of home health care system, which greatly reduces the time and space constraint of health checkup and health care by combining ubiquitous concept with medical welfare, are being actively conducted, and the needs for improving products and medical environment based on user-centered medical service and user needs in accordance with the Health Care 3.0 Era, it becomes necessary to develop on-site medical diagnostic products that reflect user-centered needs and needs. This study is intended to research and develop a product that sufficiently reflects the needs of users by applying suitable materials and shape for on-site diagnostic product in researching and developing Wireless X-ray Detector.

• Journal of the Korean Society of Food Culture
• /
• v.11 no.2
• /
• pp.243-253
• /
• 1996

The purpose of this study was to evaluate the foodservice management practices in child-care centers in order to provide basic information for the development of a model of a centralized food service information center. This approach was achieved using a variety of qualitative and quantitative information including general foodservice management practices and plate waste. A self-completed questionnaire survey of 651 child-care centers in Korea was undertaken and detailed information was carefully collected at 6 representative child-care centers. The results of the empirical survey were as follows: 1. Child-care centers categorized by location were in large cities (59.9%), medium cities (27.6%) and in provincial areas (12.5). 2. Private sector of child-care centers was 46.4% of the total followed by National/public (44.2%) and licensed home day-care programs (9.4%). 3. Total average number of children in child-care centers was $63.3{\pm}43.1$ with a very significant difference (p<0.001) in types of child-care centers. 4. The average space of kitchen and dining room was $5.0{\pm}3.8\;and\;10.8{\pm}11.0$ pyung ($1pyung=3.3058\;cm^2$). 5. The average cost of interim snack in morning and afternoon in child-care centers were $345.9{\pm}459.3$ won and $359.3{\pm}226.6$ won respectively. The average cost of lunch was $644.0{\pm}481.1$ won. There was a significant difference (p<0.001) by types of child-care centers with a highest cost of 863.9 won in licensed home day-care programs. 6. Only a limited number of dietitian were employed, therefore most of food service management practice was not conducted by professional personnel. 7. The result of nutritional analysis of the food revealed that the level of energy and nutrients contained in the food was below the recommeded level (RDA/3).

• Korea Journal of Hospital Management
• /
• v.8 no.4
• /
• pp.149-181
• /
• 2003

It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

• Korea Journal of Hospital Management
• /
• v.9 no.1
• /
• pp.46-65
• /
• 2004

The study was designed to investigate what effect of working time reduction which will be gradually expanded to corporate size from June, 2004 could give to medical industries, and to provide basic information for hospitals and government to prepare the policy. 276 hospitals were surveyed about medical service income and manpower realities during the first half of 2003, using a structured survey tool. Response rate was 8% and 20 hospitals were finally analyzed. The effect of working time reduction in hospital management was different to the size of hospitals and the alternative. Income to existing service income was decreased by $2.2{\sim}4.6%$ in tertiary hospitals, by $3.2{\sim}5.7%$ in general hospitals with more than 300 beds, and by $3.7{\sim}6.0%$ in general hospitals with less than 300 beds. In preparation against such decrease in income, government is required to raise insurance payment, to calculate added service charge for day-off on Saturday forenoon, to retain emergency care payment, to expand emergency care facilities, to secure duty doctors, and to support middle and small sized hospitals. Hospitals are required to give self improving efforts such as fortifying of weekday care, development of weekend care program, strengthening of care capacity and function of emergency care center, and making manpower operation efficient.

• Korean Journal of Child Education & Care
• /
• v.19 no.1
• /
• pp.159-174
• /
• 2019

Objective: The study wanted to find out what changes the mother, who is the main parent of the severely disabled children, experienced in their lives through the use of day hospitals and child care services, and what difficulties they had, and discussed policy practical improvements that could satisfy both the medical and developmental needs of the severely disabled. Methods: The participants of the study were 9 mothers of a child with severe disabilities who had experience using hospitals and kindergarten. They were recruited by snowball sampling method. Focus group interview and individual interview were conducted. Results: As a result of the analysis, the mother of severely handicapped child gradually began to seek the balance of life as her child grew and became aware of the institution other than the day hospital. - (e.g) Although I was distracted and worried for the first time, I was gradually adjusting to the time away from my child thinking positively. Children with severe disabilities were also positively influenced by various experiences. They become to show som positive behavior or feeling such as brightening facial expressions or smile as they were using daycare centers or kindergartens in addition to daytime hospitals. Conclusion/Implications: Through the results of this study, comprehensive policy proposals on child care, welfare, and medical care were discussed.

• Women's Health Nursing
• /
• v.6 no.2
• /
• pp.234-257
• /
• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of Korean Public Health Nursing
• /
• v.32 no.1
• /
• pp.109-121
• /
• 2018

Purpose: This study was conducted to identify the barriers and improvements to promoting physical activity among children using community child care centers. Methods: A qualitative research using focus group interviews was employed. Three focus group interviews were conducted with a total of 18 service providers, and open-ended questions were used. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. Results: Two main themes in the barriers to promoting physical activity were 'lack of resources' and 'limitations of program composition'. In addition, five sub-themes emerged as a result of analysis: 1) lack of human resources, 2) lack of finance, 3) lack of space, 4) one-off and short-term physical activity programs, 5) learning-oriented programs. Conclusion: The results indicate that it is necessary to have adequate human resources and a realistic government subsidy that allow community child care centers to provide sufficient services to children. In addition, promoting physical activity can be achieved through physical activity programs focused on peer group advisors, habituation, and development of programs suited to the needs of children and their environment.

• Journal of Korean society of Dental Hygiene
• /
• v.9 no.4
• /
• pp.606-619
• /
• 2009

Objectives : This study was to examine the state of customized visiting oral health programs in a bid to help facilitate the unified operation of the programs and the development of required guidelines. Methods : The subjects in this study were 49 dental hygienists who were professionals responsible for customized visiting health care programs across the nation. Results : 1. Regarding the form of employment of the dental hygienists were investigated many contract and daily workers. 2. As to the possession of equipment necessary for visiting oral health programs, denture cleaners(12.2%) were most widely possessed in some regions, followed by mobile scalers(10.2%) and mobile suctions(8.2%). In terms of expendable devices and materials, dental mirrors, pincettes and explorers were the most widely possessed dental checkup devices, and the most widely possessed oral hygiene supplies were toothbrushes, interdental brushes and denture cleaners. Those devices and materials were in more possession than the other types of devices and materials. The most widely possessed equipment for educational purpose was laptop computers, followed by beam projectors and screens. The most widely possessed teaching materials were dentiform, followed by CD-ROMs. 3. Those whom they visited the most for oral health care service were elderly people, followed by the disabled and patients with chronic diseases. The dental hygienists who went out to visit those people outnumbered the others who stayed at public health centers. Concerning the types of visiting oral health care service, the most prevalent service provided to the elderly included denture cleaning/management, oral massage and preventive treatment against dental caries. The most dominant service provided to the disabled involved education of the oral health care act, preventive treatment against dental caries and toothbrushing by professionals. The most common service offered to patients with chronic diseases was education of the oral health care act and oral health education. The dental hygienists paid a visit to a mean of 5.8 households a day. The average weekly number of households cared by the dental hygienists was 27.3. It took a mean of 37.1 minutes for them to take care of each household. 4. As for satisfaction level with the implementation of the visiting oral health programs, they expressed the greatest satisfaction at teamwork with professionals($3.56{\pm}0.94$), followed by the professionalism of their work($3.21{\pm}0.94$) and workload($3.08{\pm}0.94$). Their satisfaction level with the work conditions required for creative job performance($2.75{\pm}0.98$) and partnership with other institutions($2.64{\pm}1.03$) was below 3.0. In regard to the impact of their characteristics, marital status made a statistically significant difference to satisfaction level with workload. The unmarried dental hygienists were more pleased with their workload than the married ones(p<0.05). 5. As to needs for education for professionalism improvement, they asked for education about visiting oral health care skills the most, followed by education about oral health care for patients with chronic diseases, education of planning/evaluation and education of oral health care for the disabled. Conclusions : The top priority for the vitalization of the programs was the procurement of budget, followed by the procurement of equipment and educational media and the procurement of human resources.

• Journal of Nutrition and Health
• /
• v.39 no.7
• /
• pp.617-623
• /
• 2006

The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.