• Title/Summary/Keyword: Day care service

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The effects of symptoms of dementia elderly on the primary caregiver's depression : moderating effects of family support (치매환자의 증상정도가 주부양자의 우울에 미치는 영향 : 가족지지의 보호효과를 중심으로)

  • Park, Sun Won;Kwak, Ju Yeon
    • Journal of Family Relations
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    • v.21 no.3
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    • pp.3-23
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    • 2016
  • Objectives: The purpose of this study is to examine the effects of symptoms of dementia elderly on the primary caregiver's depression. In addition, moderating effect of family support was examined. Based on the results, the necessity for intervention in the level of social welfare as a way to mitigate primary caregiver's depression was suggested. Method: In order to accomplish these purposes, a total of 197 who are spouse and adult-children of dementia elderly using day care facilities or services in Seoul, Gyeonggi, Busan province, South Korea were utilized. Data were analyzed by frequency analysis and descriptive statistics, regression model analysis with SPSS 18.0. Results: In case of analysis results, the mean value was reported 0.9 out of four point about primary caregiver's depression and the mean value of family support was reported 3.34 out of five point. And besides, the analysis result of dementia elderly's symptoms showed that prevalence of depression/dysphoria were 62.2%, prevalence of aberrant motor were 61.3%, prevalence of apathy/indifference were 56.6%. Crucial findings are as follows: the symptoms of dementia elderly was significantly associated with the primary caregiver's depression. At the same time, family support significantly influenced lower level of the primary caregiver's depression. While, in the relationship between the symptoms of dementia elderly and the primary caregiver's depression, family support has a moderation effect by important protection factor. Conclusions: From these findings, the necessities to provide the care service for dementia elderly to help improve symptoms of dementia as well as the policy and service to manage the mental health of the family as primary caregiver were suggested. Also, the necessities to provide the family therapy program to improve the relationship with family members were suggested.

Increasing Work Efficiency with Prevention of Reinspection for Bone Mineral Density (BMD) Exams (골밀도 검사의 재검사 방지에 따른 업무효율 향상)

  • Kim, Ho-Sung;Dong, Kyung-Rae
    • The Journal of the Korea Contents Association
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    • v.9 no.5
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    • pp.174-181
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    • 2009
  • Recently hospitals are implementing a One Stop Service as part of patient-care service. With the One Stop Service, medical treatment including consultation, inspection, and results are changing to be made available in one visit. Therefore most examinations are reserved for the same day; however, there are cases in which additional visits are necessary because of certain properties related to exams. This study compares and analyzes the number of reinspections before and after reforms. By designating the order of priority for BMD examinations and implementing education from information obtained in the OCS E-manual update, the number of reinspections for wards was reduced from 58 to 21, Outpatient departments were reduced from 51 to 12, and errors in reservations made by employees in the department of radiology were reduced from 98 to 11. Reinspections can be reduced with full understanding the factors related to reinspection and a background check prior to inspection in order to determine the order of priority for inspections. This will also reduce workers' stress and increase their efficiency and at the same time decease patient dissatisfaction and improve hospital reliability.

Status of Oral Health in Relation to the Acknowledgement of Oral Health Trouble and Oral Health Habits in Recipients of Dental Screening in Hospital (병원 내 치과검진 수혜자의 구강건강인식 및 습관에 따른 구강건강상태)

  • Lee, Eun-Sook;Kim, Kyung-Min;Kim, Hey-Jin
    • The Korean Journal of Health Service Management
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    • v.10 no.2
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    • pp.121-131
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    • 2016
  • Objectives : The purpose of this study was to analyze the status of oral health in relation to the acknowledgement of oral health trouble and oral health habits. Methods : This study was conducted after IRB was received, on 273 patients who had received health screenings between October-1, 2014 and January-31, 2015 at a general hospital in Busan. Results : Regarding the status of oral health in relation to the acknowledgement of oral health trouble, the rates of dental caries and periodontal disease were higher when the patients knew the reasons for trouble about the oral hygiene. With regard to oral health habits, our results showed that the more frequently the patients ate sugary snacks per day, the probability of experiencing periodontal disease was higher than for the patients who did not eat sugary snacks. Our results also, showed that the occurrence of dental caries is very much dependent upon whether a patient had experienced education on toothbrushing. Conclusions : Patients need to become more aware of their oral health through education. A program that emphasizes the importance of preventive oral health behaviors and the maintenance of correct oral health behavior should be developed.

Management Strategies for Medical Expenses Depending on Type of Diseases for Patients of Seafarers Insurance - Focused on Busan - (선원보험 수진자의 상병유형에 따른 진료비 관리방안 - 부산지역을 중심으로 -)

  • Park, Eun-Ha;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.10 no.4
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    • pp.1-11
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    • 2016
  • Objectives : The aim of this study is to investigate the actual condition of the occurrence and recovery of medical expenses through seafarers insurance and to provide basic data that will be helpful in the establishment of efficient hospital management strategies for medical expenses of insurance companies depending on the type of seafarers insurance. Methods : Three general hospitals located in Busan, Korea, were selected, and seafarers insurance claim data was collected from January 1, 2012 to December 31, 2013(24 months) and analyzed. There were 5,490 cases in total. Results : There was a significant difference in the distribution of disease incidence, accrued medical expenses, reimbursement of medical expenses, and the actual condition of medical receivables depending on the insurance company. Conclusions : Therefore, differentiated payback strategies for medical expenses are needed that consider the various seafarers insurance companies and their treatment characteristics.

Pre-service Teachers' Observational Experience From Post-modernsist Perspective (포스트 모더니즘적 관점에서 살펴본 예비교사의 관찰 실습경험)

  • Ahn, Hyo-Jin
    • Korean Journal of Human Ecology
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    • v.21 no.2
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    • pp.197-211
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    • 2012
  • This purpose of this study was to explore the meaning and significance of experiences encountered by preservice teachers' during their observational practicum at day care centers. This study involved one cohort of 32 junior students who were majoring in early childhood education at a 4-year university. Data was analyzed using qualitative research methodology. The findings were as follows: 1) the meaning and significance of students'experiences related to observing children was to develop a trusting relationship with children and a cooperative relationship with teachers in an unfamiliar context. 2) the meaning and significance of students'experiences in observing children was to understand the children and their circumstance. 3) the meaning and significance of students'experience in observing children was to understand the importance of listening in child-teacher spoken interaction.

Development of a Critical Pathway for Patients with Coronary Artery Bypass Graft (관상동맥 우회술 환자를 위한 Critical Pathway개발)

  • 김기연
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.117-131
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    • 1998
  • The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

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A Study of Family Caregiver's Burden for the Terminally III Patients (지역사회 말기질환자 가족 부담감에 관한 연구)

  • Han, Sung-Suk;Ro, You-Ja;Yang, Soo;Yoo, Yang-Sook;Kim, Sek-Il;Hwang, Hee-Hyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.10 no.1
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    • pp.58-72
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    • 2003
  • The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

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Review of Communal Housing for the Elderly in the UK (영국의 노인공동생활주택에 대한 검토)

  • 홍형옥
    • Journal of Families and Better Life
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    • v.19 no.4
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    • pp.49-68
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    • 2001
  • The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.

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A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea (일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究))

  • Kim, Yong-Ik;Yun, Dork-Ro;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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A Study on the Clinical Statistics of Oriental Medicine Service in the Health Center (보건소내(保健所內) 한방의료(漢方醫療)에 대(對)한 임상통계연구(臨床統計硏究) (전주시(全州市) 완산구(完山區) 보건소(保健所) 중심으로))

  • Song, Beom-Yong;Yuk, Tae-Han
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.40-57
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    • 1997
  • The Background and Purpose It is done the study on the public health care of oriental medicine and improvement of its system recently, I think that these effect a good health care for a people through the public health care of oriental medicine. Since Woosuk university and Chonju-Wansan health center had taken upon the oriental medicine service in the health center in 1995, we have public favor from the local population. So in other to a study on the clinical statistics of oriental medicine service in the health center, I investigated general character, style of diseases, effect of treatments and the like for a paitents received oriental medicine treatments in there. Objective and Methods This study researched into clinical statistics for paitents received oriental medicine treatments in the Chonju-Wansan health center during one year period from January 4 1996 to December 26 1996. The number of object was 238 case of 234 persons. Results and Conclusions Analyzing these 234 persons, the proportion of males to females was 1 to 6.8. As for the distribution of age, the ages of 61 to 70 occupied 34.62 per cent in the ages of 51 to 90 occupied 88.89 per cent in the whole paitons. Therefor female was very highly more than male and paitents were for the most part, old ages(51years old and over). Musculoskeletal system and connective tissue disease of 238 case occupied 82.77 per cent. were the greatest proportion. At the duration of disease, 1 year to 5 years occupied 32.35 per cent, was the highest The grade Ⅲ was the most of the sign of paitents at first visit, it occupied 55.88 per cent. The good(++) and over effect of treatments occupied 62.18 per cent, the fair(+) and over effect of treatments occupied 78.99 per cent. As for the duration of treatment, the case of 2 times to 5 times visit occupied 34.03 per cent, was the highest. And the case of 2 times to 10 times visit was 4 times as good effect as the case of only one visit. By medication of treatment, O-Juk-San(五積散) occupied 32.21 per cent, was the greatest proportion, and Pal-Mj-Hoan(八味丸) occupied the second greatest proportion. Therefor the most of paitents had the chronic diseases and was diagnosed Sin-Yang-He(腎陽虛). The average 22.58 persons received acupuctural treatment a day, the average 0.58 persons received the moxibustion a day, the average 2.28 persons received venesection (bloodletting) a day. And others treatment performed physical therapy and the like. The case received treatment of the oriental and western medicine at the same time. marked 21 persons among 30 persons and had a good effect by 70 per cent. The average 26.95 persons received treatment of oriental medicine a day, the average 3.9 persons received the first medical examination a day.

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