• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Journal of Korean Academy of Nursing
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• v.37 no.2
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• pp.201-207
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• 2007

Purpose. The purpose of this study was to determine the subjects' health status according to the needs of visiting health and the function of the family in home care nursing. Sample and Method. The data collection period was from 07/01/04 to 10/31/04 and the subjects were 488 of those above 60 years of age staying at home or living alone who registered at a visiting health service of public health center at an urban area in Korea. This survey was carried out by visiting health nurses and participation was agreed on by the elderly people. Results. The extent of the subjects' total health status to the general characteristics had differences according to the age, sex, monthly income, perceived health status, known functional disorder, and yes-or-no for disease. At all health status domains, visiting health need care in the group I was very lower than one in II, III, or IV groups. Also the severe dysfunctional family was lower than lightly dysfunctional family and normal functional family in all health status domains. Conclusion. Nurses must provide their characteristics considered nursing intervention for the elderly who have high visiting health needs and severe dysfunctional family with vulnerable health care.

• The Journal of Korean Society for School & Community Health Education
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• v.20 no.2
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• pp.53-67
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• 2019

Objectives: The purpose of this study is to obtain the basic data for the development of maternal health care by analyzing the status and needs of service target persons in Timor-Leste. Methods: The subjects were selected through the non-probability sampling method applying the FGI. Researchers interviewed 3 maternal health service managers, 6 midwives at Gleno and Railaco Health Centers and 2 women between 15 and 45 years of age. Results: In the results of on-site visit of the delivery facility and the FGI, we found poor sanitation in delivery room, lack of medical equipment related to antenatal consultation and delivery. In the case of the health center manager, the public health center provides various maternity health services, but the lack of the staff has difficulty in providing the service and managing the subjects. Midwives asked for regular maintenance education. Women in child bearing age living in mountainous areas had poor access to delivery facilities and lack of awareness of delivery services. Conclusions: It is necessary to increase the maternity management rate through regular maternity and maternal health check service and application to maternal management database, to improve the sanitation of the maternity clinic in the public health center, to strengthen the midwife competency program.

• Journal of Genetic Medicine
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• v.2 no.1
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• pp.11-15
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• 1998

This paper reports 3 cases with 46,XX sex reversed male. Three 46,XX hypogonadal subjects showed complete sex reversal and had normal phallus and azoospermia. We studied them under clinical, cytogenetic and molecular aspects to find out the origin of the sex reversal. Patients had markedly elevated serum follicle-stimulating hormone (FSH) and lutenizing hormone (LH) and decreased or normal range of serum testosterone. The testicular volumes were small (3-8ml). Testicular biopsy showed Leydig cell hyperplasia and atrophy of seminiferous tubules. We obtained the results of normal 46,XX, and the presence of Y chromosome mosaicism was ruled out through XY dual fluorescent in situ hybridization (FISH). By using polymerase chain reaction (PCR), we amplified short arm (SRY, PABY, ZFY and DYS14), centromere (DYZ3), and heterochromatin (DYZ1) region of the Y chromosome. PCR amplification of DNA from these patients showed the presence of the sex-determining region of the Y chromosome (SRY) but didn't show the centromere and heterochromatin region sequence. The SRY gene was detected in all the three patients. Amplification patterns of the other regions were different in these patients; one had four amplified loci (PABY+, SRY+, ZFY+, DYS14+), another had two loci (SRY+, ZFY+) and the other had two loci (PABY+, SRY+). We have found that each patient's translocation elements had different breakpoints at upstream and downstream of the SRY gene region. We conclude that the testicular development in 46,XX male patients were due to insertion or translocation of SRY gene into X chromosome or autosomes.

• Journal of agricultural medicine and community health
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• v.32 no.1
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• pp.27-39
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• 2007

Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.679-688
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• 2002

Purpose: The purpose of this study was to examine the relationships among self-care, self-care agency, self-efficacy, and quality of life in type II diabetic patients registered at a public health center. Method: The study subjects were 128 type II diabetic patients who were living in G city. The data were collected from March 2001 to February 2002. The instruments used for this study were the self-care scale developed by Jeung(1997) and designed by Park (1984) based on the original scale, the self-care agency scale developed by So (1992), the self-efficacy scale developed by a Jeung (1997) and designed by Paek (1996) based on the original scale, and the quality of life scale developed by Ro (1988). The data were analyzed using descriptive statistics, pearson correlation coefficient, and stepwise multiple regression. Results: 1. The relationships among self-care, self-care agency, self-efficacy, and quality of life were significant. Self-care was significantly related to self-care agency (r=.609. p<.01), self-efficacy (r=.763. p<.01), and quality of life (r=.493. p<.01). 2. The stepwise multiple regression analysis was performed to identify factors influencing quality of life of the subjects. The most powerful predictor was self-care agency (48.4%). The combination of self-care, complication status, age, education level, and self-efficacy accounted for 88.7% of the variance of quality of life in type II diabetic patients. Conclusion: The results suggest that self-care, self-care agency, self-efficacy, and quality of life are important variables for development of nursing intervention programs for patients with diabetes.

• Journal of agricultural medicine and community health
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• v.43 no.2
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• pp.74-84
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• 2018

Objectives: The purpose of this study is to compare the perceptions of the rural healthcare service improvement project' performance and reorganization of public health centers between project staffs and local residents. Methods: Data collection from this study was performed in 141 project areas using structured questionnaires. Data analysis was used in SPSS 22.0 version. Results: The public health center staffs were more positive about the items for improving health facilities than the local residents. Residents in the Si area generally perceived performance as more positive than residents in the Gun area, while public health center staffs in the Gun area perceived performance as more positive than public health center staffs in the Si area. Local residents expressed negative opinions about the reduction in the number of branches of public health clinics and health medical clinics. Conclusions: In conclusion, careful improvement projects for rural health care and the establishment of health care systems will be necessary, reflecting the opinions of local residents, along with a variety of regional characteristics.

• Journal of Korean Public Health Nursing
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• v.21 no.2
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• pp.134-145
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• 2007

Purpose: To test the effects of health education on the blood pressure, knowledge, and self-care of visiting nursing clients. Methods: The study subjects were 96 participants who had been diagnosed with hypertension or had high risk factors for hypertension among those registered at a public health center in Seoul. The education program was individualized and delivered to enhance the management of hypertension including life-style modification, medication, and complication managements. Data were collected using questionnaires from May to December 2006 and analyzed using descriptive analysis, t-test, paired t-test, and ANOVA. Results: The blood pressure of the participants after the education was significantly decreased compared to before the education. Education also significantly affected the increases of knowledge of the disease and self-care capability. However, the blood pressure and self care were not significantly improved for the age group over 85 years. Conclusions: This study proves that the individualized health education for visiting nursing clients was effective in improving blood pressure, knowledge, and self-care of hypertension. However, it is necessary to develop strategies that are specifically targeted at particular age groups in order to improve the capability of self-care of hypertension.

• Safety and Health at Work
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• v.9 no.4
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• pp.408-415
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• 2018

Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set. The association between employee satisfaction and resident satisfaction was examined with multiple and multilevel linear regression. Associations between employee satisfaction and the rates of pressure ulcers, weight loss, and falls were examined with simple and multilevel Poisson regression. Results: A 1-point increase in overall employee satisfaction was associated with an increase of 17.4 points (scale 0-100) in the satisfaction of residents and family members (p < 0.0001) and a 19% decrease in the incidence of resident falls, weight loss, and pressure ulcers combined (p < 0.0001), after adjusting for staffing ratio and percentage of resident-days paid by Medicaid. Conclusion: Job satisfaction of nursing home employees is associated with lower rates of resident injuries and higher resident satisfaction with care. A supportive work environment may help increase quality of care in the nation's nursing homes.

• Perspectives in Nursing Science
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• v.8 no.2
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• pp.121-128
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• 2011

Sensitive issues are both common and problematic for health care providers because sensitive issues may interfere with the future provider-client relationship and effective care. Most current training for providers focuses on a particular issue, but this is inadequate because many issues may be sensitive, and which issues will be sensitive is unpredictable. We argue that issues become sensitive when they activate one or more of three common triggers, fear, stigma, and taboo. A cycle of negative internal and interpersonal responses to the sensitive issue often leads to unresolved health issues for clients and stress and feelings of inadequacy for providers. We recommend integrated pre-service and in-service skill building to help individual health care providers respond appropriately to a wide variety of sensitive issues. We also identify specific policies and procedures to strengthen organizational support for caregivers so that providers can address these sensitive issues effectively with their clients.