• Title/Summary/Keyword: Managed care

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An Analysis of the Relationship between Climacteric Symptoms and Management of Menopause in Middle-aged Women (일 지역 중년여성의 폐경증상과 폐경관리와의 관계에 대한 연구)

  • Song, Ae-Ri
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.308-322
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    • 2001
  • The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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Development of a Human Biomonitoring Empirical Model for Health Promotion Value Evaluation of Organic Foods (유기농식품의 건강증진가치 평가를 위한 Human Biomonitoring 실증모형 개발)

  • Choi, Deog-Cheon
    • Korean Journal of Organic Agriculture
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    • v.21 no.4
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    • pp.569-588
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    • 2013
  • The organic foods is the terminology calling the organic products, the organic livestock and the organic processing food. The value of organic food may be evaluated as the index of the nutrient content, the safety and the health promotion. The reason why consumers prefer the organic food in the market is because the value of health promotion to be obtained through its consumption is expected to be bigger than the expense according to the purchase of organic food. This study has the significance in developing the direct evaluation model like the human biomonitoring method. The hypothesis for this study is summarized, "If the metabolome of metabolic syndrome of decreases, the exposure of substance of health harm decreases, the number of hospital care decreases and the quality of life shall be improved if the organic food is incepted in the long term and the health care is managed well". The consumer's cooperative and the health consumer's cooperative select the experimental group of 100 persons and the comparative group of 100 persons in 5 areas in the whole country at the same time to verify this hypothesis. Its rate of change is compared and analyzed by measuring the blood and urine of each biomarkers such as the exposed agriculture pesticides, the nitrate in the body at intervals of 2 months for 1 year. Also, by letting participants in the experiment record the major activity such as the dietary intake and the exercise, etc., in the questionnaire and the performance evaluation form, the statistical analysis for the correlation of this with the metabolome, etc., is conducted. The time that is called minimum 1 year and a lot of expense are required to implement this model. Accordingly, the cooperative study by composing the consortium of the interdisciplinary and the interagency is desirable.

The relationship among the experiences of chronic diseases, dental health status, and the behaviors in the Korean elderly people (우리나라 노인의 만성질환경험과 구강건강상태 및 행태와의 관련성)

  • Han, Yeo-Jung;Hong, Sun-Hwa;Yu, Mi-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.1
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    • pp.65-75
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    • 2018
  • Objectives: This study aims to contribute to the prevention of dental diseases and health care in the elderly by investigating the relationship among the experiences of chronic diseases, dental health status, and the behaviors in the Korean elderly people. Methods: A total of 2,856 elderly people aged 65 or older were selected as the final analysis subjects using data from the 6th National Health and Nutrition Examination Survey (2013-2014). Chronic diseases were defined as 'cardiocerebrovascular diseases', 'diabetes', 'chronic respiratory diseases', and 'cancer' diagnosed by the doctors. For the statistical analysis, SPSS 21.0 for Windows was used. Descriptive analysis and a Chi-square test were conducted to investigate the relationship among the experiences of chronic diseases, general characteristics, dental health status, and the behaviors in the Korean elderly. Finally, logistic regression analysis was performed to investigate the relationship among the experiences of chronic diseases, dental health status, and the behaviors. Results:The prevalence of Cardiocerebrovascular diseases was significantly higher in the 3-4 group of community periodontal index with the score of 1.36 (95% CI 1.03-1.00) than in the 0-2 group. The prevalence of Cardiocerebrovascular diseases was significantly higher in the group without dental examination during the past one year with the score of 1.29 (95% CI 1.00-1.66). The prevalence of diabetes was significantly higher in the uncomfortable speaking state group with the score 1.46 (95% CI 1.12-1.91). The prevalence of cancer was significantly higher in the partial denture needs group with the score 1.67 (95% CI 0.98-2.83). Conclusions: Regular dental examinations and dental health care for the elderly with chronic diseases showed that periodontal health and residual teeth could be maintained and managed. Therefore, continuous customized dental health services should be implemented for the elderly with chronic diseases.

Demographic Characteristics and Health Problems of Low Income Children in Underserved Area (취약지역 빈곤아동의 인구.보건학적 특성 분석)

  • Kim, Hye-Kyeong;Lee, Yun-Hee;Moon, Sun-Young;Kwon, Eun-Joo
    • Korean Journal of Health Education and Promotion
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    • v.24 no.4
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    • pp.65-85
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    • 2007
  • Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.

A Community-Based Integrated Preventive Program of Depression and Its Effectiveness in Caring for Vulnerable Elderly (취약계층 노인의 우울예방을 위한 지역사회기반의 통합프로그램 개발 및 효과검증)

  • Ahn, Yang-Heui
    • Research in Community and Public Health Nursing
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    • v.14 no.2
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    • pp.287-298
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    • 2003
  • The purpose of the study was to develop an integrated prevention program to strengthen elders self-care capability and to examine its effectiveness on their psychological condition. This study used one group pre- and post-test design. Subjects were 85 elderly residents (over 65 years of age) who lived alone, and received free basic medical care and social welfare services in a rural community in Korea. Subject eligibility criteria for this study were to an elders who 1) is not currently taking any anti-depressant medication 2) is able to communicate, and 3) agrees to participate in this study. The integrated program was composed of horticulture, reminiscence, and friendship activities. Twelve sessions were provided for 12 weeks in community-based partnerships to achieve better outcomes. The intervention was case-managed by a public health nurse and aided by six volunteers. The main outcome variable was depression, which was assessed by using 15 items selected from the Geriatric Depression Scale-short form Korean version. Socio-demographic characteristics, functional status, and satisfaction with social support were used as covariates. Results showed that there was a significant intervention effect at post-intervention time point compared to pre-intervention time point(E.S. 0.94). Multiple linear regression analysis showed significant interaction effects between intervention and satisfaction with social support. These findings must be interpreted within the context that an effects of an integrated program could be more synergistically increased when social support factor is considered in the program. A community-based integrated prevention program of depression is effective for vulnerable rural elderly. It is suggested that randomized controlled trials within community setting for better methodological strength as well as multi-level outcomes on community need to be conducted in future.

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A Strategic Study on National Disaster Medical System (국가재난의료체계에 대한 정책적 고찰)

  • Baek, Hong-Sok
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.235-246
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    • 2003
  • Due to major disasters Korea has been damaged, and they caused lots of casualties: for last ten years natural disasters caused 1288 deaths including missing people; human disasters including industrial disasters brought as many as 4,512.148 casual ties (126,372 deaths with 4,385,400 injuries); and they cost 44.1 trillion property damage. However, even though major disasters have brought about tremendous human loss and property damage, Koreas National Disaster Medical System to rescue casualties is insufficient, and it has not been activated. Fortunately, through major disaster management process, the National Disaster Management System has been developed, increasing its own efficiency, and resulting in to organize an Office of Firefighting and Prevention of Disasters under the central government. Considering the value of human lives, the disaster medical part, in the U.S.A. as well as in Korea, must have an independent organization in the government, not as one sector of the government department. It will have its own organizational structure, such as disaster planning, operation, and logistics, and interact with central and local government or between local government agencies. So each agency will cooperate and supply resources interchangeably. Also, with the system of disaster management and restoration, the disaster medical system must be advanced in keeping step. Its role must be extended due to the possibility of biological terror or SARS around the world, resulting in severe casualties. Korea has the Emergency Medical Service System based on the regulation of emergency medical care, yet it is a part of the National Disaster Management System. It must be managed independently apart from it. As we see the emergency medical technicians playing as the backbone in disaster medical care in the US, we should have legal foundations for Koreas emergency medical technicians, emergency medical providers, to participate in rescue operation actively. At the same time, we need to have a national register system to classify disaster medical resources, and a total plan to place resources according to the impact of disaster, and how to organize teams. We also need to draw up a scheme to activate civil disaster medical resources, as integrating public and private or voluntary organizations.

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Case Study on Job Flow Improvement of Foodservice at a University Hospital (대학병원 급식업무 개선 사례 연구)

  • Kim, Hyung Mi;Yang, Il Sun;Park, Eun Cheol;Lim, Hyun Sook
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.244-261
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    • 2000
  • Background : In order to cope with changes in the management environment at hospitals, increased interests are drawn in patient foodservice system on Continuous Quality Improvement Activity as the method of approaching a quality food service and effective management. Thus, as a part of this activity, this study was conducted to evaluate job flow improvement that was already performed and the results of that process at the dietetic department of a university hospital, focusing on improving management. Method : On February 15 of 1998. the dietetic department formed a job flow-improvement to decide on the priority of job flow improvement, and prepared specific action strategies and schedule of the priority: after a 5 month process period, job improvement achieved on June 15. 1998. Also, economic achievement of the task was evaluated through labor productivity analysis and cost-benefit analysis. Results : The patient food service system which was managed decentralized at the present hospital was centralized, some steps of the food service process were integrated, and quality of patient food was improved. Also, as a solution of the problems expected when conducting job flow improvement was made on food service equipments and utensils. The result of evaluating the job flow improvement that labor productivity improved by 18.2% compared to before the improvement and the result of the analysis of cost-benefit showed that Benefit-Cost (B/C) ratio was 2.22. showing financial merit on the investment. Conclusions : Continuous Quality Improvement Activity needs to be initiated and conducted in the future in various areas of hospital foodservice system in order to actively adopt to ever changing hospital management environment. In order to achieve this goal, many researches and more efforts need to be put in by people in charge of hospital food service management, and interests and support are needed from hospital policy makers.

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Evaluation of Thyroid Cancer Medical Information Sites using HONCODE (HONCODE를 근거로 한 갑상선암에 대한 의료정보 제공사이트의 질 평가)

  • Heo, Jun;Jung, Yong Gyu;Sihn, Sung Chul;Kim, Jang Il
    • Journal of Service Research and Studies
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    • v.3 no.2
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    • pp.45-52
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    • 2013
  • With the development of information and communication technology, the Internet is more important in the social and economic influence rapidly, and it is no different in the field of health care. As health information on the Internet increasing, the availabilities of health information from the Internet becomes more important with health care professionals and information specialists. the quality of health information on the Internet are continually being presented without any guarantee or judge on the quality. It is needed to provide the right to use of qualified health information through Internet. HONCODE has been established and managed by HON (Health On the Net) Foundation. In this paper, Web sites of thyroid cancer Information are evaluated using HONCODE. They provide domestic medical information on the Internet. Through this, more accuracy and evaluated information could be provided on the Internet about the thyroid cancer.

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A Study on the Effects of Smoking Habit to Health Status in Some Male Employees (일부 남성 직장인에서 관찰된 흡연행태가 건강상태에 미치는 성향연구)

  • 한영미;이시백
    • Korean Journal of Health Education and Promotion
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    • v.7 no.1
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    • pp.54-63
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    • 1990
  • This study aims to find out the prevalence of smoking, and to analyze the effect of smoking for health status, and then to emphasize the necessity of stop smoking. The data used in this study are obtained from periodic health care programe at Health Care Center in a suburban hospital, and selected 435 males who have occupation. The independent varibles chosen for the analysis are general charactersitic variables and smoking habit. The dependent variables are designed to cover the health status of individual cases, and include blood pressure, blood cholesterol level with HDL-cholesterol and blood triglyceride level, recent symptoms and recently being managed diseases. The result of this study are summarized as follows. 1) Percentage of smoker by the age groups is highest in 4th decade, being 71.1%. The second and third ranks are 6th and 7th decades, being 53.5% and 44.4%, respectively. 2) In the view of socio-economic levels, smoking rate is higher in the groups who live at rural area and whoes occupation is labor or merchant. Smoking rate is significantly higher in the heavy drinking group. 3) Among the atherosclerotic risk factors, which include hypertension, HDL-cholesterol by total cholesterol ratio lower than 0.2 and triglyceride level higher than 200gm/dl, hypertension was not statistically associated with smoking, but others revealed statistically high association with smoking. 4) The groups who have the symptoms of severe fatigue, gastrointestinal symptoms, pulmonary symptoms, palpitation and chest tightness havepositive association with smoking. 5) The groups who have hypertension with cardiovascular diseases and gastrointestinal diseases showed highly significant association with non-smoking. 6) In relation of the smoking habit to the atherosclerotic risk factor index, smokers have more atherosclerotic risk factors, but that is not statistically significant. 7) In relation of the smoking habit to the recent symptom index, smokers have more symptoms than non-smokers with statistical significance. In conclusion, smokers have worse health status than non-smokers especially in the atherosclerotic risk factors such as hypertension or abnormal blood lipid status and have more symptoms such as severe fatigue, gastrointestinal symptoms, pulmonary symptoms, palpitation and chest tightness. And the campaingn against smoking should direct for the male in 4th decade because they have highest smoking rate.

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