• Research in Community and Public Health Nursing
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• v.16 no.3
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• pp.320-328
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• 2005

Purpose: This study is to identify the types of role awareness of home health care specialists working at medical institutions, to understand their role awareness correctly by grasping the quality of each type, and to provide useful help in the education of home health care specialists. Method: Q-methodology is used to objectify role awareness of medical institution specialists who may recognize situations differently according to their individual experience and comprehension based on the view of behavior. Q-classification was carried out on 30 home health care specialists working at medical institutions using 30 selected questions. Collected data were examined through factor analysis using QUANL PC program. Results: Three different types of role awareness of home health care specialists working at medical institutions were identified. Type I is 'educational-function-centered', Type II 'patient-centered' and Type III 'professional-service-centered'. Conclusion: Regardless of these types, home health care specialists commonly had a high pride as a specialist and a sense of mission regarding themselves as important persons responsible for patients' health.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.13 no.1
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• pp.33-45
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• 2006

Purpose : The purpose of this study is to present the desirable level of home health care services by identifying the roles and activities by task of home health nursing specialists as well as to raise the level of professionalism in home health care services. Method : This is a methodological study. The roles and activities by task were identified through a review of literature and a state-of-the-practice survey, and were structured into a questionnaire after being reviewed and modified through a consensus of experts. The field survey was conducted on 136 home health nursing specialists at medical institutions, public health centers. public medical institutions, non-governmental organizations, and religious institutions in Seoul, Gyeonggi Province. Incheon, Busan, Daegu, and Gwanggju from June 4 to August 4. 2004. Seven roles. 34 tasks and 130 activities were identified in association with home health nursing specialists. Result : The roles of home health nursing specialists were identified as professional nursing service provider, advisor, educator, administrator, case manager, researcher and leader. Under these roles. 34 tasks and 134 task-specific activities were identified. Conclusion : The the roles and activities of home health nursing specialist identified in this study can be used in various home health care settings. These the roles and activities should provide the evaluation criteria of home health care services for institutions with existing home health care programs. An evaluation tool should be developed in order to ensure the hish quality of home health care services.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.81-93
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• 2000

The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.277-293
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• 1997

This study was conducted to provide basic materials required to enforce and develop welfare policies, as well as the health system, for the aged, by surveying the status of health care utilized by the daily increasing old population and the importance of receiving physical therapy. Data that need in this research was gathered from over ages of 65, during the period from Jan 4, 1996 to Jan 31, using the inquiries previously made by geriatric researchers and through literatures investigator by this writer. The data were analyzed by $X^2$, Z-test, Likert scale. The findings were as follows : 1) General characteristics of subjects. People in the age group between 65 and 69 were 55.6% and the highest number, while male were 37% and female 63%. Analysis of income group disclosed 60.6% whose monthly income, including the pocket money given by children, was less than 200,000 won. 91.1% of the elderly people surveyed owned houses; only 36.4% live with spouses; while 15.6% live alone. 2) Characteristics with respect to utilization of health care institution. 56% of the total medical institutions used by the elderly people were clinics and the rates of chronic disease and musculoskeletal disease were 73.2%. 3) Characteristics with respect to approach of health care institution. 45.1% of the respondent stated it took 20 minutes to arrive at hospital, and bus accounted for 48.6% of all transportation means used to go to hospital. 4) Degree of cognition with respect to the rights of geriatric patients. (1) There is no financial support from the government for geriatric patients(71.4%). (2) Government financial support is needed for geriatric patients(95.3%). (3) Have never been regionally surveyed or called upon for interviews with respect to treatment desire and problems relating to geriatric patients(87.2%). (4) Health and medical policies for geriatric patients must be established rapidly(98.4). (5) Expansion and construction of specialized medical facilities for geriatric patients such as elderly hospital and medical center are needed(90.2%). (6) Government's welfare policies for the elderly people is insufficient(82.0%) 5) Degree of cognition on importance of physical therapy with respect to geriatric patient. (1) Physical therapy is considered most effective in treating geriatric patients(82.9%). (2) Physical therapists specializing in only elderly people must be need of separately(76.2%). (3) It is desirable for medical specialists to visit geriatric patients at home to provide physical therapy(82.9%). (4) Hospitals specializing in physical therapy for geriatric patient are required(85.6%). Based on the result for this research, the following suggestions are presented to facilitate the utilization of health care institution for the welfare of geriatric patients. Medical facilities such as elderly hospital and geriatric patient's medical center specializing in elderly people must be constructed as early as possible; and home-visiting physical therapist system must be important to treat chronic geriatric patients; our government must establish policies to provide the old ages with means for the health care and curing chronic diseases, and carry out the plans of reasonable distribution and effective untilization of medical resources.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.26-37
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• 2022

Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000-2006); (2) quality evaluation introduction stage (2008-2014); and (3) quality evaluation maturity stage (2016-2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion: It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Journal of Families and Better Life
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• v.27 no.1
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• pp.61-71
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• 2009

The purpose of this study was to resolve the issues of inferior housing environment and the population decrease in rural community by improving the environment and attracting urban inhabitants. A simulation on the costs and the local programs was operated from a point of view that Pension Insurance House with Long-term Lease and a plan for the program in connection with local resources should be accompanied to attract urban inhabitants. The study was carried out through mainly documents analysis and specialists' opinions. The simulation results are as follows. Firstly, the pre-existing rural housing development projects have only emphasized the hardware, while underestimated the post-management with operating programs. The software should be underlined when Pension Insurance House is developed. Secondly, as a result of the simulation on construction expenditure and the operating and maintenance cost for 30 years, about 82.3 million Wons are necessary residential expenses for 15 years per unit. Thirdly, in case of MUJU County, it has made the most of its pre-existing institutions. It's medical institutions provide medical care system with health education, facilities related leisure and culture offer recreational programs and the local community center and its program of each town helps new habitants adopt to the rural life. Additionally, the employment project of a local welfare center allow people living in a rural community to continue their careers with their talents and interests through local class programs for a life worth living. Lastly, guide for getting information of rural life, local community gathering and preliminary education should be carried out to reduce expectant tenants' incompatibility and assist them settle down early. The community program expansion is also required at the local government level.

• Journal of the Korean association of regional geographers
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• v.3 no.2
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• pp.163-193
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• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.