• Title/Summary/Keyword: Patient Focused

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Effect of Problem-Based Learning (PBL) on Problem-solving and Communication Skills in Pharmacy Student (문제 중심 학습법 수업이 약학대학 학생의 문제 해결 능력과 의사 소통 능력에 미치는 영향)

  • Sunmin Lee
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.3
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    • pp.175-183
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    • 2024
  • Background: The evolving healthcare environment necessitates changes in pharmacy education to meet these demands, with problem-based learning (PBL) being a promising approach. Methods: This study employed a single-group, repeated-measures design to evaluate the effects of PBL on the communication and problem-solving skills of fifth-year pharmacy students at S University. The course, which focused on pharmacy practice and communication, included 36 students who participated in structured pre- and post-intervention surveys, as well as self-reflection journals. The primary competencies assessed were problem-solving and communication skills. Data collection involved quantitative measures through surveys and qualitative insights from self-reflection notes. Results: Of the 36 students, 35 completed the pre-intervention surveys, and 27 completed the post-intervention assessments. Significant improvements were observed in problem-solving skills, including problem identification, information gathering, and planning. Communication skills showed overall improvement, though the differences were not statistically significant. Qualitative analysis of self-reflection notes revealed enhanced understanding of elderly patient care, increased responsibility, teamwork, and the importance of effective communication in pharmacy practice. Commonly identified themes included a heightened sense of responsibility, the importance of teamwork, and an appreciation for the multifaceted nature of pharmacy practice in elderly care. Conclusion: The PBL approach effectively enhanced students' problem-solving abilities and provided valuable experiential learning in pharmacy practice. The qualitative data indicated that students gained a deeper understanding of their roles and responsibilities, fostering greater motivation and teamwork. Further research should focus on broader applications across different institutions to validate these findings.

Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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An Optimization Method of Measuring Heart Position in Dynamic Myocardial Perfusion SPECT with a CZT-based camera (동적 심근관류 SPECT에서 심장의 위치 측정방법에 대한 고찰)

  • Seong, Ji Hye;Lee, Dong Hun;Kim, Eun Hye;Jung, Woo Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.75-79
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    • 2019
  • Purpose Cadmium-zinc-telluride (CZT) camera with semiconductor detector is capable of dynamic myocardial perfusion SPECT for coronary flow reserve (CFR). Image acquisition with the heart positioned within 2 cm in the center of the quality field of view (QFOV) is recommended because the CZT detector based on focused multi-pinhole collimators and is stationary gantry without rotation. The aim of this study was to investigate the optimal method for measuring position of the heart within the center of the QFOV when performing dynamic myocardial perfusion SPECT with the Discovery NM 530c camera. Materials and Methods From June to September 2018, 45 patients were subject to dynamic myocardial perfusion SPECT with D530c. For accurate heart positioning, the patient's heart was scanned with a mobile ultrasound and marked at the top of the probe where the mitral valve (MV) was visible in the parasternal long-axis view (PLAX). And, the marked point on the patient's body matched with the reference point indicated CZT detector in dynamic stress. The heart was positioned to be in the center of the QFOV in rest. The coordinates of dynamic stress and rest were compared statistically. Results The coordinates of the dynamic stress using mobile ultrasound and those taken of the rest were recorded for comparative analysis with regard to the position of the couch and analyzed. There were no statistically significant differences in the coordinates of Table in & out, Table up & down, and Detector in & out (P > 0.05). The difference in distance between the 2 groups was measured at $0.25{\pm}1.00$, $0.24{\pm}0.96$ and $0.25{\pm}0.82cm$ respectively, with no difference greater than 2 cm in all categories. Conclusion The position of the heart taken using mobile ultrasound did not differ significantly from that of the center of the QFOV. Therefore, The use of mobile ultrasound in dynamic stress will help to select the correct position of the heart, which will be effective in clinical diagnosis by minimizing the image quality improvement and the patient's exposure to radiation.

HyungSang Medical Approach to Phlegm-Fire (담화(痰火)에 대한 형상의학적(刑象醫學的) 고찰)

  • Kim, Jong-Won;Jun, Soo-Hyung;Ji, Gyu-Yong;Kim, Kyung-Chul;Lee, In-Sun;Lee, Tae-Sik;Kim, Kyu-Kon;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.1-6
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    • 2009
  • Many of our contemporaries suffer from the symptoms of phlegm-fire, which is caused by stress, processed food, heavy diet, and unseasonal fruits and vegetables. With consultations from 'Euihaklpmoon', 'DongeuiBogham', and 'Ji-San's clinical lectures' this research, which is mainly focused on phlegm-fire, concluded as following. Phlegm-fire is caused by congestion of seven emotions, congestion of qi, complication of phlegm on fire, depletion of body fluids after long periods of disease, heavy diet, or congenital unbalance of yin-yang and qi-hyul. Concentration of phlegm-fire on the head causes headache, dizziness, frontal headache, tinnitus, and auditory dysfunction. The patient usually complains breaking pain. Dhamhwabang of Yijin-tang, Chunghoonhwadham-tang, and Yijin-tang variation for right headache can be used. Concentration of phlegm-fire on the thorax causes insomnia, palpitation, and insanity. Samhoohndham-tang variation, Chungsimgondhanhwan can be used. Concentration of phlegm-fire on the gastric region causes reflux of gastric acid, eructation, vomiting, abdominal discomfort, dysmenorrhea, and fluor gentalis. Yijin-tang variation for abdominal discomfort, Yanghyulsamul-tang, Hwadhamchunghwa-tang can be used. Shin type or Gi type, female with prevalence of qi and tendency of fire, female with dark facial color, female with raised eye tails and large noses, female with pointed noses, and male or female with large noses and mouths are likely to possess phlegm-fire. Abdominal discomfort of male with thick eyebrow and headache of Gi type female is usually caused by phlegm-fire.

The Level of Job Satisfaction and Organizational Commitment of Medical Record Technicians (의무기록사의 직무만족도 및 조직몰입도)

  • Choei, Eun-Mi;Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.72-91
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    • 2003
  • The purpose of this study is to investigate the recognition of health information managers, and to analyze the level of job satisfaction and organizational commitment of medical record technicians. The data for this study were collected through a self-administered survey with a structured questionnaire to 172 subjects from medical record technicians working in hospitals in Seoul and Gyeonggi Province as well as the faculty of medical schools across South Korea. In this analysis frequency, t-test, ANOVA, factor analysis and structural equation model were used. The main findings of this study are as follows: 1. As for recognition of the seven dimensions in the role of health information managers, the role as clinical data specialist received the most positive feedback, followed by document & repository managers, patient information coordinators, health information managers, data quality managers, security officers and research & decision support analyst. 2. The level of job satisfaction among medical information handlers and managers averaged 3.14. In terms of the factors in the work environment concerned with job satisfaction, being able to work independently and as team players reached the top among 6 factors with the average of 3.39, followed by professional position, salary & rewards, expectations for job performance and administration. 3. The average rate of organizational commitment stood at 3.09. Respondents tend to be focused on present tasks rather than future-oriented tasks. 4. The result of the analysis based on the relationship between recognition as health information managers, job satisfaction and organizational commitment found that all analysis are statistically meaningful. The more the respondents were aware of their roles as health information managers, the more they tended to be committed to their work and satisfied with their work. The more the respondents were committed to their work, the more satisfaction was seen. The effects of recognition as health information managers on organizational commitment measured 0.27 and for job satisfaction it was 0.17. The effects of organizational commitment on job satisfaction stood at 0.71. The feasibility of the model meets the standard at Chi-square value of 66.755 and the P value of 0.057. The Normed Fit Index (NFI) of 0.930 was in compliance with the standard for model feasibility and the squared multiple correlation coefficient of this model was 8% in organizational commitment and 60% in job satisfaction.

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The Study on Service Design Development for Pharmacy Users: Using Smart Phone Application

  • Lee, Dong-Min;Park, Hye-Jung;Lee, Dong-In
    • Journal of the Ergonomics Society of Korea
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    • v.31 no.1
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    • pp.93-100
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    • 2012
  • Objective: This study is to review the current state of services offered to pharmacy users, and develop a service design converging a prescription service and a smart phone application service in order to enhance patients' experience at pharmacies and home. Background: Under the new medical system; separation of prescribing and dispensing drugs, a doctor writes a prescription to their patients and patients have their prescription filled at the pharmacy. As the number of flue, allergy and atopy patients has increased, waiting lines have been longer at pharmacies. Besides, the current medical service system lacks of providing proper information on prescribed pills to patients. There are already services offered during waiting times such as offering free drinks, magazines or suggesting general drugs which you can buy without prescription, however they neither cover the current medical service's shorts nor shorten the waiting time. Method: I researched objective and perceived waiting times reduction methods, the current service status at pharmacies, and the government's policy direction in a medical service. Also, I observed a patient's journey from the hospital to pharmacy and then home. I examined the circumstance at pharmacies, patients' behaviors and their thoughts during their journey, and extracted three main goals to design a service in order to help patients have positive perception during the waiting time; (1) to reduce the perceived time by the way of visualizing time and offering readings about what patients consider necessary, (2) to educate patients what they are into and how to get through, (3) to establish trust among patients, doctors and pharmacists. Based on three goals, I designed a structure and a wireframe for a new service application of smart phones. Results: With a new service design for pharmacy users, users can track their medical record and visit the information about their current medical treatments anytime. Also the service helps patients build reliable relationships with doctors and pharmacists. Conclusion: Experience is not just an activity but series of multiple activities. The serving range of a medical service should not be determined by stakeholders but user's holistic experience. By approaching a service design with a holistic vision, it can enrich not only a temporary experience but also a whole life well being. Application: Since there are already many service applications advising patients about their illness and finding right doctors, this service design is focused on the experience from getting a prescription till feeling better. The next move is to combine those two parts medical services and design an integrated service application. As a prescription is going to be coded in numbers, we might consider to design an un-attended pharmacy which can shorten huge amount of time for filling prescriptions.

Benchmarking the Regional Patients Using DEA : Focused on A Oriental Medicine Hospital (자료포락분석방법을 이용한 내원환자의 지역별 벤치마킹분석 : 일개 한방병원을 중심으로)

  • Moon, Kyeong-Jun;Lee, Kwang-Soo;Kwon, Hyuk-Jun
    • The Journal of Society for e-Business Studies
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    • v.19 no.3
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    • pp.91-105
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    • 2014
  • This study purposed to benchmark the number of patients who visited an oriental medicine hospital from its surrounding regions using data envelopment analysis (DEA) model, and to analyze the relationships between regional characteristics and efficiency scores from DEA. Study data was collected from one oriental medicine hospital operated in a metropolitan city in Korea. Patient locations were identified at the smallest administrative district, Dong, and number of patients was calculated at the Dong level based on the address of patients in hospital information system. Socio-demographic variables of each Dong were identified from the Statistics of Korea web-sites. DEA was used to benchmark the number of patients between Dongs and to compute the efficiency scores. Tobit regression analysis model was applied to analyze the relationship between efficiency scores and regional variables. 6 Dongs were identified as efficient after DEA. In Tobit analysis, number of medical aid recipients and number of total population in each Dong was significant in explaining the differences of efficiency scores. The study model introduced the application of DEA model in benchmarking the patients between regions. It can be applied to identify the number of patients in each region which a hospital needs to improve their performances.

An Exploratory Study on the Care Farm Governance: Focusing on the Netherlands and Belgium Cases (케어팜 거버넌스에 대한 탐색적 연구: 네덜란드와 벨기에 사례를 중심으로)

  • Hwang, Jeong Seop;Hwang, Yoon Min
    • The Journal of the Korea Contents Association
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    • v.20 no.4
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    • pp.358-372
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    • 2020
  • Recently, there has been growing social interest in the use of care farms as part of therapy for neurological or mental patients and regional innovation for rural areas. Care farm, which combines the health treatment and rural innovation perspectives, is important to establish a proper governance system for mutual collaboration with various stakeholders. However, there is still a lack of research on this. Therefore, this study designed the care farm governance framework and comparatively analyzed the governance between Netherlands paradise care farm and Belgium blue farm, which are major successful care farm cases. The results showed different governance system between Netherlands and Belgium care farm in terms of institutional and financial support, regional characteristics, structure, operation, and strategy. In Netherlands, as the central government-initiated therapy-centric, care farm governance is concentrated in treatment of patient mainly supported by Ministry of Health, Welfare and Sports under the law on social support. Whereas, in Belgium, as local government-initiated agriculture-centric, care farm governance is mainly focused to lead voluntary participation of agricultural cooperatives and medical institutions in regional area. This study provides a theoretical foundation of governance type and system for the care farm research and suggests guidelines of care farm governance for the governments like South Korea consider activating care farm.