• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.99-113
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• 2002

For this study a sample of 205 people, 66 males and 139 females, over 65 years of age, residing in C-gu of S-si and utilizing senior centers, were selected, The objective of the study was to provide basic data for health promotion program development provided by health centers. A questionnaire was used to collect date on general characteristics, health status, social health status and utilization rate for health services. The instruments used in this study were the Lawton scale, to measure daily routine function, the MMSE-K developed by Folstein and modified to fit the Korea situation, for mental health status, and the CES-Dtool developed by Radloff, for emotional health status. the SPSS Window program was used to calculate percentages. Tests of significance were done using t-test and ANOVA. Multiple regression analysis was used to identify variables influencing the use of health services. The results are as follows : Of those utilizing senior citizen centers, 40.9% of males and 17.3% of the female thought they were healthy. The average score for IADL was 7.4. The daily routine of female respondents consisted of buying household articles and drugs, and other IADLs such as riding the bus or subway alone. These resulted in a higher score compared to males. For emotional health, 7.6% of the males reported depression compared to 21.6% of the females. For mental health, 48.5% of the males and 28.8% of the females were found to be in the group suspicious for dementia. On social health, 57.6% of the males and 62.6% of the females reported no intimate human relations. Of those older people who had close human relations, 52.5% of the males indicated a friend as the closest person and 53.8% of the females, their children. On use of health services, there was a significantly higher need for mobile medical care services treatment for those with lower education levels and status of window/widower. There was a significantly higher need for health exmination services for those with lower levels of exercise, greater satisfaction with sleep, higher levels of oral health care, and higher social contacts. In conclusion, there is a need to provide varied programs for the promotion of health, along with parallel resolution of social, psychological and economic issues. It is recommended that health services for elderly people provided by the health centers be implemented with full recognition of these characteristics and differences.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2004.10a
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• pp.59-88
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• 2004

' Healthy Japan 21 ' is a new health policy that has been proposed for the 21st century: it embodies a totally new concept for its viewpoints and methods. To start with, for its goal, the focus is placed on the ' quality of life ' or a life that is tree of diseases, rather than mere prolongation of life. For its doctrine, the emphasis has shifted dramatically from improving the health of the entire population (the traditional approach for health improvement) to ' achieving an ideal health status for each individual. The ultimate aged society that arrives first in Japan is a society in its ultimate form for human being. Why did Japan become westernized, giving up her traditional culture? Why did she go through industrialization, sacrificing her nature? And why does she try so hard to industrialize the developing countries? These efforts are all preparation for the arrival of a ultimate aged society. During the 20th century, we believed in unlimited possibilities and expanded our social frontier. 1n the 21st century, on the other hand, a super-aged society (the ultimate society), a glimpse of which we have witnessed from time to time, will descend on us sooner or later. It is expected to arrive first in Japan. ' Healthy Japan 21 ' is intended to prepare for the arrival of the hitherto unheard of super-aged society by building the physiological basis of people. This policy is social experimentation on an immense social scale, in which questions are posed on the understanding of health, the relationship between individuals and society, the relationship between administration and citizens, the manner by which central and local governments operate, and the new relationship between prevention and therapy. ' Healthy Japan 21 ' may be summarized as an experiment on a huge scale directed to the ultimate form of human society, in which Japan and each of her citizens playa role and set an example for the rest of the world. Even just by considering various approaches newly suggested for this venture, one may be convinced that it is a policy with features suitable for a country that has already achieved the world's highest longevity.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.389-400
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• 1999

The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.3
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• pp.403-414
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• 2001

The study was intended to identify the nurses' experiences, understanding, and attitudes on DNR. Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 347 nurses in eight general hospitals. The data were collected between August 1 and August 31, 2000. The data were analyzed using descriptive statistics and $x^2-test$. The results of the study were as follows : 1. Regarding DNR-related experience, 74.6 percent of the participants experienced DNR situations. Eleven percent of the participants received DNR education. DNR was most frequently (81.5%) requested by family members and relatives of patients. The decision-making on DNR was most frequently (76.8%) made by agreement between family members and medical staff. The DNR order was recorded at 81.9 percent on charts. Problems after DNR order were negligence in treatment and nursing care (30.6%) and guilty feelings due to doing the best (22.1%). CPR (cardiopulmonary resuscitation) was performed about 49.8 percent of DNR cases. 2. Regarding understanding and attitude on DNR, most of the participants (93.1%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery (44.4%) and death with dignity (41.1%). The decision-making on DNR was most frequently made by patient and family members (47.8%) and followed by agreement between family members and medical staff (25.6%), and patients themselves (16.4%). Most of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. Forty four percent of the participants thought that the most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals. Most of the participants (90.2%) thought a guide book for DNR is necessary to be made in hospitals. 3. There were significant differences in the participants' understanding and attitudes on DNR according to religion career education and experience of DNR. Of the participants those who have religions and education experience on DNR thought that there would be more DNR requests after DNR is explained to patients and family members (p<.05). In addition, there was higher understanding on the necessity of DNR in those who have more career and DNR experience(p<.01). The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects. Also, there needs to be more education on DNR in medical ethics to health care professional and to provide more information on DNR to the general public.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.680-691
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• 1998

This study was conducted to examine the species differences in the urinary excretion of trichloroethanol(TCE-OH) and trichloroacetic acid(TCA) of trichloroethylene (TCE) metabolites and the effect of ethanol on these metabolites in mice and rats. TCE administered to Male Sprague Dawley rats and ICR mice as a single oral dose(100, 200, 500, 1,000 or 2,000 mg/kg body weight) and ethanol(3.0 g/kg body weight) was taken orally 12 hours before TCE administration. The metabolites in urine were measured 0, 12, 24, 36 and 48 hours after TCE administration. The results of metabolite excretion were as follows; Total trichlorocompounds(TTC) in urine increased with TCE dose in mice while increased only below dose of 1,000 mg/kg TCE in rats. The net excretion of TCE metabolites was significantly greater in mice than rats, although the proportion of TCE-OH to TCA was not different between mice and rats. These findings indicate that mice were internally exposed to significantly higher concentration of TCE metabolites than rats and this trend appeared to be more prominent with the increase of TCE dose. Ethanol increased significantly TCE-OH in urine of rats while the increase of TCE-OH induced by ethanol was not significant in mice, and didn't increase TCA of urine in both of rats and mice. This result suggests that the effect of ethanol on TCE metabolism may be due to the increase of TCE-OH.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.69-89
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• 2001

This study is focused that the electronic commerce(EC) on the purchasing section may improve the efficiency and transparency of the hospitals management. After reviewing the purchasing activity of hospitals, I study the introduction, expected effects, and problems of EC. So, I am going to provide basic information for activating EC. The samples are managers of 170 hospitals, which are located on Seoul. As a result of collection this survey, I analyze 79 hospitals. For data analysis, I use $X^2$-test and ANOVA for purchasing management and the relevance of EC according to the level of care. The results of this study are 1. The problems on the management of purchasing section are: firstly, they don't have sufficient time to study market. Secondly, it is difficult to find competitive suppliers. And, lastly, they cannot gather a lot of information about the price of products. 2. There are many answers of the needs on the introduction of B2B. However, some hospitals think they don't need it. But, the most answers are that the EC will be settled within 4 years. So, we can realize that these hospitals are getting interested on the EC. On the other hand, I find that they prefer outside EC companies for the introduction of EC. 3. On the expected effects on EC, first is the effectiveness of the market survey. The next is to collect information of adequate price of products owing to clear transaction, find easier new suppliers and gather useful data. 4. On the external problems of the introduction of EC, there is low credibility related to the security and the weakness of suppliers' information system. Especially, on the Real Transaction Price Payment system, the bigger bed size, the higher understanding on these problems. On the internal problems of the introduction of EC, first is the burden of the introduction of EC and operating cost. Especially, on the burden of the disclosure of revenue source, the smaller bed size, the higher understanding on this problem So, this is a point which deserves my attention statistically. However, this shows relatively little understanding about incomplete the standard of product category and the weak information system of hospital. Through this study, I am going to suggest 3 points for the activation of the introduction of EC on hospitals. 1. The reform of the Real Transaction Price Payment System on medical supplies and materials for medical treatment 2. The establishment of the standard of product category 3. The promotion of information system based on network.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.63-76
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• 1999

The main objective of this study was to develop a concept of service marketing promotion in nursing that is derived from the concepts of service marketing theory. This research was a descriptive study, at the factor isolation level. The principle of concept derivation suggested by Walker and Avant (1988) and the Hybrid model suggested by Schwarz-Barcott and Kim (1993) were employed as the research method. The data were collected from December, 1997 to April. 1998 at a large general hospital located in Seoul. The procedures of this study were as follows: First. at the theoretical phase: the meaning, attributes, and definition of service marketing promotion were identified through an extensive review of the literature. Second, at the empirical phase: fieldwork was done to identify the promotional activities and events in nursing. Top nurse managers from 4 units (Director of Nursing, Head nurses of inpatient nursing unit, outpatient nursing unit. and home care nursing unit) were interviewed and the content of the interview was analyzed to identify the meaning and attributes of promotion in nursing. Other methods such as brochures and other audio-visual materials which were relevant to nursing promotion were used to supplement the interviews. Finally, the results of the theoretical and empirical analyses were intergrated to develop a concept of service marketing in nursing practice. A final definition of service marketing promotion in nursing was identified as follows. 1. Promotion as a marketing function in nursing service is concerned with communication to target markets on all information related to nursing service in order to satisfy the objectives of both a nursing service organization and the target markets. 2. The goals of nursing service promotion include: 1) increasing visibility of nursing services and delivering the information on nursing services, 2) affirming the value of nursing services, so it can contribute to formulation of reimbursement policy for nursing services. 3) advancing the general image of the nursing profession and nursing services. 4) achieving and attaining a desirable positioning for nurses among health care professionals. and 5) creating and stimulating the demand for nursing services. 3. In order to obtain these goals it is necessary to provide information on nursing services, to persuade target markets. to remind them about nursing services. and to establish a collaborative relationship with related departments. 4. The tools used to carry out the above functions of promotion in nursing are the providing nursing services, public relations and publicity. QA of nursing, advertising, and sales promotion. 5. The target markets of nursing service include the nursing customer markets. the internal markets, the influence markets. the recruitment markets. the supplier markets. and the nursing referral markets. In conclusion, the concept of promotion in other service marketing areas can be applied to the promotion of nursing service marketing. The promotion of nursing service is more than just effective communication in nursing service. it is the effective use of the concepts of service marketing promotion. Promotion of nursing service will contribute to create and expand nursing services.

• Journal of Korean Clinical Nursing Research
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• v.15 no.2
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• pp.139-155
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• 2009

Purpose: The purpose of this study was to identify role through job analysis (duties and tasks) of nurses who work as clinical nurses with education and clinical nurse with patient coordination within the hospital. Methods: The DACUM committee was organized with 8 nurses each, clinical nurses with education and clinical nurses with coordination. The committee derived the duties and tasks of the two groups of clinical nurses from their actual work in the hospital through a DACUM workshop. Validity of the derived duties and tasks was tested by 12 nurses at each of 3 hospital. Results: For clinical nurse with education, 8 duties and 45 tasks were identified, which included patient education and consultation, patient advocacy, management of the therapeutic process, direct nursing care, activities work directed at improvement, management of health promotion events, administration work, and self-improvement. For clinical nurse with coordination, 10 duties and 54 tasks were identified, and included client consultation, client education, direct nursing care, coordination of therapeutic flow, employee education, public relations with the community, planning and operation of meetings, administration work, work directed at improvement, and self-improvement. Conclusion: The results of this study contribute to not only the work of the participants but also basic data for human resource management in the hospital.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.5
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• pp.1897-1904
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• 2010

The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 432,915 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December. As a result of analyzing their prescription compliance and factors affecting it, the following findings were given: The average rate of the prescription compliance of the patients stood at 61.5 percent. It denoted that they were prescribed to take medicine for approximately 113 days during the six-month(184 days) period of time, and the rate of the patients who complied with the prescriptions just stood at 13.0 percent. They used out-patient department for 4.3 days on the average due to hypertension and they visited 1.1 medical institutions on the average. 94.9 percent just used a medical institution. The largest group (11.6%) suffered from diabetes as co-morbidity, and 23.3 percent of the hypertensives had co-morbidity. Concerning the relationship between their characteristics and prescription compliance, those who were male, who were beneficiaries of the national health insurance, who mainly used general hospitals and who suffered from co-morbidity complied better with the prescription they got. Their prescription compliance got better at the age of 65 to 74 and got worse afterwards. As for factors affecting their prescription compliance, the patients who were male, who were aged between 55 and 64 and who were beneficiaries of the national health insurance, who mainly used specialized general hospitals, general hospitals and public health centers and who had heart diseases and diabetes as co-morbidity complied better with the prescriptions. The above-mentioned findings of the study suggested that it's needed to make a factor analysis of the poor prescription compliance of patients from diverse angles, and that existing hypertension care plans should carefully be reviewed to improve the prescription compliance of patients and to find a feasible alternative. As hypertensives are easily likely to develop co-morbidity like diabetes, systematic health education should be provided for them to get into the right life habits such as taking low-salt meals or quitting smoking. In addition, the development of health care programs is required.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.93-106
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• 1997

By the increase of the rate of existence of the hemodialyzing patients, they were required the long run treatment. Regardless of medical insurance expansion, hemodialyzing cost much expenses so that hospital has been considering the reuse of hemodialyzer and flowing euqipments along with the diverse study and progress of the ways of hemodialyzing and medical instruments. This study was aimed to provide the basic materials regarding the reuse of hemodialyzer which is used for the patients of chronic renal disease. The reusing program in the artificial kidney center of K hospital has been used for this study from 50 patients aften one year result from Sep. 1995 through Aug. 1996. Automatic equipment of DRS-4 made by Seratronic Co., was used as the equipment and it was retreated with the function test simultaneously. Compliaction and confirmation of the infection were by the records of the hemodialysis of the patients. SPSS was used for the analysis of the materials by computerization. The character of the patients and the rate of removal was by mistake and percentage, function test and rate of complication by Ftest(ANOVA) and the rate of complication per items by ${\chi}^2$ and Ftest. As the post test the Duncan's test was used for the statistically significant different variables in the standard of p<.05 after Ftest. The followings are the summary of the result : 1) In the function test of the new hemodialyzer and the reused one, and in all of CA110 and CF15.11, the dialyzer ultrafiltration coeffient(KUf) was appeared to have been higher in the reusing groups than the first use ones. This has been the normal limit showing no troubles with them. 2) In the function test of the new and reused hemodialyzer, in all of CA110 and CF15.11, the total blood volume was appeared to have been the less value in the reuse groups than the new ones. This was the price within 80% of the first price that both showed possible for use. 3) The result of reuse hemodialyzer of CA110 was $29.48{\pm}7.83$ in average in the test of leak test while $17.3{\pm}7.96$ in reuse of CF15.11. The normal limit of <60 was the leak test result. So both of the hemodialyzer was normal for reuse. 4) The rate of removal of Blood Urea Nitrogen(BUN) was 72.25% in CA110 hemodialyzer by reusing 16-20 times as the highest rate showing the better result in the reuse hemodialyzer, while in CF15.11 hemodialyzer showed 71.16% by highest rate in the first use by the highest rate with no difference from the reuse. 5) The rate of removal of serum creatinine of CA110 was 64.08% by highest rate in reuse of 1-5 times by showing better result in reuse hemodialyzer. While in CF15.11 66.47% the highest by reuse of 16-20 times showing no difference from each other. 6) No patients were admitted or precribed by antibiotics in relation with reuse dialyzer and no reports were shown about hepatitis $B{\cdot}C$. AIDS in fection. 7) Of the total 248 episods of complication due to the hemodialyzing, 86 by first use, 73 by 1-5 times, 35 by 6-10 times, 35 by 11-15 times and 19 by 16-20 times have been shown which have had no significant difference between the groups. 8) In the comparison of the expense for the hemodialyzer, there was the effect of saving 11,597.6 Won between the first and reuse hemodialyzer. And by decreasing the extracted materials, they did the great role of disposing the waste matters.