Journal of Korean Academy of Nursing Administration
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v.23
no.2
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pp.139-150
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2017
Purpose: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. Methods: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in 'Public Hospitals Alert', was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. Results: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as \29,128 The nursing cost per inpatient per day was calculated as \157,970, and the administration cost per patient was calculated as \133,710. Conclusion: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.
Purpose: Hypertension has been a major cause of death in Korea since the 1970s, and has resulted in being a significant economic burden to the finances of national health care. The Ministry of Health and Welfare made several efforts. but hypertension control programs in Korea are still non standardized and ineffective. We wanted to investigate the current hypertension control program in public health centers systematically and suggest the direction for future programs. Method: The design of this study is a cross sectional investigation. From September to October in 2002, we sent a set of questionnaires to all PHCs, and 179 centers responded (response rate = 74.0%). The instrument was developed based on components of National health systems. Results: 1) Resources: The department responsible for hypertension control programs is the Department of Health Promotion. Health Education Center, Community Health Center, Citizen's Health Center, etc. The chief personnel of those departments are nurses. but 27.4% of PHCs have no full time nurse for hypertension management programs. PHCs had a lot of teaching materials (nine types per a PHC) and most of the recommended contents were included. But, periodical evaluation and revision were not being made, 2) Management: Nurses' (13.03 9.46 in 23 score) actions for hypertension control were not qualitative, but regular training and evaluation were seldom carried out. Need assessment (25.9%) and evaluation (about 10-20%) for the hypertension control program were indicated as low. 3) Programs: Programs focused on individuals rather than community or public, and 2nd prevention rather than 1st, 3rd prevention. Conclusion: The Ministry of Health and Welfare has to construct the infrastructure for hypertension control programs. Related scholars and committees should develop and declare standardized manuals for hypertension control and the management system, as well.
In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.
This study was to examine the characteristics of aggressive behaviour of dementia patients. It was based on the observation of the patients in a facility for dementia patients. Observation continued for two days from 9a.m. to 5p.m .. aggressive behavior was recorded using the instrument of Ryden. The result of this study is as follows. 1. appearance rate of aggressive behaviour During two days $74\%$ of the patients did aggressive behaviour(first day-$41.8\%$. second day-$62.8\%$). The average aggressive behaviour per person was 1.65. 2. types of aggressive behaviour Aggressive behaviour was the most frequent in verbal domain(157 case; $52.5\%$). Physical domain was the second$(136case;\;45.5\%)$, and sexual domain was the last$(6 case;\;2.0\%)$. More concretely, abusive/vulgar language$(74case;\;24.7\%)$ was more than anything else. Aggressive language$(65case;\;21.7\%)$, pushing$(39case;\;13.0\%)$, intimidating posture$(21case;\;7.0\%)$. slapping $(18case;\; 6.0\%)$ followed it. 3. correlation to other factors such as sex. age etc. The average aggressive behaviour of female(2.07) was higher than that of male(1.23) (p=.05). Age also had meaningful correlation to the frequency of aggressive behaviour(p=.04). All the other factors-the period of living in facility, the seriousness of dementia. movements in daily life. CAPE, emotional state. the extent of trouble in cognition- have nothing to do with the frequency of aggressive behaviour. 4. the time, place and the target of aggressive behavior Aggressive behaviour appeared more frequently in the afternoon $(138case;\;46.4\%)$ than in the morning or at lunch time. The patient's room ranked the first in the list of places where aggressive behaviour took place $(162case;\; 54.5\%)$. Nursing personnel topped in the target of aggressive behaviour$(119case;\; 39.8\%)$. 5. the preceding causes of the aggressive behavior the most frequent preceding causes of the behavior was the stimulus of another residents $(133case, 44.4\%)$ and that of nsg personnel was few relatively$(65 cases,\; 21.7\%)$. 6. Nursing personnel used verbal reaction most frequently$(40 cases,\; 51\%)$ and in a behavioral reaction they used physical restraint $(12 cases,\; 17.1\%)$ most frequently. In the reactions of nsg personnel. the rate of undesired reaction was high$(41cases,\; 44.28\%)$. and in that of the attacked residents, the usual reaction was most frequent $(80cases,\; 65.0\%)$. In the future it is needed to investigate the characteristics of aggressive behavior of dementia patients, and based on this the method of intervention must be developed. Today the number of dementia patient increases so nurses must strive to encounter aggressive behavior more desirably.
Batbold, D.;Baigalmaa, Dovdon;Ganbaatar, B.;Chimedsuren, O.
Perspectives in Nursing Science
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v.7
no.1
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pp.50-54
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2010
The studies of M. Colombo (1989) and W. Lange (1992) showed that 30~40% of people became chronic after suffering from hepatitis B virus (HBV) and C virus (HCV) infection, and about 50% of the chronic cases transformed into primary liver cancer. There have been few studies done in Mongolia on hepatitis infection among health professionals, particularly in nurses. In a study done by Chimedsuren (8), the study showed that 19.4% of people with identified surface hepatitis B antigen (HBsAg) and antibodies to hepatitis C virus and 8% of people with the identified nucleotide of RNA for the hepatitis C virus (polymerase chain reaction) had an acute form of hepatitis C. Studies on the hepatitis virus genome damaging effect on liver cells showed that genotype 8 (A, B, C, D, E, F, G, TTV) had the most damaging effect on liver cells (Hahn and Faeka, 2007). Several studies have shown a relationship between hepatitis B virus infection and a lack of compliance regarding safety regulations and rules by medical personnel. Results of a study from the Maternal and Child Health Research Center showed that tests done to detect hepatitis B virus antigen and antibodies to C virus did not reveal anything. Both antigen and antibodies in 69% cases did not show, and separately, B virus and antibodies to hepatitis C virus were identified in 13% and 9%, respectively. Results of the tests taken from health personnel in Shastin Central Hospital showed that in 76% of the cases, the B virus antigen with C virus antibodies was not identified. In 8% of the cases, the B virus antigen was present on its own. The combination of B the virus antigen and C virus antibodies were present in 8% of nurses and doctors, respectively. 82% of the cases had negative results for the detection of a combination of B virus antigen and C virus antibodies taken from health personnel from the State Central Clinical Hospital whereas the B virus antigen and C virus antibodies by themselves were present in 7% and 14% of the cases, respectively. Combined cases of the B virus antigen and C virus antibodies were identified in 4% of the personnel. Results of the tests taken from the health personnel in the Hospital of the Ministry of Justice and Internal Affairs showed that in 79% of the cases, the B virus antigen with C virus antibodies were not identified. Separately, the B virus and antibodies to hepatitis C virus were identified in 8% and 13% of the cases, respectively.
This study aimed at examining participation rate in taking health examinations. abnormal findings. and recognition and responses for re-examination recommendation among junior students at a university. Data were collected by interviews and self-reports between March and April. 2000. five months after receiving findings of health examinations. Question items in the questionnaire were made by the researchers. Participation rate for the health examination was $22.5\%$ of all registered junior students: $25.4\%$ for men and $16.6\%$ for women. College of medicine ranked the first in the participation rate. Of the examinees. $22.8\%$ showed abnormal findings. Of those students with abnormal findings. 149 students who were registered at the time of data collection became the subjects of the present study. The average age of the subjects was 23.7 years. The proportion of those with very good or. good self-evaluated physical health was $24.1\%$. while the proportion for mental health was $55.1\%$. The most prevalent problem for men was liver problem and for women anemia. More than $92\%$ of the subjects were aware of their abnormal findings. Those who sought advice were $71.8\%$ and their parents were most frequently asked for advice. As for the contents. $33.7\%$ were advised to visit a hospital. Of the 65 students recommended for re-examination. $60.9\%$ with liver problems took re-examination. while $37.2\%$ with urine problems. The multiple responses of the reasons for not following the recommendation for re-examination were 'not a serious problem $(63.9\%)$,' 'having no time $(22.2\%)$,' Students' recognition of the importance of health examination should be raised to increase their participation rate. When abnormal findings were detected. parents need to be informed for achieving adequate follow-up. All the students with abnormal findings need to be consulted by university health personnel to facilitate proper actions.
Journal of Korean Academy of Nursing Administration
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v.4
no.2
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pp.321-349
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1998
Since 1990 the effort for unification has been active in each department of our society. But the study for health policy in Unified Korea has been scarce. Unified Korea should be a democracy and a constitutional state. So we should have lively discussion on the health law as well as unified general laws. The purpose of this study is to compare the health law of South Korea and North Korea and to understand the differences in them. We guess both Korea are considerably different each other. But this study found out that there are many health related laws that have same goals and contents. The reason for this is that both health laws have its root in Korea Law. And the right to health is the social basic right. whose characteristic can not be compatible with market economy and demands state intervention for securing the right to health. The health related laws are divided into 4 fileds. 1. There is a field A which is affected by unified political and economic system and differs little from the law system: the license system of medical personnel. 2. There is a field B which is seldom affected by unified political and economic system and differs little from the law system: the right and duty of medical personnel. quarantine law. 3. There is a field C which is affected by unified political and economic system and differs greatly from the law system: health institution law(exclusive of quarantine law), the laws of medical personnel category, of research center(especially per-mission, registration and establishment). of the role of basic health in private and public area. 4. There is a field D which is seldom affected by unified political and economic system and differs greatly from the law system: health equipment law(the laws of drugs, of cosmetics and of medical instrument. of blood management). the laws of health knowledge. of cooperation in chinese medicine and western medicine. the health promotion law. the rules of first-aid. the law of separation of dispensary from medical practice. The laws which are seldom affected by political and economic system can be consolidated. which in turn can be revised and enacted before unification of Korea through the interchange between North Korea and South Korea and the support to North Korea health system.
Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.
The term 'nursing' is often defined as a therapeutic and interpersonal process that ultimately functions to help clients. In the process of helping, empathic ability(ability to entering into the another's feeling or motives) is an essential factor that has been proved in the fields of psychology and social psychology. In the sense, nursing personnel with high level of empathy is required to accomplish the comprehensive nursing. The purpose of this study was (1) to investigate empathy between nursing and non-nursing students, (2) to examine changes of empathic ability in accordance with their academic years, and (3) to show relationships, if any, between the two concepts, empathy and need-affiliation. For the survey, 325 respondents for nursing department and 378 from non-nursing departments were randomly selected from the two universities in Seoul. The instruments used in this questionaire survey method were Hogan's Empathy Scale and Mehrabian's Need-Affiliation Scale, each of them has established its validity and reliability in many different people and settings. For the analysis, descriptive stative statistics were mostly used by calculating frequencies, percentages and mean scores. T-test, analysis of variance and correlation coefficient were employed to test the differences and the statistical significance. The results of this study are summarized as follows: (1) There was no significant difference in empathic ability detween the nursing and non-nursing student (2) The levels of empathy among the nursing students, 'surprisingly enough, were negatively correlated with their academic years, even though statistical significations was not found. The scores of the empathy are somewhat dropped as academic year going up. (3) No significant relationship was revealed between empathy and need-affiliation. In conclusion, the results of the study repeatedly support the claim that the nursing education must empathize and, also, include the programs that enable nursing students to develop the ability of empathy for their clients.
The purpose of this study was to develop a strategy for the promotion of the image of nursing. The study questions were; Do nurses have a proper self image\ulcorner What image of nursing do the public have\ulcorner It is thought that the prejudices that the public have about nursing personnel have to be eliminated in order to provide for better health care. Even though the public have misconceptions of prejudices, nurses have not paid much attention to them, nor sought ways to change them. This study was designated to make out a model project to improve the image of nursing held by the public. This study was a strategy building descriptive study. This study was oriented to a model project to improve the image of nursing. The subjects for the study were 650 nurses who were staff nurses. The study procedures were as follow ; First step ; a special action committe for nursmg image making was established of nine members who were divided into five subgroups. 2nd step ; a 1st workshop was held to improve self concept of nurses and to recognize them the necessity of nursing image development, a 2nd workshop was held to develop a conceptual framewrk for the action plan and for budget planning. 3rd step ; a master plan for a nursing image was developed and evaluated through discussion and presentation. 4th step ; lecture and role playing were used to further the development of a caring attitude in the nurse. 5th step ; a situation oriented video film was made and previewed the film is done for nurses and doctors, and lastly ; an academic symposium was held to redefine and reinforce the nursing image under the title of future directed nursing for Yonsei University, at this time three nurses were given awards for demonstrating a caring attitude in order to motivate nurses to develop a care oriented attitude.
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