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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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The Creating Situations and Social Characteristics of Gutchum-pan to Pray - Focused on Donghaeanbyulsingut - ('축원-굿춤' 판의 생성 국면과 사회적 성격 - 동해안별신굿의 경우 -)

  • Jeon, Seong-Hee
    • (The) Research of the performance art and culture
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    • no.38
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    • pp.349-383
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    • 2019
  • This discussion is focused on Donghaeanbyulsingut's 'gutchum-pan to pray'. 'Gutchum-pan to pray' is repeated in almost all of the geori in Byulsingut, so it is a crucial chum-pan that can never be disregarded in understanding Byulsingutchum. Meanwhile, it supposes that Donghaeanbyulsingut is grounded on the activity of producing 'praying (words) and dance (motions)' within its relationship with the structure of capitalistic society along with the context of traditional rituals. The motion that is newly generated as a response to the concrete expression of 'praying' conducted by a mudang (a shaman), that is, the expression coming from the inside associated with the praying is seen as gutchum. This dance is bound to be in competition and interest among shaman groups, and they tend to influence one another. If praying leads to dance, a mudang can gain profits from capital as well as the value of labor. When the mudang succeeds in forming a bigger bond of sympathy with her praying, the object of praying gets more eager to select byulbi and dances a heoteunchum (impromptu dance) more vigorously. This means that a mudang's ability to perform a ritual is associated with the object of praying's consumption. With his impromptu motions, the object of praying comes to go into 'the field of consumption' within the structure of capitalistic competition before he is aware of it. Behind the communication that praying leads to dance, a lot of things are associated with one another organically. 'Gutchum-pan to pray' is generated by the continuous movement of diversity and unity that the time has within the ritual of the mudang and the object of praying. It continues to create the future 'self' that is different from the present 'self', and it means that he expects variability from the present 'self' through 'gutchum-pan to pray'. The mudang also prays for him arranging the variability of the other (the object of praying) inside her labor. In a big picture, of course, the mudang expects the variability of herself, too, which is connected to the value of her labor. The variability that they expect forms a crucial axis that determines where the flow of time and space that the 'gutchum-pan to pray' has is directed to. The contents of praying are directly related with the villagers' lives, and what leads to dance is mostly related with their jobs. This implies that what the mudang experiences in her everyday consuming activity is directly associated with the villagers' activity for earning money. In other words, the contents of that praying change constantly according to the flow of capitalistic economy. Also, those striving to respond to it before anyone else also expect better life for them by substituting their self to the 'gutchum-pan to pray' eagerly. If so, who are the ones that generate 'gutchum-pan to pray'? This can be understood through relationship among mudangs, relationship between the mudang and villagers, and also relationship among villagers. Their relationships can never be free from the concepts like labor in capitalistic society, consumption and expenditure, or time; therefore, they come to compete with the other, the present self, or the better self within the diverse relationships. This gets to be expressed in any ways, words or motions. And the range that covers the creation of either group or individual 'gutchum-pan to pray' in the village is the village community. Outside the range, it is upsized to the competition of the village unit, so individual praying may become diminished more easily. Although mudangs pray in each geori, it does not mean all praying leads to dance. Within various relationships between mudangs and villagers, 'gutchum-pan to pray' comes to be generated, repeated, and extinct. As it is mitigated to more positive competition, it does not lead to gutchum any longer. In other words, repeating 'gutchum-pan to pray' previously created has turned the object of praying into the state different from the former. Also, the two groups both have experienced the last step of Byulsingut, and at that point, praying does no longer lead to dance. In other words, from the position of the shaman group, it is the finish of their labor time and ritual performance, and from the perspective of the villagers, it means the finish of consuming activity and participation in a ritual. The characteristics of 'gutchum-pan to pray' can be summarized as follows. First, it goes through the following process: competition in the village group → competition in the group → competition among individuals. Second, repeated praying does not lead to 'gutchum'. Third, in the cases of praying for each of the occupation groups, the mudang can induce a bond of sympathy from the objects of praying directly, and this lead to dance. Fourth, the group that fails in being included in the category of praying gets to be alienated from 'gutchum-pan to pray' repeatedly.

Dual Path Model in Store Loyalty of Discount Store (대형마트 충성도의 이중경로모형)

  • Ji, Seong-Goo;Lee, Ihn-Goo
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.1-24
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    • 2010
  • I. Introduction The industry of domestic discount store was reorganized with 2 bigs and 1 middle, and then Home Plus took over Home Ever in 2008. In present, Oct, 2008, E-Mart has 118 outlets, Home Plus 112 outlets, and Lotte Mart 60 stores. With total number of 403 outlets, they are getting closer to a saturation point. We know that the industry of discount store has been getting through the mature stage in retail life cycle. There are many efforts to maintain existing customers rather than to get new customers. These competitions in this industry lead firms to acknowledge 'store loyalty' to be the first strategic tool for their sustainable competitiveness. In other words, the strategic goal of discount store is to boost up the repurchase rate of customers throughout increasing store loyalty. If owners of retail shops can figure out main factors for store loyalty, they can easily make more efficient and effective retail strategies which bring about more sales and profits. In this practical sense, there are many papers which are focusing on the antecedents of store loyalty. Many researchers have been inspecting causal relationships between antecedents and store loyalty; store characteristics, store image, atmosphere in store, sales promotion in store, service quality, customer characteristics, crowding, switching cost, trust, satisfaction, commitment, etc., In recent times, many academic researchers and practitioners have been interested in 'dual path model for service loyalty'. There are two paths in store loyalty. First path has an emphasis on symbolic and emotional dimension of service brand, and second path focuses on quality of product and service. We will call the former an extrinsic path and call the latter an intrinsic path. This means that consumers' cognitive path for store loyalty is not single but dual. Existing studies for dual path model are as follows; First, in extrinsic path, some papers in domestic settings show that there is 'store personality-identification-loyalty' path. Second, service quality has an effect on loyalty, which is a behavioral variable, in the mediation of customer satisfaction. But, it's very difficult to find out an empirical paper applied to domestic discount store based on this mediating model. The domestic research for store loyalty concentrates on not only intrinsic path but also extrinsic path. Relatively, an attention for intrinsic path is scarce. And then, we acknowledge that there should be a need for integrating extrinsic and intrinsic path. Also, in terms of retail industry, this study is meaningful because retailers want to achieve their competitiveness by using store loyalty. And so, the purpose of this paper is to integrate and complement two existing paths into one specific model, dual path model. This model includes both intrinsic and extrinsic path for store loyalty. With this research, we would expect to understand the full process of forming customers' store loyalty which had not been clearly explained. In other words, we propose the dual path model for discount store loyalty which has been originated from store personality and service quality. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. II. Research Model Dual path model integrates intrinsic path and extrinsic path into one specific model. Intrinsic path put an emphasis on quality characteristics and extrinsic path focuses on brand characteristics. Intrinsic path is based on information processing perspective, and extrinsic path emphasizes symbolic and emotional dimension of brand. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. Hypotheses are as follows; Hypothesis 1: Service quality perceived by customers in discount store has an positive effect on customer satisfaction Hypothesis 2: Store personality perceived by customers in discount store has an positive effect on store identification Hypothesis 3: Customer satisfaction in discount store has an positive effect on store loyalty. Hypothesis 4: Store identification has an positive effect on store loyalty. III. Results and Implications We examined consumers who patronize discount stores for samples of this study. With the structural equation model(SEM) analysis, we empirically tested the validity and fitness of the dual path model for store loyalty in discount stores. As results, the fitness indices of this model were well fitted to data obtained. In an intrinsic path, service quality(SQ) is positively related to customer satisfaction(CS), customer satisfaction(CS) has very significantly positive effect on store loyalty(SL). Also, in an extrinsic path, the store personality(SP) is positively related to store identification(SI), it shows significant effect on store loyalty. Table 1 shows the results as follows; There are some theoretical and practical implications. First, Many studies on discount store loyalty have been executed from various perspectives. But there has been no integrative view on this issue. And so, this research was theoretically designed to integrate various and controversial arguments into one systematic model. We empirically tested dual path model forming store loyalty, and brought up a systematic and integrative framework for future studies. We want to expect creative and aggressive research activities. Second, a few established papers are focused on the relationship between antecedents and store loyalty; store characteristics, atmosphere, sales promotion in store, service quality, trust, commitment, etc., There has been some limits in understanding thoroughly the formation process of store loyalty with a singular path, intrinsic or extrinsic. Beyond these limits in single path, we could propose the new path for store loyalty. This is meaningful. Third, discount store firms make and execute marketing strategies for increasing store loyalty. This research provides real practitioners with reference framework needed for actual strategy formation. Because this paper shows integrated and systematic path for store loyalty. A special feature of this study is to represent 6 sub dimensions of service quality in intrinsic path and 4 sub dimensions of store personality in extrinsic path. Marketers can make more analytic marketing planning with concrete sub dimensions of service quality and store personality. When marketers of discount stores make strategic planning like MPR, Ads, campaign, sales promotion, they can use many items which are more competitive than competitors.

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Study of new adsorption isotherm model and kinetics of dissolved organic carbon in synthetic wastewater by granular activated carbon (입상활성탄에 의한 합성폐수의 용존유기물질의 새로운 흡착등온 모델 및 운동학적 흡착 연구)

  • Kim, Seoung-Hyun;Shin, Sunghoon;Kim, Jinhyuk;Woo, Dalsik;Lee, Hosun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.4
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    • pp.2029-2035
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    • 2014
  • In this study, we conducted the adsorption equilibrium and batch experiments of dissolved organic carbon (DOC) in the wastewater by granular activated carbon (GAC). The components of organic compound were Beef extract (1.8 mg/L), Peptone (2.7 mg/L), Humic acid (4.2 mg/L), Tannic acid (4.2 mg/L), Sodium lignin sulfonate (2.4 mg/L), Sodium lauryle sulfate (0.94 mg/L), Arabic gum powder (4.7 mg/L), Arabic acid (polysaccharide) (5.0 mg/L), $(NH_4)_2SO_4$ (7.1 mg/L), $K_2HPO_4$ (7.0 mg/L), $NH_4HCO_3$ (19.8 mg/L), $MgSO_4{\cdot}7H_2O$ (0.71 mg/L), The adsorption characteristics of DOC in synthetic wastewater was described using the mathematical model through a series of isotherm and batch experiments. It showed that there was linear adsorption region in the low DOC concentration (0~2.5 mg/L) and favorable adsorption region in high concentration (2.5~6 mg/L). The synthetic wastewater used was prepared using known quantities of organic and/or inorganic compounds. Adsorption modelling isotherms were predicted by the Freundlich, Langmuir, Sips and hybrid isotherm equations. Especially, hybrid isotherm of Linear and Sips equation was a good adsorption equilibrium in the region of the both the low concentration and high concentration. In applying carbon adsorption for treating water and wastewater, hybrid adsorption equation plus linear equation with Sips equation will be a good new adsorption equilibrium model. Linear driving force approximation (LDFA) kinetic equation with Hybrid (linear+Sips) adsorption isotherm model was successfully applied to predict the adsorption kinetics data in various GAC adsorbent amounts.

Effect of L-ascorbic acid on the degradation of aflatoxin $B_1$ (아스콜빈산에 의한 Aflatoxin $B_1$의 파괴에 관한 연구)

  • Park, Kun-Young;Kweon, Mee-Hyang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.16 no.1
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    • pp.1-9
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    • 1987
  • Large amount of aflatoxin $B_1(AFB_1)$ is disappeared in the presence of L-ascorbic acid(AA) in buffer solution at pH values from 1 to 7 during 5 days of Incubation at $37^{\circ}C$. $AFB_1$ was quite stable at pH's between 5 and 7 when AA was absent(control), however, $50{\sim}60%$ of APB, was degraded in its presence after 5 days. The rate of disappearance of $AFB_1$ increased with a decreasing of pH in the presence of AA, even though $AFB_1$ in the control degraded increasingly with the decrease in $pH(pH{\leq}4)$. The level of $AFB_1$, decreased as the reaction temperature increased when $AFB_1$ reacted with AA. The aflatoxin could not be detected at all after 3 days when the reaction occurred at $60^{\circ}C$, while the aflatoxin was stable at $5^{\circ}C$ thoughout the reaction period. $90{\sim}96%$ of $AFB_1$ was found to be degraded in a far when $AFB_1$ reacted with AA plus different concentrations of $CuSO_4{\cdot}5H_{2}O$, showing remarkably faster rate than the control; however, different concentrations of L-cysteine instead of $CuSO_4\;5H_{2}O$ protected the degradation of aflatoxin and no $AFB_1$ was degraded for a day and resulted in less $AFB_1$ disappeared than the control. The degradation of $AFB_1$ was dependent on AA concentration and the rate of disappearance as the concentration of AA decrease, but $AFB_1$ concentration did not influence the rate. The product formed when $AFB_1$ reacted with AA was identified to $AFB_{2a}$ by using HPLC chromatographic examinations, and by UV spectrum of $AFB_1$ reacted with AA. The disappearance of $AFB_1$ was correlated well in the appearance of $AFB_2a$. From the results, the degradation of $AFB_1$ in the presence of AA is probably due to one or more of the oxidative products of AA which was produced during the AA oxidation.

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Grain Yield and Nitrogen Use Efficiency due to Long-Term Fertilization in Paddy Rice (동일비료(同一肥料) 장기운용(長期連用)에 따른 벼의 수량과 질소이용효율(窒素利用效率))

  • Yun, Eul-Soo;Choe, Zhin-Ryong;Jung, Yeun-Tae;Park, Kyeong-Bae;Lee, Jae-Saeng
    • Korean Journal of Soil Science and Fertilizer
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    • v.32 no.2
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    • pp.109-114
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    • 1999
  • This study was carried out to obtain some information on the sustainability of paddy rice through the long-term variation of nitrogen use efficiency. The experiment was conducted during 30-year with the same amount of N, P, K and compost at Milyang, southern part of Korea. The results were as follows. Grain yield was increased significantly in the plots of compost incorporation only. However, yield productivity was decreased slightly in the plots with nil and unbalanced fertilization. The effects of rice straw compost on grain yield was not clear at the early crop years but was shown slightly at the late period of the experimental. The grain yield in the plots of compost incorporation at 30th crop year was come to about 80% of NPK plots. The amount of nitrogen uptaken by rice plant was the highest as $167kg\;ha^{-1}$ in NPK plus compost incorporation. Recovery efficiency)($RE_N$) was higher as 0.48~0.74 in compost incorporation plots than in other plots of balanced and unbalanced application. Average agronomic efficiency($AE-N$) and partial factor productivity from N fertilizer applied($PFP_N$) during 30 crop years in NPK plots was 12.8 kg/kg N and 37.7 kg/kg N, respectively, and difference of $AE-N$ and $PFP_N$ shown as indigenous soil nitrogen supply(INS) was higher as 28.4 kg/kg N in NPK + compost plot than NPK plot and was widened at the late period of experiment.

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Comparison of sheep erythrocytes and Korean native goat erythrocytes-rosette forming rate of pig peripheral blood mononuclear cells (돼지 말초혈액 단핵세포의 면양 및 재래산양 적혈구 rosette 형성능 비교)

  • Kim, Young-jin;Song, Hee-jong;Kim, Jong-myeon;Kang, Myeong-dai;Yoon, Chang-yong;Kim, Tae-joong
    • Korean Journal of Veterinary Research
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    • v.32 no.2
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    • pp.175-179
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    • 1992
  • To develope the methods for isolation and enumeration of lymphocyte subpopulations in pigs, we carried out the rosette-assay using sheep erythrocytes(SRBC) and Korean native goat erythrocytes(GRBC) as a target cells. To enumerate T lymphocytes, E-rosette methods were applied with RBC treated with various concentration of polymers such as Aet and Dex, singly or in combination. And to enumerate B lymphocytes, EAand EAC-rosette assay was adopted. The results were as follows; 1. E-RFR with polymer-untreated SRBC and GRBC was $32.9{\pm}7.9%$ and $31.3{\pm}9.4%$, respectively. On the other hand, RFR with 0.1M Aet plus 8% Dex treated SRBC and GRBC was increased about two-fold($67.8{\pm}7.4%$ and $69.8{\pm}8.5%$), respectively. 2. EA-RFR with SRBC and GRBC were $ 39.1{\pm}10.2%$ and $32.6{\pm}6.1%$, respectively. 3. EAC-RFR with SRBC and GRBC were $27.6{\pm}7.0%$ arld $21.0{\pm}3.2%$, respectively. These results showed that both SRBC and GRBC could be recommanded as a binding cells for rosetteassay to isolate of lymphocyte-subpopulations in pigs.

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Effects of Dietary Supplementation of Oriental Herb Extracts on Growth Performance and Proliferation of Splenocytes Under High Density Stocking Condition in Broiler Chickens (사료내 한방약제 추출물 첨가가 과밀사육환경 하에서의 육계의 성장과 면역세포 증식에 미치는 영향)

  • Choi, Hyoung-Seog;Kim, Ki-Hyun;Park, Sang-Hoon;Nam, In-Sik;Hwang, Seong-Gu;Nam, Ki-Taeg
    • Korean Journal of Organic Agriculture
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    • v.18 no.3
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    • pp.387-399
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    • 2010
  • This experiment was conducted to investigate the effects of dietary supplementation of oriental herb extracts (Alpha $Plus^{(R)}$ (AP)+Dried Foxglove Powder (DFP)) on growth performance and proliferation of splenocytes in broiler chicken raised under low or high density stocking conditions. A total of 240 male broiler chicks were randomly divided into four treatment groups with three replicates composed of ten birds in low density stocking groups and thirty birds in high density stocking groups. The four treatment groups were as follows: Cl (low density without AP and DFP); T1 (low density with AP 0.2% and DFP 0.03%); C2 (high density without AP and DFP); T2 (high density with AP 0.2% and DFP 0.03%). The feed intake of the high density stocking group was significantly lower than that of low density stocking groups during overall experimental period (p<0.05). The body weight of high density stocking groups was lower than that of low density stocking groups (p<0.05). The decrease of feed intake and body weight gain in growing stage (7~25day) under the high density stocking condition seems to be recovered in final stage (26~34day). Meanwhile dietary supplementation of AP+DFP in low and high density stocking groups tended to have higher daily body weight gain than control groups. The proliferation of splenocytes in treatment groups was significantly higher than control groups (p<0.05). In conclusion, the result of the present study suggested that the oriental herb extracts (AP+DFP) could be used as an alternative feed additive resources to improve growth performance and immune activity in broiler chickens.

Effects of Dietary Mulberry Leaf on Loperamide-Induced Constipation in Rats (식이뽕잎이 흰쥐의 Loperamide로 유도된 변비에 미치는 영향)

  • Lee, Jae-Joon;Lee, Yu-Mi;Jung, Seoung-Ki;Kim, Keun-Young;Lee, Myung-Yul
    • Food Science and Preservation
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    • v.15 no.2
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    • pp.280-287
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    • 2008
  • We investigated the effect of dietary mulberry leaf powder (MP) on loperamide-induced constipation in rats. Male Sprague-Dawley rats were given MP in their diets at a concentration of 0% 5% and 10% for 33 days. Rats were divided into 4 groups: normal diet group (NOR), normal diet and loperamide treated group (MPL0), 5% MP and loperamide treated group (MPL5), and 10% MP and loperamide treated group (MPL10). Constipation was induced by subcutaneous injection of loperamide (1.5 mg/kg body weight/day) for the final 5 days of the experiment Supplemental MP had no effect on the food efficiency ratio, but it reduced body weight gain and food intake in a concentration dependent manner. Administration of loperamide decreased food intake. MP had a concentration-dependent effect on decreasing total cholesterol, LDL-cholesterol, and triglycerides and on increasing HDL-cholesterol. Loperamide had no significant effect on serum lipid profiles. Loperamide decreased the number and wet weight of fecal pellets and fecal water content MP increased the number and wet weight of fecal pellets and fecal water content in a dose-dependent manner. In addition, MP increased gut transit time and transit speed, and the guts of mts treated with MP plus loperamide were longer than those of mts treated with loperamide alone. These results indicate that MP is an effective treatment for constipation.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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