The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.
Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.8
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pp.113-126
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2016
The main purpose of this study is to provide the necessary information for educational intervention by discovering the components and factors related to the adaptation experience of male students in the department of nursing. The participants were seven male nursing students. Data were collected from in-depth interviews, and the results were analyzed by the Giorgi's phenomenological analysis method. The main components of adaptation experience of participants were summarized into four categories: 'hopes and expectations for the future careers,' 'conflicts and wandering under realistic issues,' 'compromise and emotion management,' and 'efforts for self-growth.' Causative, accelerative, and recursive characteristics were shown among these components. The adaptation process was structured in the temporal context. The results suggest that for amicable adaptation, internal controls, such as 'improving willpower,' 'inspiring solid career awareness,' and 'selecting adaptation strategy' were all critical. Moreover, the support of families, relatives, college seniors, and department professors were revealed as the factors that help in the adaptation experiences. Based on the results, further studies are required to identify the dropout rates by maladaptation of male nursing students, and analyze possible factors that contribute to dropout and maladaptation. In addition, it is necessary to construct various coping methods and practical support systems, as well as to develop appropriate educational programs.
This study investigated how drivers' cognitive characteristics, such as perception-motor skills and safety-seeking motivation; personal characteristics, such as sensation-seeking disposition coping with physical and social dangers; their self-perceived driving ability; and their normal driving behaviors influence the number of driving violations. 352 drivers participated in the study. MANOVA was performed in order to test the differences in their driving behaviors according to their level of sensation-seeking disposition and driving ability, and Structural Equation Modeling was used to examine the causal relationships among their demographic characteristics, sensation-seeking dispositions, driving ability, driving behaviors and the number of violations. The results indicated that drivers who had higher perception-motor skills seemed to be careful with pedestrians. From the results, drivers who had somewhat higher safety-seeking motivation tended to violate fewer traffic regulations intentionally or accidentally and showed more positive driving behaviors. Furthermore, drivers who had higher perception-motor skills, higher sensation-seeking disposition, and lower safety-seeking motivation had a tendency to violate intentionally more traffic regulations. The older drivers showed driving behaviors that were careful of pedestrians. The drivers who had higher sensation-seeking disposition and longer driving careers violated more traffic regulations, both intentionally and accidentally. Results from LISREL indicated that the predictive variables directly or indirectly influenced on drivers' violation numbers ($x^2$=341.62(p=.00), GFI=.94. RMR=.10).
Jin, Dae-Gu;Kang, Yune-Sik;Cho, Yong-Kee;Lee, Sang-Won;Kim, Jong-Yeon;Ahn, Soon-Gi;Chun, Byung-Yeol;Yeh, Min-Hae;Kam, Sin
Journal of Preventive Medicine and Public Health
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v.36
no.2
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pp.153-162
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2003
Objective : This study was conducted in order to investigate professional job perception, job stress and job satisfaction in doctors. Method : The authors conducted a survey using a self-administered questionnaire, conducted between August and September,2001. The study subjects were 457 doctors practicing at local clinics in Daegu City. Results : For the professionalism scale, the score for 'sense of calling to field' and 'feeling of autonomy' were relatively high, Age, working hours per day, and perception of socioeconomic status significantly influenced the professionalism scale scores (p<0.01). For the job stress scale, the scores for 'clinical responsibility/decision' factor were the highest of all the surveyed factors. Working hours per day significantly influenced the job stress scores (p<0.01). To investigate the overall relationship between the variables, the authors conducted a linear structural equation model analysis. The equation was statistically appropriate and a good fit. The job stress, and the professionalism factors, respectively influenced job satisfaction negatively and positively (T>2.0). The working hours per day and status perception also influenced their job satisfaction (T>2.0). Conclusion : To promote the iob satisfaction of doctors, the development of coping tools and other intervention methods are needed to increase doctor's professional job perception and reduce their job stress. Further studies are required to understand the characteristics of job satisfaction and for its promotion with doctors.
Objective : This study aimed to understand the burnout experience of hospital occupational therapists through phenomenological research. Methods : We conducted in-depth interviews with 6 occupational therapists working at hospital for 8 weeks. The data were analyzed using the Palangsae 2.0 software to derive meaning through the process of transcription and data entry, coding, and topic creation. Results : From the collected data, 14 sub-themes, 9 theme clusters, 3 categories were identified. The cause of burnout was confirmed as being due to therapy-related work and workplace conditions. The impacts of burnout on individual life were psychological in nature and also included being an adverse, influence on others. The coping strategies to deal with burnout were enrichment of personal life, self-awareness and philosophy, conscious approach, social support, and setting new goals for life. Conclusion : We suggest that spontaneous efforts are needed by occupational therapists in order to alleviate the conflicts of job identity. In addition, organizational regulations and programs and the establishment of horizontal organizational cultures are required to overcome and prevent burnout of occupational therapists.
This study was done to define nursing diagnose and to test the validity of the characteristics for patients with cerebrovascular accidents being seen at home by home health care nurses. This study was a descriptive study. The sample consisted of 10 experts(professors and home health care nurses) who had had a variety of experience using nursing diagnoses in clinical practice, and 336 nurse progress notes for 18 patients with cerebrovascular accidents. First, 32 nursing diagnoses were defined by the analysis of 336 nurse progress notes, and ten nursing diagnoses were selected according to a criteria of frequency and four nursing diagnoses from home health care clinical practice. Second, content validity was examined by an expert group which considered the sign / symtoms of the fourteen nursing diagnoses. The instrument used for this was a checklist for sign / symtoms based on the nurse progress notes and literature : Carpenito(1993), Kim Cho Ja et al (1994), Lee Sun Ok et al.(1994), Kim Mae Ja et al. (1992), Seoul University Hospital (1993) , Kim Mi Ja et al. (1991). The data were collected from March 1995 to April 1995. Data were analyzed using Content Validity Incidence where if 80% or more of the expert group agreed, characteristics were defined as a major sign/symtoms, if between 50% and 79% of the expert group agreed with the characteristic it was defined as a minor sign / symtoms. The results of this study are summarized as follows : 1. Thirty-two nursing diagnoses related to patients with cerebrovascular accidents were defined. There was a high frequency for the following : 'Potential for disuse syndrome (61%)', 'Impaired physical mobility(50%)', 'Impaired skin integrity (44.4%)', Potential for aspiration(33.3%)', 'Potential for infection: respiration(33.3%)', 'Self-care deficit : bathing /hygine(27.8%)', 'Ineffective family coping(22.2%)', 'Potential for trauma(22.2%)', 'Alteration in nutrition: less than body requirements(22.2%)'. The following diagnoses were also used in home health care clinical practice : 'Anxiety in family (50%)', 'Caregiver fatigue(27.8%)', 'Ineffective treatment behavior (22.2%)', 'Ineffective Levin tube management and Levin tube feeding(22.2%)'. Fourteen nursing diagnoses were selected. 2. Ten of the nursing diagnoses for patients with cerebrovascular accident were listed as nursing diagnoses by NANDA but four nursing diagnoses were new nursing diagnoses used in home health care clinical practice. 3. Characteristics of the ten Nursing Diagnoses from NANDA were developed from the sign /symtoms in the literature and in the nurse progress notes. These characteristics was verified as major or minor sign / symtoms by the expert group. 4. Characteristics of the four nursing diagnoses used in home health care were not defined by the literature but only by the nurse progress notes and verified as major or minor signs /symtoms by the expert group. On the basis of the findings of this study, the following recommendations are made : 1. Continual study is necessary to identify other signs /symtoms not verified in this study. 2. It is necessary to use verified signs /symtoms in home health care clinical practice. 3. It is necessary to define related factors which define each diagnoses in this study. 4. It is necessary to develop of standardized nursing are plans which include defined signs and symtoms. 5. It is necessary to study the outcomes of the standardized nursing care plans.
Journal of Agricultural Extension & Community Development
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v.16
no.2
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pp.363-384
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2009
This study aimed at finding directions for Korean agriculture to establish a new paradigm of sustainable development. Various problematic issues and concerns in the environment necessitate the transformation of Korea's development paradigm from unconditional growth to "Green Growth" through new policies on green value and review of various advanced researches. In this research, the environment-friendly agriculture's problems, particularly in agribusiness were analyzed. Drawing from Michael Porter's Value Chain Analysis, this research developed a value chain model in agriculture that reflects the environment and the present situations. Future directions in the agriculture sector were also discussed. Korea realized food self-sufficiency through the green revolution in the early 1970s. However, a lot of problems have also occurred, including ground and water pollution and the destruction of ecosystems as a result of the overuse of pesticides and chemical fertilizers. In the late 1970s, the growing interest on environment-friendly agriculture led to the introduction of sustainable methods and techniques. Unfortunately however, these were not innovative enough to foster environment-friendly agriculture. Thereafter, the consumers' distrust on agricultural products has worsened and concerns about health have increased. In view of this, the Ministry of Food, Agriculture, Forestry and Fisheries introduced in December 1993 a system of Quality-Certified Products for organic and pesticide-free agri-foods. Although a fundamental step toward the sustainability of the global environment, this system was not enough to promote environment-friendly agriculture. In 2008, Korea's vision is for "Low Carbon Green Growth" to move forward while also coping with climate change. But primary sectors in a typical value chain do not consider the green value of their operations nor look at production from an environmental perspective. In order to attain sustainable development, there is a need to use less resources and energy than what is presently used in Korean agricultural and value production. The typical value chain should be transformed into a "closed-loop" such that the beginning and the end of the chain are linked together. Such structure allows the flow of materials, products and even wastes among participants in the chain in a sustained cycle. This may result in a zero-waste sustainable production without destroying the ecosystem.
A review of this literature and discussions reveal a development of ideas concerning the elements of nursing models. The elements of a nursing model are the nurses view of the human being, nursing's goal, and nursing activities. It has long been recognized that human beings, at one time or another, require nursing care. Varieties of literature were reviewed in regard to the human being as recipient of nursing care through the theory development in nursing. Florence Nightingale initiated the modern era of nursing and described more clearly man as the recipient of nursing care. She looked at man as responding to the laws of nature whether the person was healthy or sick. Henderson added to Nightingale's concept of man , the recipient of nursing care by emphasizing that man is a whole, complete, and independent being. Her view is further specified by her enumeration of the activities the human being must perform. Johnson has developed a very comprehensive view of man as the recipient of nursing care. Man is a behavioral system which has a tendency to achieve and maintain stability in patterns of functioning. Like Nightingale, Johnson sees that similar patterns occur in both health and illness. Johnson postulates that the whole behavioral system of the human is composed of eight sub-systems: affiliative, achievement, aggressive, dependency, eliminative, ingestive, restorative, sexual. Roger's main contribution to the development of nursing models was her emphasis upon unitary man. She pointed out that man is a unified whole, possessing his own integrity and manifesting characteristics that“are more than and different from the sum of his parts.”Rogers focuses on the life processes of the human and points out that these processes have the following characteristics. Wholeness, openness, unidirectionality, pattern and organization, sentence, and thought. According to Roy, man is a biopsychosocial being in constant interaction with a changing environment. To cope with this changing environment, man has certain innate and acquired mechanisms. Man's ability to respond positively or to adapt, depends upon the degree of the change taking place and the state of the person coping with the change. When she analyzes man as an adaptive organism she further describes man as being composed of four adaptive modes: physiological needs, self-concept, role function, and interdependence. Based on the literary review through the theory development in nursing, general approach by a unified nursing model to a view of the recipient of nursing care may be stated as follows: Man is a unified whole composed of subsystems with a flexible and normal line of defense; his internal regulating mechanisms help him to cope with a changing environment; he functions by the principles of homeodynamics.
In accordance with the increase of the importance of information security, organizations are making continuous investments to develop policies and adapt technology for information security. Organization should provide systemized support to enhance employees' security compliance intention in order to increase the degree of organization's internal security. This research suggests security policy goal setting and sanction enforcement as a method to improve employees' security compliance in planning and enforcing organization's security policy, and verifies the influencing relationship of Theory of Planned Behavior which explains employee's security compliance intention. We use structural equation modeling to verify the research hypotheses, and conducted a survey on the employees of organization with information security policy. We verified the hypotheses based on 346 responses. The result shows that the degree of goal setting and sanction enforcement has positive influence on self-efficacy and coping efficacy which are antecedents that influence employees' compliance intention. As a result, this research suggested directions for strategic approach for enhancing employee's compliance intention on organization's security policy.
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