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Resource use of the Elderly in Long-term Care Hospital sing RUG-III (요양병원 입원노인의 환자군 분류에 따른 자원이용수준)

  • 김은경
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.275-283
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    • 2003
  • Purpose: This study was to classify elderly in long-term care hospitals for using Resource Utilization Group(RUG-III) and to consider feasibility of payment method based on RUG-III classification system in Korea. Method: This study designed by measuring resident characteristics using the Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. The data were collected from 382 elderly over sixty-year old, inpatient in the five long-term care hospitals. Staff time was converted into standard time based on the average wage of nurse and aids. Result: The subjects were classified into 4 groups. The group of Clinically Complex was the largest(46.3%), Reduced Physical Function(27.2%), Behavior Problem(17.0%), and Impaired Cognition(9.4%). The average resource use for one resident in terms of care time(nurses, aids) was 183.7 minutes a day. Relative resource use was expressed as a case mix index(CMI) calculated as a proportion of mean resource use. The CMI of Clinically Complex group was the largest(1.10), and then Reduced Physical Function(0.93), Behavior Problem(0.93), and Impaired Cognition(0.83) followed. The difference of the resource use showed statistical significance between major groups(p<0.0001). Conclusion: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care hospitals in Korea.

The Validation of Standardized Nursing Care Plans Developed for Computerized Use in Clinical Practice (간호업무 전산화를 위해 개발된 표준화된 간호계획서의 타당성 검정)

  • 김용순
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.349-364
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    • 1991
  • Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.

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The Role of Breast Care Center in the Breast Reconstruction (유방재건에서의 유방센터의 역할)

  • Minn, Kyung Won;Park, Jin Hong;Park, Gul Gyoo
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.617-621
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    • 2007
  • Purpose: With the necessity of comprehensive care for the breast cancer patients, Breast Care Center of our hospital started to work in March 2004. This study examined the 3-year execution of Breast Care Center. The role of Breast Care Center was evaluated in aspect of clinical activities in quality and quantity. Methods: A retrospective review was carried out from 2001 to 2007 with breast cancer patients. The number and type of breast cancer surgery and breast reconstruction procedure were compared before and after Breast Care Center's foundation. Time required for the diagnosis and treatment was also compared. Regression analysis and T-test were used to identify the statistical significance. Results: The number of breast cancer surgery did not statistically increase compared with progressive increase of breast cancer. QUART(quadrantectomy, axillary dissection, radiotherapy) procedure statistically significantly increased and MRM(Modified Radical Mastectomy) procedure decreased for breast cancer surgery after foundation of Breast Care Center. The number of breast reconstruction procedures statistically significantly increased. The number of immediate TRAM free flap (Transverse Rectus Abdominal muscle free flap) procedures has grown 3.8 times after foundation of Breast Care Center. The time required for diagnosis and treatment was also shortened. Conclusion: After foundation of Breast Care Center, the number of breast reconstruction surgery increased, while the counselling time in breast reconstruction was reduced. Breast Care Center provided a prompt and comprehensive care to the breast cancer patients through the multidisciplinary therapeutic approaches.

Measuring Workload of Home Visit Care Activities Using Relative Values (방문요양 행위 업무량의 상대적 가치 측정)

  • Han, Seong-Ok;Park, Eun-Cheol;Kang, Dae-Ryong;Kang, Im-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.331-338
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    • 2008
  • Objectives : The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. Methods : The participants of this study were 126 home-helpers of 50 home visit care agencies at the 2nd Long-term Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. Results : Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. Conclusions : The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.

A Study on the health care with eating food and exercise (음식섭취와 운동를 통한 건강관리 유형 연구(전문가 집단을 중심으로))

  • 김기영
    • Culinary science and hospitality research
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    • v.5 no.1
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    • pp.27-48
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    • 1999
  • This article a little bit lack of elements for the basis of study of health care in the respect of taking a certain expert group as the sample. However researcher chose people who is in same situation with himself and tried to make clear how to do for their behavior of health care to know that how the experts groups are taking care of their health. For the study, the main aim of this article is studying the health care situation of experts group which is taking crucial role in the economy, society and cultural field. When it comes to the experts group's health care by eating habits and exercise related program is, first, it indicates that most people are eating for their health, lives and work through the analysis of responds; they eat food for their health and their health, lives or task.(Surely they family-centered structure. Third, 78% of 40s group responded that they enjoy finding good restaurants while 20s to 30s are enjoying fastfood and instant food instead of Korean traditional foods. fourth, health care by the exercise is done in one or half one hour and the dependant exercises like jogging or swimming which can be done whenever they have time are perferred to group exercise. It's desirable that one has to take care of himself with systematic and effective way. But it's very difficult and care for most people to take care of themselves, so they have to make the program and practice it systematically. The result from this study shows that practicing the health related program rationally, at the same time increasing leisure time and doing dependant or group exercise, taking a walk, and various kind of exercise considered spending money are more common than eating foods for health care. These are regarded as a desirable phenomenon in terms of the health care.

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The Effects of Education on Knowledge and Confidence in Postpartal Self-care and New baby care (산모교육의 효과 측정 - 산욕기 자가간호와 신생아양육에 대한 지시와 자신감을 중심으로-)

  • Kwang, Youn-Hee;Lee, Mi-La
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.284-297
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    • 1996
  • A maternity ward in a hospital in Seoul has an educational program for postpartal mothers since its opening, but evaluation on the program has not been done. This study was to find whether the educational program contributed to increase of knowledge and confidence of the post-partal mothers in the area of postpartal self-care and the newborn baby care or not. This study aimed at improvement of the educational program for posrpartal mothers and the newborn babies. Subjects were 40 primiparae who were admitted to the obstetric ward in a general hospitals in Seoul from August 20th to September 10th, 1995. Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery, gave a birth to a healthy baby, and agreed to participate in this study. All subjects were well educated and were in well-to-do group. Most of them received antenatal care adequately. They were tested on knowledge and self-confidence in the area of postpartal self-care and infant care two times, one at the admission time and the other prior to discharge. After the first test, nurses in a maternity ward and nursery taught them on postpartal self-care and infant care. Education consisted of a 1 hour planned program and incident teachings done at bed side. Four tools were developed by authors based literature review. The test tool for knowledge of postpartal self-care consisted of 15 items which included the definition of postpartum, dangerous symptoms in postpartum, lochia, time to begin coitus, postpartum exercise, sitz-bath, and perineal care. The test tool for self-confidence in postpartal self-care included such items as emergency care on dangerous symptoms in postpartum, sexual life and contraception after postpartum, self-confidence in postpartum exercise and perineal care. The test tool for knowledge of newborn baby care consisted of 18 items which included bathing, umbilical cord care, vaccination, breast feeding, abnormal symptoms of neonate. The test tool for self confidence in the newborn baby care included umbilical cord care, vaccination, breast feeding, emergency care for baby. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. SAS / PC (Release 6.04 for DOS) program are as follows. 1. Mothers' knowledge of postpartal self-care increased significantly after education (t=10.04, df=38, p=0.0001). 2. Mothers' self-confidence in postpartal self-care increased significantly after education (t=6.53, df=38, p=0.0001). 3. Mother's knowledge of the newborn abay care increased significantly after education (t=9.74, df=38, p=0.0001). 4. Mothers' self-confidence in the newborn baby care increased significantly after education(t=8.22, df=38, p=0.0001) Suggestions for further studies and nursing practice were as follows. 1. We suggest studies by randomized control-group pretest-posttest design or nonequivalent control group pretest-posttest design will be done. 2. We suggest follow-up studies to find if mothers's confidence will last or not after discharge. 3. We suggest general hospitals to establish a phone-counseling system.

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Time Spent on Housework by Employed Wives (취업주부의 가사노동시간에 관한 연구)

  • 한경미
    • Journal of Families and Better Life
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    • v.7 no.2
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    • pp.1-13
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    • 1989
  • The purpose of this stud is : (1) to figure out the amount of time being usually spent on the housework performed by the employed wives and (2) to find out factors influencing the total and the specified housework time. The major findings are the following : 1) A employed wife spends 374 minutes(6.2 hours) on the average a day on the housework. Compared with research results of the past, this shows little difference, and less 157 minutes than full time homeworker. Time connected with meals is 123minutes, clothing (68), management and marketing(64), family care(61), and housing care(58). 2) Family environment variables (the wife's education level, wife's employment status, income, young child's age and presence of employed housekeeper) significantly differentiates the housework time. In general, a wife with higher SES level spends less time for housework except family care. 3) Housework related variables (planning, preference, performance competency, and performance stand rd) significantly differentiate the specified houseworks. High planning, preference, and performance competency do not necessarily diminish the housework time except routine houseworks. High performance standard causes her to spend more time. 4) A wife' sex-role attitudes and a husbands attitudes perceived are more traditional, she spends more time.

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Analysis on Daily Routine Types Based on Daily Care Plans of Child Care Centers and the Characteristics of Child Care Programs According to Daily Routine Types (일일보육계획안에 따른 일과유형 분류 및 일과유형별 보육프로그램의 특성)

  • Park, Chan Hwa;Rha, Jong Hay;Kwon, Yeonhee;Choi, Mock Wha
    • Journal of the Korean Home Economics Association
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    • v.51 no.1
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    • pp.45-57
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    • 2013
  • This study explores the types of daily routines in child care centers based on the time planned for indoor free choice activities, outdoor activities, group activities and nap/rest. The daily routine plans of 63 classes of 0 to 2-year-olds and 51 classes of 3 to 5-year-olds were cluster analyzed. Also, openness and closeness of child care programs as well as the most participated indoor/outdoor activities were examined using questionnaires developed for teachers. The results were as follows: First, teachers planned the most time for free play choice activity and comparatively less time for outdoor play during the day. Time for rest and naps were planned more for 0-2 year-olds whereas group activities were planned more for the 3-5 year-olds. Second, 3 daily routine types were found in the daily plans of child care centers, such as "Low-Activity Oriented," "Free Choice Activity Oriented" and "Group Activity Oriented" in 0 to 2-year-old classes and 3 to 5-year-old classes. Also, "Group Activity Oriented" type in 0 to 2-year-old classes showed more "closed" child care programs than the "Free Choice Activity Oriented" type. However, no difference was shown among the 3 types of daily routines in the openness and closeness of 3 to 5-year-old child care programs. Finally, all children, regardless of the types of daily routine, participated most in block activity and role play indoors and fixed-play equipment, sand play and free play outdoors.

Analysis of Risk Factors of Musculoskeletal Disorder for Child-care Teachers' Job

  • Kim, Jin
    • Journal of the Ergonomics Society of Korea
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    • v.30 no.3
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    • pp.409-418
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    • 2011
  • Objective: This study was performed to evaluate the child-care teachers' job in relation to physical work. Background: Child-care teacher is directly related to the quality of child care. And their physical activity is higher than general education teachers because the proportion of day care is high. But analyzes of child-care teachers' job burdens and the work environment associated with physical activity is not well established. Method: To conduct this study, the child-care teachers' job was classified into 18 physical works. After classification, posture was evaluated by ergonomic posture evaluation schemes of OWAS, RULA, REBA and evaluated for each physical part. Next, musculoskeletal subjective symptoms were analyzed. Results: The results showed the following: The highest assessment on the posture evaluation was "helping children to ride a school bus", "feeding: meal/snack", "brushing children's teeth" and "arrangement of nap-stuff". The rank of high-risk assessment on the neck/trunk/leg part was arranged by: "feeding: meal/snack", "helping children to ride a school bus", "making nap", "arrangement nap-stuff" and "brushing children's teeth". The rank of high-risk assessment on the upper limbs part was arranged by: "helping children to ride a school bus", "the bust - group activity", "meal/snack time - preparing, feeding, arrangement", "nap time - preparing, arrangement", "brushing children's teeth", and "using the toilet". According to the results of each musculoskeletal subjective symptom, teachers ordered the pain area as follows: waist, shoulder, leg/feet, and neck, and they showed more pain on trunk than the upper limbs. Conclusion: To sum up the results from ergonomic posture evaluation and a subjective symptom, the following are high working pressures: "feeding: meal/snack", "the bust - group activity", "making nap", "brushing children's teeth" with deep bending and waist twisting, "helping children to ride a school bus", "brushing children's teeth" with lifting shoulder; "meal/snack time - preparing, arrangement", "nap time - preparing, arrangement", and "using the toilet" with moving or an up-down position in their job. Application: The results of this study might be information for improvement of the child-care teachers' job environment.

Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby (산욕기 첫 출산 부부를 위한 산후관리 행동기술 강화 프로그램 효과)

  • Park, Meera;Park, Kyung Min
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.137-148
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    • 2019
  • Purpose: This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby. Methods: The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used. Results: For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004). Conclusion: This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.