• Journal of health informatics and statistics
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• v.43 no.4
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• pp.300-306
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• 2018

Objectives: The purpose of this study is to demonstrate empirically through a specialist AHP analysis what factors should be more important in the development of the public health care system. In addition, we will use Analytic Hierarchy Process (AHP) method for experts to achieve research purpose. Methods: The data analysis method of this study is as follows. First, we set up three metrics in order to measure the relative importance between the factors to be improved for the development of the public health care system and each of the sub-factors. A total of nine measurements (items) were set by combining the three measurement criteria for each measurement index. Second, the relative importance and priority analysis use the AHP analysis. Third, the subjects of this study were 15 experts in the field of public health care. The statistical processing was performed using the Expert Choice 2000 statistical program. Results: In order to development of the public health care system, experts ranked the most important as improvement in the systematic aspect of public health care (56%) as the first priority. Next, the relative importance analysis of the measurement items considering the multiple-weights of the sub-factors is as follows. The strengthen institutional improvement (revitalization of secondary public function hospital) was the number one, strengthen cooperation between agencies was the second, and Re-establishing the role of local public health care system was the third place. Conclusions: Considering the relative importance, factors that are considered to be important in the first place may not be improved as the best policy alternative due to limitations in spatial, temporal, financial, and institutional aspects. In this case, we suggest that we should choose the best policy alternative by using prioritization considering relative weights.

• Journal of Home Health Care Nursing
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• v.25 no.3
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• pp.153-163
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• 2018

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

• Journal of Home Health Care Nursing
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• v.12 no.1
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• pp.92-116
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• 2005

Purpose: This study was a predicative survey to provide home care clients with indwelling urinary catheters for furnishing basic educational material to their families by analyzing the family members' knowledge, educational needs and educational experience about indwelling catheter management. Method : The subjects consisted of 108 family members who cared for home care clients with indwelling catheters. Data were collected by home care nurses in nine hospitals in Pusan, who directly interviewed with them through questionnaires from Sep. 6th to 30th in 2004. The questionnaires for data collection were developed through pre-survey and reference review. The collected data was analyzed by using frequency, percentile, mean, variation, t-test, ANOVA on SPSS 10.1 package. Results : There were characters of home care clients with indwelling catheters: women(67.6%) were more than men; the average age of them was $69.60{\pm}14.99$ years old; neurogenic and cerebrovascular diseases(80.0%) were the most common disease group; 81.5% of them were totally dependent on others in terms of level of activity. Home care clients' families had these characters: women(76.9%) were more than men; the average age was $54.5{\pm}13.70$ years old; 46.3% of them were parents or sons or daughters in terms of relation with patient; tl1e average care period was $39.8{pm}34.20$ months. Level of knowledge about indwelling catheter management of the family members were 69.8% and its mean were $20.24{\pm}4.53$. Educational needs were 90.9% and its mean were $14.55{\pm}3.56$. Educational experience were 53.3% and its mean were $8.53{\pm}4.30$. 'Complications in using an indwelling catheter', 'Symptoms to call for a home care nurse' and 'Method to attach an indwelling catheter' were high ranked in both educational needs and educational experience. 'Anatomy of urinary tract', 'Functions of urinary tract' and 'Catheter placement' were low ranked in both educational needs and educational experience Level of knowledge about indwelling catheter management of the families showed a significant difference according to their age(F=5.35, p=0.01). Educational needs showed a significant difference according to care period(F=3.06, p=0.04). Conclusion: the family members' level of knowledge and educational experience about indwelling catheter management and their educational were not sufficient while their educational needs were high. In other words although the family members were acknowledged education needs, but the care for the patients with indwelling catheter weren't performed well because of their lack of related knowledge. Therefore systematic educational programs about indwelling catheter management for home care clients and their families should be made on the base of this study.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.507-516
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• 2000

This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.118-132
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• 2017

This study developed key elements of dental service guidelines for the disabled patients. In order to provide consumer-oriented service guidelines for the dental patients with disability, service design method was applied. Using service design method guided by the double diamond design process, this study implemented consumer survey, observation, and contextual interviews for consumers' needs assessment. And customer journey map, mind maps, and blueprints were utilized to visualize consumer needs and guidelines for dental care services for the disabled. According to the study, disabled consumers have needs for expertise of the medical staff, dental care institutions specialized on the disabled, financial support, establishment of the facilities for the disabled, comfortable atmosphere in the institutions, and communication with medical staffs. Based on the needs of the disabled, 5 key elements of the dental care services were developed: convenience, expertise, empathy, financial support, and education and management. And service design guidelines were proposed to implement key elements of dental care services for the patients with disability. This study is significant in that it is the first attempt to apply the service design technique from the consumer perspectives in the field of dental care for the disabled. Furthermore the process of this study has become a reference that can be utilized and applied to other medical institution.

• Korean Journal of Social Welfare
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• v.57 no.1
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• pp.5-30
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• 2005

This article attempts to restructurize the current arguments on how to change the method of financing child care programme, which is currently under discussion in Korea. There has been a series of changes in Korean child care policy, such as the amendment of Child Care Act, the transition of its responsible administrations, adoption the child care policy as a national agenda. In these changes, new needs for child care financing method comes out with a new direction of child care policy and a plan of expansion of finances. That's the transition from 'facility-centered subsidy' to 'child-centered subsidy'. This article redefine it as the arguments about 'supply-side subsidy' vs. 'demand-side subsidy'. To analyse the different traits of two branches of arguments, this article reviews the social welfare models, and has come to the conclusion that the Burchardt's model is appropriate to explain the financing debates. Thus, the analysis the traits of the two perspectives is based on three dimensions i. e. service provision, financing and decision making according to the Burchardt's model. This also examines how the two sides is connected to the discussion of publicity and quality improvement of child care service. Through this approaches and analysis, this helps us restructurize the debates on the method of financing from the present superficial arguments.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.18 no.1
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• pp.25-31
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• 2014

Objective This study aims to understand the actual utilization of the oriental rehabilitation medicine center of the initial interdisciplinary medical care at the National Rehabilitation Center and to arrange proper development plans for more effective interdisciplinary medical services for future activation of interdisciplinary medical care. Method: The interdisciplinary patient status, composition of patient care, and major disease-related status were studied and analyzed for oriental rehabilitation medication relating to interdisciplinary medical care at the National Rehabilitation Center. Furthermore, the interdisciplinary status and its operating conditions were evaluated to devise a development plan for the National Rehabilitation Center. Results: As a result of the analysis of oriental rehabilitation medical care diagnosing status utilization at the National Rehabilitation Center regarding interdisciplinary medical care, the ratio of the number of those receiving interdisciplinary oriental rehabilitation medical care was less than half of the total receiving interdisciplinary care. As the major disease status from the patients of interdisciplinary care, stroke patients covered the large majority, and musculoskeletal pain patients covered the majority of outpatients. The establishment of additional oriental medication departments and assigning of interdisciplinary coordinators were presented as the goals of a development plan for the manpower and structural side of interdisciplinary medical care at the National Rehabilitation Center. On the institutional and systematic side, improvement in the interdisciplinary hierarchy and interdisciplinary model development based on the number of patients per disease was proposed. In addition, operation on ward bedding and construction of interdisciplinary EMR medical care is necessary on the medical and administration service side. Conclusion: To understand the actual utilization and to arrange development plans aimed at constructing a safe and effective interdisciplinary hierarchy for interdisciplinary medical care at the National Rehabilitation Center, patient-centered care needs to be implemented.

• Journal of Families and Better Life
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• v.31 no.5
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• pp.143-157
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• 2013

This study used a qualitative research method to comprehensively deal with child care training in depth with the following content: the goals of child care teachers preparing for practical training; how they perform and feel about their roles throughout the training period as child care teachers; and their evaluation after the training period. A total of 10 people participated in the research and the training activities of child care teachers were qualitatively explored based on the results. The research findings are as follows. First, child care teachers have expectations for prospective teachers and take time for self-evaluation while preparing for teaching. Also, child care teachers set a goal of helping prospective teachers develop into outstanding teachers and have expectations for it. Second, child care teachers evaluate prospective teachers by treating them as colleagues while teaching them. Furthermore, child care teachers consider themselves as educators who train and produce child care professionals. Prospective teachers define their roles as assistants and learners in the actual educational scene. In addition, child care teachers feel a sense of pride by performing as hands-on training teachers. At the same time, they reflect on themselves by evaluating their duties as educators in their relationships with prospective teachers. Third, child care teachers suggested the need for changing the training system for themselves and prospective teachers after training. In addition, they argued that the gaps between school education and the actual educational scene should be reduced through solid training for acquiring new knowledge and information in both places in accordance with the rapidly-changing child care environment. Finally, the suggested the necessity of establishing a standard training curriculum and educational programs within their institution.

• Health Policy and Management
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• v.30 no.1
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• pp.92-99
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• 2020

Background: The purpose of this study is to analyze the effect of the income support allowance policy for the care workers on wage level. Methods: The analysis data was constructed using database (DB) of long-term care institution, DB of long-term care personnel status, and DB of health insurance qualification and contribution possessed by National Health Insurance Services. We analyzed the wage status of care workers 2009 to 2016 through basic analysis. We used the difference-in-difference analysis method for the workers who worked in the same institution from 2012 to 2013, The effects of the income allowance policy on wage increase were analyzed. Results: As a result of the net effect of the income support allowance policy, the monthly average wage of the care worker increased by 25,676 won and the hourly wage increased by 478 won. As a result of the analysis, it can be confirmed that the income support allowance policy has achieved some of the goals of raising the wage level of the care workers, and the effect of raising wages for other occupations in the long-term care business can be confirmed. Conclusion: The low wage problem of long-term care workers such as care workers is not the only problem in Korea. In other countries, there are various wage support policies for employees. In particular, it is necessary to refer to the improvement in the treatment of care workers in Japan and wage pass-through in the United States. In addition to wages, there is a need to promote policies to provide employment motivation through efforts to improve their social status and improve their job status and career development for employees in long-term care facilities.

• Journal of Home Health Care Nursing
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• v.19 no.1
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• pp.63-73
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• 2012

Purpose: The purpose of this study was to determine the factors related to the social support, family and friend support as well as home care nurse support, in family caregivers of patients with home care service. Method: The participants were 111 family caregivers of patient, who were receiving home care services from home health care centers of 3 different general hospitals located in Seoul. The data was collected, using self-administered questionnaires. Result: The level of family and friend support varied significantly according to patients' mental status, period of home care nursing, frequency of home care service, caregiver's education level, family income, and family functioning level. On the other hand, home care nurse support varied significantly according to patients' mental status, caregiver's age, existence of interchangeable family caregivers, and family functioning level. There was a significantly positive correlation between the social support the family caregivers' perceived and family function while there was a negative correlation between family and friend support and the period of home care service. Conclusion: Thus, the establishment of nursing interventional program, with understanding of their social support, is needed for both patients and their caregivers.