• Korean Journal of Social Welfare Studies
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• no.39
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• pp.83-113
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• 2008

The purpose of the study is to explore the mental health social workers' experiences concerning client's self-determination by grounded theory, one of the qualitative method. Although a lot of previous studies has proved that the practitioners have suffered from the ethical considerations in their practice, on which the matter of client's self-determination is centered, little attention is paid to deep exploration of practitioners' real experience about those aspects. To carry out the research question, first, through literature reviews focusing on clarify the underlying issues about client's self-determination, three intrinsic clues are found out; incompetence, medical benefits, the harm to the third party. Data obtained by in-depth interview with 10 participants are analyzed by employing the methode developed by Corbin and Strauss, which could categorize the raw data into several high-level concepts and constructs. The findings of the study show that most practitioners would consider the clients as the intrinsic subject of self-determination. Therefore, in practice, they are trying to support the client's self-determination even within the some constraints. In addition, they also experience the clients' latent potential in actualizing autonomy and self-determination, and identifies the positive effect of self-determination not only on the client's self-help and mental health but also on the practitioners themselves. The results of the study clearly suggests that it is critical to provide the practitioners with adequate ethical education and training to help them to overcome their ethical suffering concerning clients self-determination.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.857-874
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• 1998

The objective of this study is to collect the opinions on the present condition and the improvement directions of urban health centers from and to make a comparison. Samples were drawn from the various sources of a district in seoul. 53 persons involved in district health's administration(the Members of a District Parliament, the senior officials of a District office, village chief) and 84 health center workers were surveyed with anonymous postal questionaires and 427 district private medical personnels with postal questionaires and 625 users of a health center with direct questionaires, from November 18 to 25, 1996. Additionally, 12,151 households were surveyed with self-reported questionaires including priorities on special district health services of health center, from September 1 to 7, 1996. The major findings were as follows : 1) Although the persons involved in district health administration tend to put lower priority on health service over other community activities, they well acknowledged the importance of health center. But health center workers strongly acknowledged the importance of both health service and heath center. 2) As to the level of human resoureces, equipments and ammenities of Health Center commpared with private medical institute, the persons involved in district health's administration and health center workers responded that health center was higher in following order : 54.9%, 41.6%, 36.5% and 88.0%, 80.7%, 44.1%. 3) Concerning the priorities of health center's improvement, the persons involved in district health's administration replied in the order of reinforcement of proffesional health workers (43.3%), improvement of equipments and ammenities(28.3%), and the health center workers replied in the order of reconstruction of organization(24.1%), public health education and promotion(22.8%), reinforcement of proffesional health workers(21.0%). 4) Both the persons involved in district health's administration and health center workers replied that Ministry Health and Welfare, District office, health center were essential as the most critical organizations in the activation of Health Center's Function. 5) Persons involved in district health's administration and health center workers chose, as the most important health center's Function, medical treatment and prevention of infectious disease, and prevention of acute and chrone disease control and special district health service, respectively. Both Groups replied that fammily planning and parasite control are no longer in need. 6) As the future health service requiring reinforcement, every human resources parties considered health conselling, health line, sex education as the most imortant elements in public health education. Concerning the reinforement of other health services such as medical checkup and visiting nurses, every human resources parties showed more than 80% approval rate, but for oriental medical care service, the private medical personels showed relatively low approval rate(52.9%). Therefore the planning for reinforcement of health center's function requires the reflection of human resources party's opinion and the implication of system which can control and combine the differences in party's opinions.