• 한국호스피스완화의료학회:학술대회논문집
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• 한국호스피스완화의료학회 2004년도 정기총회 및 하계학술대회
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• pp.103-105
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• 2004

Every one experiences death one day, however no one can hows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning i.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28, 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. Every one experiences death one day, however no one can knows exactly what it is because people ran not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning i.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung lancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization.

• Journal of Korean Academy of Nursing Administration
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• 제1권1호
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• pp.132-146
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• 1995

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

• Korea Journal of Hospital Management
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• 제9권3호
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• pp.128-142
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• 2004

To evaluate the effects of critical pathway on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a tertiary care academic medical center. The basic research design is a retrospective case-control comparative study. 470 patients of gastrectomy were included in the study; 180 before pathway development (control), 163 right after pathway implementation (path group I) and 127 one year after pathway implementation (path groupII). 476 patients of modified radical mastectomy were also analyzed to examine whether the reduction of the length of hospital stay is from the hospital-wide trend or due to the critical pathway. Death after operation, ICU stay, unplanned re-operation, readmission after discharge, the length of hospital stay and cost were analyzed. 2-test, one-way ANOVA, Bonferroni and Turkey's test were used for statistical analysis. (1) There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. (2) The length of hospital stay was 13.0 days in control group, 12.2 days in path group I and 10.0 days (p<0.01) in path groupII. (3) The total costs during the hospital stay were reduced. However the cost per day was significantly increased from reduction of hospital stay (358,488won in control, 366,017won in path group I and 413,220won (p<0.01) in path groupII). Critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제20권10호
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• pp.395-405
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• 2019

Korea is undergoing a change in its population structure, due to economic development, falling birth rates and the development of health care. As the population ages, the number of elderly people who have difficulty in daily life such as dementia and paralysis increases every day. The growth of nuclear families and the increased participation of women in society make it difficult to take care of elderly people who need long-term care at home. As the social problems resulting from this have emerged as serious problems, the government enacted and implemented the Long Term Care Insurance Act to improve the quality of life for the elderly subject to long-term care and to ease the burden of family support in order to solve such problems. Therefore, the present study explores ways to improve legal and institutional aspects, and seek mental and psychological measures for the stability of old life as well as the physical health of welfare.

• Women's Health Nursing
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• 제1권1호
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• pp.5-27
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• 1995

One of the important tasks for new parents, especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the health development of the child and the well-being of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. The purpose of this longitudinal descriptive correlational study is to investigate the changes of the mother - infant interactions from postpartum 1 day to postpartum 8weeks of the transition to parenthood. The aim was to contribute to the development of theoretical under standing on which to base care toward promoting the quality of maternal - infant interaction. Data were collect ed directly by the investigator and at rained from Jul, 1, 1990 to Jun 8, 1991, Subjects were a random sample of 44 mothers, 44 who had a normal delivery (but with out other perinatal complications) at four general hospitals in Seoul. Instruments used were the Stainton Parent-infant Interaction Scale (1981). The first observations were made in the delivery room, followed by day 1, day 2, day 3 and 2 weeks, 4 weeks, 6 weeks and 8 weeks after, birth, for a total of 8 contacts. Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was don by computer using as SPSS program and included, Paired t-test, t-test and Pearson Correlation coefficient ; the results were as follows. 1. The daily maternal-infant interaction score for the initial contact ofter birth to 8 weeks postpartum had the lowest average score 5.21 and the highest 8.02(in a range of 0-10). This subject group of mothers needed Extra nursing supporting to promote their maternal-infant interaction. 2. The daily scores for the maternal-infant interaction tended to rise, showing a gradual improvement over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day (p=0.000) and from the fourth to sixth weeks ofter birth.(p=0.000) 3. When the seven items of maternal-infant interaction were evaluated items of maternal-infant inter action were evaluated separately, "Care taking for the baby" had the highest average score, 1.60(in a range of 0-2) and "Speaks to baby" the lowest, 0.8. All items, suggested the subjects' need of nursing intervention to promote maternal-infant interaction 4. There were positive correlations between certain general characteristics, namely, both a higher economic status (p=0.027) and breast feeding (p=0.021) and maternal-infant interaction.

• Korean Journal of Hospice Care
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• 제2권2호
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• pp.49-57
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• 2002

Background: The purpose of this study is to find out to how much influence religion had on the quality of life in patients admitted to the hospice facility at Saemmul's House. Terminal cancer patients were assessed one to two weeks after admittance to Saemmul's House. Metohd: The subjects of this study were numbered at 75 patients and were admitted to the hospice facility at Sammul's house between January 2002 and July 2002. The data regarding quality of life was collected using a questionnaire prepared by the sammul Hospice and were analyzed by means of ANOVA and T-test. Result: As a result of this study, there was no noticeable difference in quality of physical, psychosocial life between the patients with conviction of salvation and the other patients. However, it shows that the former enjoyed a higher spiritual quality of life than the latter. In case of baptized patients and unbaptized patients, there were no differences in terms of physical and psychosocial quality of life, but the baptized patients demonstrated a higher spiritual quality of life. After admittance, patients were grouped by duration of conviction of salvation I.e., those that believed more than 5 years and those that believed less than 5 years. In terms of physical, psychosocial quality of life, there was little difference between the two groups. However, those who believed more than 5 years demonstrated a higher spiritual quality of life. However, there was no difference in quality of life among patients, regardless of their belief in God, after receiving spiritual care at the hospice. Conclusion: We got a few conclusions in accordance with result gained by this study. First, spiritual support is very important to improving quality of patients' lives in hospices. Second, hospice programs are needed keenly and spiritual support for patients from trained experts is needed 24 hours a day. Third, because trained experts(ministry) are urgently needed to lend spiritual support, hospice courses must be taught at all colleges of theology. Fourth, a hospice program must provide a proper atmosphere that can give spiritual support and therefore all hospices must build such as environment. Fifth, a tool for spiritual support of hospice must be developed.

• Quality Improvement in Health Care
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• 제19권1호
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• pp.30-42
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• 2013

Objectives: This study was intended to check if the "Creating Clean Wards" project, which is an innovative reinforced campaign activity targeting infection control strategies and active surveillance cultures for VRE (vancomycin resistant enterococci) high-risk patients to be admitted in the NS (neuro-surgery) wards, would be reduced the incidence rates of VRE acquisition, transmission rates. Methods: 75 subjects of the VRE high-risk patients were surveyed by carrying out active surveillance cultures of VRE colonization 11 times from January to March, 2012. And the retrospective study was conducted dividing them into two groups. Results: The incidence rates of VRE acquisition was reduced to 3.67 cases per 1,000 patients day in the control group and to 2.88 cases in experimental group, which was not statistically significant (p = .753). VRE transmission rates of 0.0015 per day before the project tended to increase to 0.0019, although not statistically significant (p = .650). As a result of multivariate analysis with regard to using glycopeptide antibiotics in order to find out risk factors of VRE colonization, the patients who had been treated with glycopeptide until VRE colonization showed 274.41 times higher rate. Conclusion : For effective VRE infection control in NS wards, We should carry out active surveillance culture regularly, especially patient of using glycopeptide. And block the spread of VRE by strengthening infection control through the strict isolation and the changed mind-set of members motivated by the "Creating Clean Wards" campaign.

• Journal of Korean society of Dental Hygiene
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• 제18권2호
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• pp.217-226
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• 2018

Objectives: The purpose of this study is to find out differences in oral health status, defined as their oral health and oral health quality of life among the elderly depending on their income and education levels. Methods: This study used 922 senior citizens over 65 from the data (2015) of the 6th National Health and Nutrition Survey (NHNS). The regression analysis was adopted to identify factors affecting their oral health status which has effect on their oral health quality of life. The statistical package SPSS 21.0 was employed. Frequency analysis, chi-squared analysis and regression analysis were used, and the significance level or Cronbach's alpha value was 0.05. Results: Depending on income levels, there were differences in their oral health status as to whether they use oral hygiene products, take dental examinations, join private health-insurances, and delay dental treatments or not. And educational levels also made significant differences in their oral health status as to whether they smoke, drink alcohol, how many times they brush teeth a day, whether they use oral hygiene products, take dental treatments, and join private health-insurances. Regression analysis on the relationship between their oral health status and the oral health quality of life showed that there were significant differences depending on whether they take dental treatments, delay dental medical treatments, smoke, take oral examinations, how many times they brush teeth a day, and whether they use oral hygiene products, or join private health-insurances. Conclusions: The study shows that a comprehensive plan is needed to raise attention on proper oral health-care and ultimately to improve the quality of life by considering the daily number of tooth brushing, oral hygiene product use, regular dental treatments, and other medical uses.

• Quality Improvement in Health Care
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• 제1권2호
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• pp.34-43
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• 1994

Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department. Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.

• The Korean Journal of Community Living Science
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• 제21권3호
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• pp.285-298
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• 2010

This study aims to analyze teachers job satisfaction according to the working environment of teachers working in child-care centers and to investigate which variables of the working environment relate to job satisfaction of child-care teachers. The main results of this study were as follows. First, married teachers are more satisfied with the job itself, supervision, and colleague relations compared to teachers who are not married. Teachers with certificates are more satisfied with the job itself compared to teachers without certificates. Second, teachers's job satisfaction is significantly correlated with their salary, welfare, and colleague relations. Also teachers' job satisfaction is correlated with responsibility in the case that teachers have a good relation with their principal and child-care parents. Third, the results of this study show that teachers consider substitute teachers, vacation systems, day care systems, compliant with the ratio of teacher and children, job security, order of legal status as important. With regard to external compensation, teachers want salary increase, payment on overtime labor, flexible work-time, use of both full-time and part-time teachers, expansion of educational materials, increase on purchasing cost for textbooks and materials. To improve the quality of child-care teachers' working environment as well as their satisfaction, practical policies need to be implemented.