• 대한간호학회지
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• 제26권4호
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.270-278
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• 2018

본 연구는 어린이집 유아교사의 질적 향상에 대한 발전방향을 모색하기 위해 CIPP 평가 모형에 기반하여 어린이집 유아교사가 이수한 보수교육에 대한 평가를 실시하고자 한다. 이를 위하여 충남 및 대전광역시에 소재한 어린이집에서 근무하는 유아교사 203명을 대상으로 설문조사를 실시하였다. 수집된 자료를 바탕으로 SPSS 21.0을 사용하여 자료를 분석하였고, 그 결과는 다음과 같다. 어린이집 유아교사 대상 보수교육은 목표제시와 사전분석과 같은 교육상황은 다른 평가영역보다 긍정적이었으나, 유아교사 개인요인과 같은 교육과정은 상대적으로 수정과 보완이 필요한 영역으로 평가 되었다. 유아교사 개인의 특성을 반영하지 못한 획일적인 교육은 체계적이고 효과적인 교육이 이루어지는 데 한계가 있을 수 있으므로 교사의 현장과 실태를 고려하여 계획이 이루어져야 하고 교사의 현장요구가 반영되어야 한다. 따라서 본 연구는 어린이집 유아교사 대상 보수교육의 평가를 통해 보수교육프로그램의 실정과 추후 보다 바람직한 어린이집 보수교육이 이루어지도록하기 위한 기초자료가 될 것이며, 보수교육 내실화를 위한 유아교사의 자질 향상 프로그램 개발에 기초자료로 활용될 것으로 사료된다.

• 한국의료질향상학회지
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• 제16권1호
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• pp.79-89
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• 2010

Background : This study was identified the effects of a video CD Rehabilitation program on the range of knee angle and activities of daily living in patients with a total knee replacement Method : The data was collected from March 1 to May 31 2009 for the control group and from July 1 to September 31 2009 for the experimental group. The control and experimental groups contained 19 subjects each. A video CD Rehabilitation program configured to 8 minutes in length was shown 8 times every other day. Result : 1. On the day of Hemovac removal, the knee angle and CPM angle in the experimental group increased significantly, but they remained relatively constant on post operation day 21. 2. The activities of daily living were significantly different in the experimental group. Conclusion : 1. On the day of Hemovac removal, the knee angle and CPM angle in the experimental group increased significantly, but they remained relatively constant on post operation day 21. 2. The activities of daily living were significantly different in the experimental group.

• 대한가정학회지
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• 제27권2호
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• pp.53-63
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• 1989

A untrition survey of early childhood was undertaken among 102 rural young children, aged 3 to 6, attending three day care centers of Hongcheon-gun, Kangwon province, in July of 1987, to investigate dietary and nutritional status. The results were obtained as follows: Mean values of height and arm circumference ranged from 96 to 97% of the KSRI's standards. However, mean value of weight met 91% of that standard. Mean value of hematocrit was 37.3±3.5%. According to the criterion established by the WHO, 3% of the subjects were proven to be anemic. Mean value of urinary urea nitrogen/creatinine ratio was 13.8±7.6; the higher the age lower the ratio was shown. Intake of energy and nutrients ranged from 63 to 88% of the RDAs. Carbohydrate provided 68% of total energy intake; protein accounted for 14%; fat provided 18%. Energy intake was divided among breakfast, lunch supper and snacks in a percentage ratio of 21:35:26:18. The survey clarified that the day care feeding largely supplemented the inadequate dietary intakes of these young children at home. Family factors, anthropometric measurements, biochemical results were positively correlated with nutrient intakes. Authors with this study can be contributed, as a reference, to develop the community nutrition programs as well as improving the quality of day care feeding.

• 기본간호학회지
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• 제25권2호
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• pp.79-88
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• 2018

Purpose: The purpose of this study was to identify the factors that affect quality of life in elderly people with dementia. Methods: The participants for this descriptive correlational study were 97 elderly patients with dementia who were attending a daycare center or were being cared for at home. Data were collected from the participants using the Mini-Mental Status Examination-Dementia Scale, the Geriatric Depression Scale (Short Form), Activity of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) Scale. Results: There were statistically significant differences in quality of life of elders with dementia according to mobility, using dementia day-care center, and cohabitation. In multiple regression analysis, depression, activity of daily of living, using dementia day-care centers and cohabitation were significant predictors of quality of life and the four variables explained 60% of the variance in quality of life. Conclusion: Findings indicate that to enhance the quality of life for elders with dementia, depression needs to be decreased and regular use of daycare service recommended. Further, various programs enhancing physical ability need to be developed and used with these elders.

• 대한영양사협회학술지
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• 제21권2호
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• pp.123-139
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• 2015

The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.

• 한국식생활문화학회지
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• 제34권6호
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• pp.707-718
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• 2019

This study assessed the nutrient consumption of children from lunch at day care centers and kindergartens. A total of 184 lunch plates were selected in two child day care centers and two kindergartens in Seoul. Weights of the menus in planned meals were measured and amount of served and consumed lunches were calculated using a digital photography technique. Nutrients of the planned, served, and consumed lunches were assessed using CAN-Pro 4.0 and the Index of Nutritional Quality (INQ) was calculated for each meal. Compared with the estimated energy requirement for lunch for 3-5 year old children, the planned meals of the child day care centers and kindergartens contributed 42.8% and 98.8% of the daily energy requirements, respectively. At a child day care center, a served meal provided more nutrients than a planned meal since some children requested more servings after eating the served meals. This showed that the planned meal did not meet children's needs as well as the nutrient requirements. At the other child care center, children were served less than the planned meal by 6.8%, which resulted in serving less energy, calcium, potassium, and vitamin C than the required nutrients for lunch. Kindergarten A served meals with the energy requirement for lunch of 101.8%, but Kindergarten B served a meal with the energy requirement of 83.5%. Since the served portions were too small to meet nutrient requirements of the children, they consumed almost all the food served, and their nutrient consumption was similar to the nutrients served. Even though they consumed all the food served, their nutrient consumption did not meet their nutritional requirements. When assessed by INQ, the quality of the meal was good; children could consume enough nutrients when served proper quantity. Teachers who are responsible for serving meals need to be educated on proper portion sizes and how to encourage children to practice healthy eating. To promote healthy eating among children, parents need to provide children with messages consistent with what they have learned at institutions and to be a good role model in daily dietary life.

• 디지털융복합연구
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• 제18권4호
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• pp.479-487
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• 2020

본 연구의 목적은 노인주간보호시설에 대한 잠재이용자들이 지각하는 이용욕구와 운영 현황을 파악하여 문제점과 발전방향을 제안하는 것이다. 자료수집은 J도에 거주하는 일반인 320명을 대상으로 기관 인식과 이용욕구를 설문지로 조사하였으며, 6개 시설의 기관장 및 종사자에 대한 심층인터뷰, 기관의 운영 현황을 파악하고자 하였다. 분석결과 잠재이용자들은 주간보호시설의 기능 및 구체적인 역할에 대해 많이 인지하고 있지 않았으며, 시설비용 부담은 국가에서 부담하며, 시설을 이용 시 중요한 요인은 시설 및 환경인 것으로 나타났다. 심층인터뷰에서는 지금의 정책이나 제도는 현실과 괴리가 커 종사자들의 지위나 역할 그리고 기관의 운영 상태와 맞지 않는 것으로 나타나, 현장형 시스템의 재정립이 요구되고 있다. 연구결과를 바탕으로 주간보호시설의 발전방향은 국가차원에서 시민들에게 주간보호시설의 인식 개선 및 제고를 위한 적극적인 홍보와 가족지원강화가 필요하다. 둘째, 이용자의 욕구를 반영한 시설과 환경의 개선을 통한 요양서비스의 질을 높여야 한다. 셋째, 종사자의 열악한 고용 여건과 처우를 현실에 맞게 개선해 요양서비스의 질을 높여 나가야 한다.

• 간호행정학회지
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• 제5권2호
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• pp.197-207
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• 1999

The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.

• 한국의료질향상학회지
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• 제27권2호
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• pp.73-82
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• 2021

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.