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The Effect of Family-Centered Coaching Based on Sensory Integration on the Performance of Children with Autism Spectrum Disorder (감각통합 기반의 가족중심코칭이 자폐스펙트럼장애 아동의 작업수행에 미치는 효과)

  • Kim, Yoon-Sung;Kim, Kyeong-Mi;Chang, Moon-Young;Hong, So Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.19 no.2
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    • pp.12-25
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    • 2021
  • Objective : This study explored the effects of family-centered coaching using a sensory integration-based approach on the levels of performance and satisfaction for children with autism spectrum disorder (ASD). Methods : From April 16, 2020 to August 6, 2020, participants included 10 children with ASD, between the ages of three to six who met the inclusion criteria, and their guardians. I used the Canadian Occupational Performance Measure (COPM) to evaluate the children's levels of performance and satisfaction and the Goal Attainment Scaling (GAS) to evaluate their occupational performance. The experimental group (n=5) continued the sensory integration therapy while receiving their personalized family-centered coaching training for 60 minutes per week. This continued for four weeks via home visits and video calls. The control group (n=5) also continued to receive the sensory integration therapy while receiving sensory integration-based general counseling in relation to activity objectives. Results : Statistically significant differences were found in the scores of COPM performance and satisfaction and the GAS scores between the experimental group and the control group, before and after the intervention (p<.05). Statistically significant differences were found in score changes in COPM and GAS, between the two groups (p<.05). Cohen's d also showed a big effect size on the scores of COPM satisfaction (d=2.768) and the GAS scores (d=2.786). Conclusion : This study demonstrated that the sensory integration-based, family-centered coaching had more positive effects on the level of performance and satisfaction of children with ASD, than general counseling.

Study on Current Curriculum Analysis of Clinical Dental Hygiene for Dental Hygiene Students in Korea (국내 치위생(학)과 임상치위생학 교육과정 운영현황 분석)

  • Choi, Yong-Keum;Han, Yang-Keum;Bae, Soo-Myoung;Kim, Jin;Kim, Hye-Jin;Ahn, Se-Youn;Lim, Kun-Ok;Lim, Hee Jung;Jang, Sun-Ok;Jang, Yun-Jung;Jung, Jin-Ah;Jeon, Hyun-Sun;Park, Ji-Eun;Lee, Hyo-Jin;Shin, Bo-Mi
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.523-532
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    • 2017
  • The purpose of this study was to provide basic data to standardize the clinical dental hygiene curriculum, based on analysis of current clinical dental hygiene curricula in Korea. We emailed questionnaires to 12 schools to investigate clinical dental hygiene curricula, from February to March, 2017. We analyzed the clinical dental hygiene curricula in 5 schools with a 3-year program and in 7 schools with a 4-year program. The questionnaire comprised nine items on topics relating to clinical dental hygiene, and four items relating to the dental hygiene process and oral prophylaxis. The questionnaire included details regarding the subject name, the grade/semester/credit system, course content and class hours, the number of senior professors, and the number of patients available for dental hygiene clinical training purposes. In total, there were 96 topics listed in the curricula relating to clinical dental hygiene training, and topics varied between the schools. There was an average of 20.4 topic credits, and more credits and hours were allocated to the 4-year program than to the 3-year program. On average, the ratio of students to professors was 21.4:1. Course content included infection control, concepts for dental hygiene processes, dental hygiene assessment, intervention and evaluation, case studies, and periodontal instrumentation. An average of 2 hours per patient was spent on dental hygiene practice, with an average of 1.9 visits. On average, student clinical training involved 19 patients and 26.6 patients in the 3-year and 4-year programs, respectively. The average participation time per student per topic was 38.0 hours and 53.1 hours, in the 3-year and 4-year programs, respectively. Standardizing the clinical dental hygiene curricula in Korea will require consensus guidelines on topics, the number of classes required to achieve core competencies as a dental hygienist, and theory and practice time.

A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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The Optimum of Respiratory Phase Using the Motion Range of the Diaphragm: Focus on Respiratory Gated Radiotherapy of Lung Cancer (횡격막의 움직임을 이용한 최적화된 호흡 위상의 선택: 폐암의 호흡 동기 방사선치료 중심)

  • Kim, Myoungju;Im, Inchul;Lee, Jaeseung;Kang, Suman
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.157-163
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    • 2013
  • This study was to analyze quantitatively movement of planning target volume (PTV) and change of PTV volume through movement of diaphragm according to breathing phase. The purpose of present study was to investigate optimized respiration phase for radiation therapy of lung cancer. Simulated breathing training was performed in order to minimize systematic errors which is caused non-specific or irregular breathing. We performed 4-dimensional computed tomography (4DCTi) in accordance with each respiratory phase in the normalized respiratory gated radiation therapy procedures, then not only defined PTVi in 0 ~ 90%, 30 ~ 70% and 40 ~ 60% in the reconstructed 4DCTi images but analyzed quantitatively movement and changes of volume in PTVi. As a results, average respiratory cycle was $3.4{\pm}0.5$ seconds by simulated breathing training. R2-value which is expressed as concordance between clinically induced expected value and actual measured value, was almost 1. There was a statistically significant. And also movement of PTVi according to each respiration phase 0 ~ 90%, 30 ~ 70% and 40 ~ 60% were $13.4{\pm}6.4mm$, $6.1{\pm}2.9mm$ and $4.0{\pm}2.1mm$ respectively. Change of volume in PTVi of respiration phase 30 ~ 70% was decreased by $32.6{\pm}8.7%$ and 40 ~ 60% was decreased by $41.6{\pm}6.2%$. In conclusion, PTVi movement and volume change was reduced, when we apply a short breathing phase (40 ~ 60%: 30% duty cycle) range. Furthermore, PTVi margin considered respiration was not only within 4mm but able to get uniformity of dose.

Current State of Vocational Rehabilitation Program for Individuals with Disabling Mental Illness in Korea (우리나라 정신장애인 직업재활 현황 조사연구)

  • Han, Myung Hun;Kim, Ji-Woong;Kim, Do Yoon;Park, Hye Sun;Park, Hanson;Hwang, Tae-Yeon;Seo, Yongjin;Kim, Seung-Jun;Im, Woo-Young;Lee, Sang Min
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.145-152
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    • 2017
  • Objectives : There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. Methods : We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. Results : Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was 'worries about being excluded from beneficiary of National Basic livelihood Protection Act'. Conclusions : Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.

Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City (1차 의료기관의 엑스선 발생장치 정도관리에 관한 현황조사:광주광역시 지역을 중심으로)

  • Dong, Kyung-Rae;Lee, Seun-Joo;Kweon, Dae-Cheol;Goo, Eun-Hoe;Jung, Jae-Eun;Lee, Kyu-Su
    • Journal of Radiation Protection and Research
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    • v.35 no.1
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    • pp.34-42
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    • 2010
  • With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.

A Study on the Development of a Competency-Based Intervention Course Curriculum of the Korean Academy of Sensory Integration (대한감각통합치료학회 역량기반 중재과정 교육커리큘럼 개발연구)

  • Namkung, Young;Kim, Kyeong-Mi;Kim, Misun;Lee, Jiyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.3
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    • pp.26-45
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    • 2019
  • Objective : The purpose of this study is to develop educational goals, training content, and training methods for the intervention course of the Korean Academy of Sensory Integration (KASI) and to conduct competency-based intervention courses based on the competency model for sensory integration intervention. Methods : This study was conducted on work therapists who participated in the 2019 intervention course of KASI. In the first phase, educational needs were analyzed to set goals for the interventional course. In the second phase, a meeting of researchers drafted the intervention course education program and the methods of education, and the intervention course was conducted. In the third phase, the changes in educational satisfaction and performance level pre- and post-intervention course for each competency index were investigated. Results : The educational goals of "learning and applying the clinical reasoning process of sensory integration intervention" and "intervention by applying the principle of sensory integration intervention" were set after reflecting on the results of the analysis of the educational requirements. The length of the competency-based intervention course was 42 hours. The average education satisfaction level of participants in the arbitration process was 4.48±0.73, and the average education satisfaction level of the supervisor was 3.92±0.71. In both groups, the most satisfying curriculums were the data-driven decision-making process and the intervention goal-setting lecture. But the satisfaction level of was the lowest. Before and after the intervention course, there were significant changes in the performance of the two behavioral indicators of the analytic skills in the expertise competency cluster of the competency model. Conclusion : This study is meaningful in that it conducted a survey of educational needs, the development and implementation of an educational curriculum, and an education satisfaction survey through systematic courses necessary for education development.

Dental Assistant and Dental Hygienist-comparison with U.S. (치과 보조 인력과 치과위생사-미국의 제도 비교)

  • Youngyuhn Choi
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.65-77
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    • 2023
  • Background: The shortage of dental hygienists as assistant is a great concern to dental clinics, while dental hygienists are rather pursuing the role of oral hygiene control and preventive treatments which is the main role for dental hygienists in the United States. The dental hygienist and dental assistant system in the United States can be a reference in these discussions. Methods: Educational requirements for licensure and work areas for dental hygienists and dental assistants were investigated through the information provided by the American Dental Association (ADA), American Dental Hygienists Association, National Board Dental Hygiene Examination (NBDHE), Dental Assistants Association of America (ADAA), and Dental Assistants National Board (DANB). Results: In the United States, each state has different systems, but in general, dental hygienists obtain licenses after completing 2~3 years of associate degree programs in dental hygiene after obtaining basic learning skills, and mainly perform tasks related to patient screening procedures, oral hygiene management and preventive care. Dental assistants can take the license test after completing a training course of 9~11 months to obtain a dental assistant certification. Additional expanded work typically requires passing state qualification tests, completing a training program, obtaining a degree, or gaining clinical experience for a certain period of time, depending on the state Conclusion: The scope of work of dental hygienists designated by the Medical Engineer Act and the Enforcement Decree in Korea includes both the work of dental hygienists and dental assistants in the United States, and if a dental assistant system like the United States is introduced to address the current shortage of dental assistants, institutional supplementation such as adjustment of the scope of work and expansion of the role of dental hygienists in oral hygiene management and prevention work is needed and in-depth discussion is necessary.

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

Elementary School Dietitian's Awareness and Performance of Food Supply Management in Gyeonggi North Province (경기 북부 지역 초등학교 영양사의 식자재 공급관리에 대한 인식도 및 실천도)

  • Eo, Geum-Hee;Park, Young-Sim
    • The Korean Journal of Food And Nutrition
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    • v.21 no.4
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    • pp.562-571
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    • 2008
  • The principal objective of this study was to assess dietitian's awareness and performance with regard to food suppliers' selection guidelines and purchase guidelines for the receipt of safe food materials. A questionnaire was administered to 203 dietitians working at an elementary school in Gyeonggi North province, and 190 responses were ultimately returned. Excluding responses with incomplete answers and significant missing data, 161 responses(79.3%) were ultimately utilized for data analysis. We determined that meat/poulty and seafood were purchased mainly by manufacturer's branch(59.8% and 78.3%), and processed food and kimchi were generally purchased by producer's cooperatives(47.7% and 44.9%). 78.3% of the contracts were made via informal purchasing and the frequency of contracts was less than 3 times per year(53.4%). Market studies were conducted individually(54.7%), and by group(47.2%). Dietitian and parents volunteered(50.3%) or dietitians, and school and foodservice staffs(45.3%) participated - together in receiving and inspection. School contracted with $4{\sim}5$(39.1%) and $6{\sim}8$ food suppliers(29.8%). Dietitians(42.3%) or school councils(40.2%) evaluated food suppliers once per semester(60.2%). The majority of dietitians(96.3%) conducted sanitary education for food suppliers once per semester (68.3%). All 13 guidelines which were usually used to evaluate food suppliers were thought to be important(more than 4) based on a 5 scale(1: never important, 5: very important). Among them, 'sanitary storage status of food products(4.85)', 'have a chill car(4.83)' and 'proper control of refrigerator, freezer and storage room(4.81)' were the most crucial guidelines. As dietitians evaluated food supplier's-observances of 13 guidelines, 'have a chill car(4.89)', 'hold medical examination of employees(4.89)' and 'hold liability insurance for handling product(4.80)' were fulfilled relatively well. The guidelines for conducting education for their employees(4.45) and keeping their establishment and equipment sanitary(4.79) were important, but were not observed well(3.39 and 3.37). Additionally, the difference between the importance and the observance score of the 'HACCP certificate' were fairly significant(4.44 and 3.54). Dietitians tended to report that purchasing management related to the removal of foodborne illness factors(4.71), return confirmation(4.50) and purchase specification(4.32) were important. The difference between importance and performance was highest in the process of changing food suppliers when the contracts were violated more than three times. Dietitian's age, education work experience and employment type had no observable effects on how important they considered purchase management to be, but their work experience significantly affected performance in terms of the removal of foodborne illness factors(p<0.05). As supplier management is the most critical factor, it is clearly desirable to educate suppliers at specialized training centers and to supervise suppliers in accordance with the established sanitary guidelines.