• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.24-36
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• 2016

The aims of this study is to investigate the status of nursing care delivery systems and nurse staffing levels and to analyze differences in the quality of nursing care by the type of nursing care delivery system. This research was based on data from 723 nurses working in 55 medical and surgical units in 26 general hospitals. Descriptive statistics on nurse staffing levels and the nursing care delivery system, and multi-level logistic regression were used to estimate the determinants of quality of nursing care. The number of patients per nurse is 17.74 patients in functional nursing care and 15.56 patients in total nursing care. In comparison to hospitals adopting total nursing care, hospitals with functional nursing care had greater patients. The nurses rated units using total nursing care as significantly better quality of nursing care than the units with functional nursing care. Total nursing care or modified total nursing care, rather than functional nursing care, could lead to improvement in the quality of care(total nursing care OR=3.895, modified total nursing care OR=2.475). Patient-centered approaches under proper circumstances can be successfully implemented and the positive effects demonstrated.

• Journal of Korean Gerontological Nursing
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• v.20 no.3
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• pp.185-192
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• 2018

Purpose: Korea is one of the most rapidly aging countries, accompanied by an increasing number of older adults with dementia. Certified-care-assistants are the primary care workers for these older adults. This cross-sectional descriptive study compared the factors influencing care behaviors among Korean and non-Korean certified-care-assistants in Korea. Methods: Participants, 113 Korean certified-care-assistants and 71 non-Korean certified-care-assistants, completed a survey questionnaire. The questionnaire was designed to assess dementia knowledge, attitude and care behaviors toward older adults with dementia. To determine the differences in these two groups, t-test was used. A stepwise multiple regression was performed to identify factors related to care behavior. Results: Significant differences in dementia knowledge, attitude and care behavior toward older adults with dementia emerged between Korean and non-Korean certified-care-assistants. Factors influencing care behavior varied by group. Dementia knowledge and education level were the significant factors of care behaviors in Korean certified-care-assistants, whereas attitude toward older adults with dementia was the significant factor in non-Korean certified-care-assistants. Conclusion: Findings indicate that different factors influence the care behavior of two groups. These findings can be utilized to develop certified-care-assistants' training curriculum that needs to be tailored by nationality to improve the quality of care for older adults with dementia.

• 한국노년학
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• v.31 no.3
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• pp.831-848
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• 2011

The purpose of this study is to analyse the family caregivers' stress pathways by types of long term care services for the elderly, and then to discuss the findings of analysis. For this research, primary caregivers that provide care the elderly requiring long term care services sanctioned by National Health Insurance Corporation were drawn and surveyed. Among collected data, data for 258 primary caregivers by type of long term care services were used for this study. The results of this study can be summarized as follows. First, on average, the elders that utilize care service in institutions for the elderly were higher proportion of women, older, higher rate of bereavement, more children than the elders that utilize in-home care service, but some cases were vice-versa. Second, the elders that utilize care service in institutions more ADL dependency, higher proportion of severe dementia or severe stroke, higher care rank by National Health Insurance Corporation than the elders that utilize in-home care service on average. Third, primary caregivers with elders that utilize in-home care service were higher proportion of women, older, lower education level, higher rate of spouse and daughter-in-law in relationship with care recipient, less health, lower income than primary caregivers with elders that utilize care service in institutions. Fourth, subjective indicators representing caregivers' reactions to caregiving for the elderly significantly impact on caregivers' stress(ie, depression), and pathway of caregivers' stress are differentiated by type of long term care services. Fifth, stressors that have direct impacts on depression as caregiving family are differentiated by type of long term care services. Therefore, policies or programs to reduce negative mental health or stress of caregivig families should be designed differently by reflecting pathway of various stressors and stress by use types of long term care services for the elderly.

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.484-489
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• 2006

A primary pulmonary leiomyosarcoma is a very rare pulmonary malignancy that arises from smooth muscle of either the bronchial or arterial walls. Common symptoms of the tumor are cough, dyspnea, chest pain and hemoptysis. The diagnosis of a primary pulmonary sarcoma can be established only after extensive clinical and radiologic examinations have failed to identify an alternative primary source. The only effective treatment for the tumor is a complete surgical resection when feasible. The type of resection is dictated by the local anatomic extent of the tumor. We report a case of a 21-year-old male with a primary endobronchial leiomyosarcoma who presented with massive hemoptysis. A necrotic ulcerative endobronchial lesion was observed in the orifice of left lower lobe bronchus on a bronchoscopic examination. He was treated with a complete sleeve resection of the left lower lobe. Three months later, local recurrence of the tumor was noticed on the follow up bronchoscopy and a then left pneumonectomy was then performed. Fifteen months later, the patient died from empyema with a bronchopleural fistula that was associated with tumor recurrence at the stump of the pneumonectomy.

• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.453-469
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• 2000

This study has a purpose to provide information to help develop nursing intervention for demented elderly staying at home. For this purpose I analysed the relationship of patients' disturbing behaviors with their demographic and social characteristics, premorbid personality, and present environmental characteristics through questionnaire survey on their family members. The survey was performed through direct interview, telephone contact. and mail in the regions of Pusan and Gyeongnam. Among family members contacted. 112 ones made an appropriate response to the survey. The statistical package SAS was utilized for descriptive statistics, correlation coefficients, stepwise multiple regression, and cluster analysis. The results of the study were as follows: 1) Demographic and social characteristics of the patients surveyed are female 81.3%, average age 81.4 years, lack of schooling 83.0%, spouse dead 73.2%, having no other disease 58.9%, average duration of dementia 3.8 years, no medical treatment for dementia 84.8%, good married life 40.2%, and primary care given by daughter-in-law 49.1%. 2) Aggressive Psychomotor Behavior(APB) was observed in a way statistically meaningful in case that primary care was given by daughter-in-law, while Nonaggressive Psychomotor Behavior(NPB) was in case of good married life and primary care given by other than daughter-in-law and spouse. Verbally aggressive behavior (VAB) was observed in groups of female, spouse dead, bad married life, and daughter-in-law's primary care. As for Passive Behavior(PB), it was observed in case that patients had educational background of not less high than middle school and that they were having medical treatment. Functionally Impaired Behavior(FIB) was observed in age group of 60-69 and more than 90, in patients' group having no other disease, and in case that the duration of dementia was not less than 5 years. 3) Premobid Neuroticism(N) showed positive correlation with APB and VAB, while Openness (O) did negative correlation with PB. Agreeableness (A) was proved to have positive correlation with PA and FIB, but to have negative correlation with APB and VAB. In addition, Conscientiousness(C) showed negative correlation with APB and VAB. 4) The worse the psychosocial environment was, the more NPB and VAB were observed. 5) APB was explained 24% by C and primary care-giver, while NPB was explained 28% by psychosocial environment, having other disease or not, and married life. VAB was explained 40% by A. sex, and married life. On the other hand PB was explained 33% by O, A. N, and having medical treatment or not. But any significant factor was not found to explain FIB. 6) A cluster analysis was performed on disturbing behaviors of demented elderly staying at home. It enabled to regroup the demented elderly in 5 patterns: high scored in NPB, high scored in FIB. high scored in NPB and VAB, moderately scored in most disturbing behaviors, and low scored in all areas. In conclusion, disturbing behaviors of demented elderly not only reflect their premorbid personality in the past, but also are affected by their present psychosocial environment. Therefore, it is necessary to encourage and respond them with understanding their disturbing behaviors in relation to their past premorbid personality. In addition, it is important to provide them better psychosocial environment in order to reduce their disturbing behaviors.

• Tuberculosis and Respiratory Diseases
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• v.76 no.3
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• pp.131-135
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• 2014

Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A $6.9{\times}5.8cm-sized$ intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.

• Journal of the Korean Society of School Health
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• v.13 no.1
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• pp.63-84
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• 2000

Primary school is regarded as an important period when many health-related behaviors and life-styles begin to be formed. Acquiring them through school heath education has a strong influence on the health promotion of not only the family but also the community. Primary school health education in Korea has a systematic flaw in that health-related subjects are divided and taught under various subjects in primary school. In order to develop a proper school health curriculum, it is essential to assess what is currently being taught. In this study the current health education of the 6th grade primary curriculum was investigated to improve school health education. The purpose of this study is to identify the health education contents and time in textbooks of the 6th grade primary school curriculum. In this study, the textbooks & teacher's teaching manuals of the 6th grade curriculum were analyzed with a health instruction framework for Korean schools developed by the Korean Nurse Association & Korean School Health Education Association in 1993 and health care framework for health education curriculum presented by Kim in 1991. The results are as follows ; 1) Health education hours of the curriculum are 206 hours, about 34.3 hours a year. 2) The contents of health education were divided into nine subjects at primary schools. Organizing principles of learning experience(eg, integrity, sequence and continuity) were not considered sufficiently. The physical education & natural science subjects include a lot of health education contents. 3) The major content areas are community & environmental health areas and daily healthy life areas. 4) The major areas at each grade level are daily healthy concerns and safety & first-aid 5) The remarkable contrast to the 5th primary school curriculum are that environmental health is offered to the first grade step by step, and that drug use & abuse and mental health education are included in the 6th primary school curriculum. 6) The main contents of health education in 1st, 2nd. and 3rd grade curricula consist of treatment & recovery health functions. Those of the 4th grade curriculum consist of treatment & recovery health functions, and daily healthy life functions. Those of the 5th grade consist of growth & development functions. Those of the 6th grade consist of treatment & recovery health, growth & development functions. Most health care functions belong to physical health care. The results above suggest that we put together the divided contents of health education and manage them on the basis of systematic integration.

• Journal of the Korean housing association
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• v.6 no.2
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• pp.139-153
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• 1995

The primary goals of this study were to find out how is the mother's perception for the importance of criteria when choosing day care center, and to examine how different there are according to the demographic characteristics, futhemore to investigate how different the importance of criteria when mothers choose an ideal day care center are given the present situation, when mother choose day care center are according to the related variables. The major results of this research are shown as follow: 1. Generally, there was significant differences in the mother's perception for the importance of quality criteria of day care center according to the demongraphic characteristics. 2. There were statistically significant differences in the importance of criteria when mothers choose day care center in 2 conditions: 1) given the present situation(income, trasportation, location of workplace etc.). when mothers choose day care center 2) when mothers choose an ideal day care center regardless of the present situation) according to several demographic variables.

• Korean Medical Education Review
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• v.21 no.2
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• pp.73-79
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• 2019

Academic medicine is built from a foundation of education, research, and patient care. Since good patient care results from the application of medical research and continuous education, these three components cannot be separated for medical development to occur. In Korea, many obstacles hinder the achievement of academic medicine, such as an inefficient medical delivery system, limitations of primary care, low insurance prices, and no long-term health care plan. Medical education has changed to outcome-based education, but presented temporal integration status. Governance of healthcare research is not centralized, and Korea is awarded relatively fewer grants than other countries. Medical professors have reached a burnout state due to patient care responsibilities in addition to research and education duties. Many medical systems, including the medical delivery system and insurance problems, may contribute to distrust between doctors and patients. The government is not involved in a long-term health care policy. The multitude of factors mentioned here are hindering the achievement of academic medicine in Korea.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.