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This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program.
The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers.
The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group.
We found that the CMP-VNC can be an effective tool to increase visiting nurses’ competency of costing and enhance efficiencies of visiting nursing centers.

The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses.
A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions.
The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group.
The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.
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The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS).
This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value.
In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively.
The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.
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This study aimed to evaluate the usefulness of a behavioral cue checklist (BCC) containing 17 items developed by Wilkes et al. (2010) for identifying potentially violent patients in emergency departments.
This was a prospective observational study to evaluate the usefulness of the Korean version of a BCC (K-BCC) as an assessment tool for predicting patient violence in emergency departments, and was conducted over 4 weeks in a regional emergency medical center located in B City. A total of 1,324 patients were finally analyzed.
Logistic regression analysis was performed to investigate whether each item of the K-BCC predicts violence, and a parsimonious set of 8 statistically significant items was selected for the tool. Receiver operating characteristic analysis of the BCC showed that the area under the curve was .97 (95% confidence interval: .94~1.0). The sensitivity, specificity, positive predictive value, and negative predictive value at the cut-off score of 2 were 75.6%, 98.9%, 68.2%, and 99.2%, respectively.
The K-BCC was found to be useful in predicting patient violence toward emergency department staff. This tool is simple, and fast to use and can play a significantly role identifying potentially violent patients. Owing to this advance identification, this tool can be helpful in preventing the potential for violence from manifesting as violent behaviors.

PURPOSE: This study was performed to measure the nursing service quality being used SERVQUAL model and satisfaction that the admitted patients perceived. METHOD: The questionnaire founded on the SERVQUAL was developed and distributed to 300 patients at the three general hospitals in three provincial city, Korea. For data analysis, Cronbach's alpha frequencies, percentages, paired t-test, Pearson Correlation Coefficient were used. RESULT: In expectation, patients most highly perceived the assurance factor that was one among the 5 factors being constituted nursing service. In performance, patients most highly perceived the responsiveness factor. The performance degrees of the 5 factors and 20 attributes being constituted nursing service did not exceed the expectation degree of those. So the calculated figures for nursing service quality of the three subjected hospitals were all minus. In relation of the patients' demographics and nursing service characteristics to their general satisfaction, patients' sex, age, income and the all factors and attributes of nursing service had relation to their general satisfaction. CONCLUSION: It could be concluded that the nursing service quality of the three subjected hospitals was poor and the patients' demographic and nursing service characteristics had relation to their general satisfaction.
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PURPOSE: This study is a fact-finding research to understand the status of visiting nursing services operated by health centers in Korea and it aims to provide basic information for policy development on operation and management of visiting nursing services in health centers. METHOD: This study investigates the results of visiting nursing services in 242 health centers from Jan. 10 through Dec. 30, 2000, where 3,106 visiting nurses were employed by the public work program. RESULT: In 2000, 129,401 new household as service recipients was identified and that was 0.9% of Koreas total households (15,137,000), and 5.8% of low income households (2,242,000). The highest high risk group was dementia patients(aver. 55.2/1,000 person). Average number of households visited by visiting nurse were 4.5 households per day and the first-visited houses per visiting nurse were 1.1 households per day. The re-visiting rate was 71.3%. Total 4,059,130 service items were provided and assessment ranked the highest with 33.7%. The satisfaction level of clients on the nurses was an average of 3.17 points in the scale of 4 and the nursing service was a 2.60 points in a scale of 3. CONCLUSION: Visiting nursing service should continue to provide comprehensive healthcare services in cost-effective ways while cooperating with others.
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PURPOSE: this study was to investigate the perception gap on nursing service between consumers and providers.
METHOD
the questionnaire founded on the SERVQUAL was developed and distributed to 300 patients and 210 nurses at the three subjected general hospitals in three provincial city, Korea during February to March, 2001. For data analysis, Cronbachs' Alpha, frequency, t-test, and paired t-test were used.
RESULT
1. In the gap analysis on the 20 properties constituting nursing service, providers almost all perceived higher than consumer in quality. Among them, the number of properties being statistically significant was 7 in the expectation, 18 in the important and 7 in the performance. 2. In the comparison analysis of the perception gap on the expectation-performance and the important-performance, it turned out that the subjected hospitals had to improve their equipment and facilities immediately. It was suggested a good strategy to strengthen the responsiveness factor and the assurance factor of nursing service.
CONCLUSION
it could be concluded that nurses have to recognize the blind spot of their perception and endeavor to take away the perception gap between consumers and providers.
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PURPOSE: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. METHOD: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. CONCLUSION: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.

PURPOSE: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. METHOD: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). CONCLUSION: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.
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The propose of this study is to give a theoretical basis for better home health service by looking at the subjective structure the collaboration between the home health nurse and doctor and at how collaboration can be improved. There are at least three types of recognition that can help the collaboration. The first type is to put more weight on the relationship between doctors and home health care nurses. This means that doctors and home health care nurses should make an effort to improve, their collaboration. The second type is to put more weight on the reward for doctors' participation. Reward will help collaboration. The third type is to put more weight on organization support. Organization support will bring about trust between doctors and home health care nurses The following conclusion were reached: 1) Trust should exist between doctors and home health care nurses. 2)Doctors should maintain an equal relationship with home health care nurses and accept them as professionals. 3) Appropriate reward should be given to doctors for their participation. 4)Home health care nurses should reinforce their skills through education, training, and professionalization. 5) Home health care nurses should cooperate with doctors by building a system that centers on patients. 6) Collaboration between doctors and home health care nurses is important because it is useful to recognize patients and their families in a broader light. 7) Doctors and home health care nurses need to be more concerned about patients. 8)More active support of hospital administrators and systems is needed to enhance collaboration between doctors and home health care nurses. 9) The present legal system for collaboration between doctors and home health care nurses can be a factor. The nine nursing strategies above will help doctors and home health care nurses build more positive relations and get closer to their patient, more effective home healthcare will get closer to people who want quality medical service.

Service quality is, unlike goods quality, an abstract and elusive term. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. The main purpose of this study is 1) to explore the differences of perception between consumers and providers about nursing service quality, 2) to identify the useful tool between two tools measuring nursing service quality. To achieve these purposes of the study, the questionnaire was developed and distributed to 210 nurses who worked at seven subjected hospitals in Seoul. Also, 280 people who had a direct experience with the subjected hospital nursing services at the time of screening were involved. They were randomly selected at the seven subjected hospitals during August to September of 1998. Among them, 165 responses from nurses and 229 responses from others resulted in worthy finds. The measurement instrument for a nursing services quality evaluation was modified from the SERVQUAL model originated from Parasuraman, Zeithaml, and Berry (1988). The reliability coefficient of the scale was calculated and showed high degree of internal consistency (Cronbachs' Alpha = .9353). For data analysis, SPSS/PC was used for descriptive statistics, t-test, ANOVA and regression analysis. The results were as follows: 1) In the perception about nursing services quality, there were gap between consumers and providers. Especially the critical attributes in point of perception nursing services quality, naming satisfy, hygiene and performance factors, are very different contents. 2) In the comparison analysis of the usefulness tools it was turned out that SEVPERF model is more appropriate than SERVQUAL model. And in the analysis to identify the construct validity of the tool, it is turned out that the relationship between the constructing factors of the tool and the general satisfaction is significant.
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As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.
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The purpose of this study was to estimate the forecast of bed demand for institutional long-term care for the elderly persons in Taegu Metropolitan City. The study subject was the total 1,877 elderly persons over age 65 living in Taegu. Among them 1,441 elderly persons were sampled from community and 436 were from the elderly admitted 5 general hospitals. Data collection was carried out by interview from 25 August to 25 December 1997. The measuring instrument of this study was the modified tool of CARE, MAI, PCTC, and ADL which were examined for validity and reliability. In order to forecast bed demand of Nursing Home, this study revised prediction techniques suggested by Robin. The results were as follows : 1. OLDi of Taegu City were 122,202 by the year 1998 and number of Low-Income Elderly Persons were 3,210. 2. The Level I : Senior Citizen Home AQi * ASTAYi ADEMi = --------------- 365 * AOCUi . AQi = OLDi * LADLi * NASi * ALONi * LIADLi * AUTILi Predicted number of bed demand for Home Based Elderly Persons were 4,210 and Low-Income Elderly Persons were 1,081 and Total Elderly Persons were 5,291 by the year 1998, 6,343 by the year 2000 and 8,351 by the 2005. 3. The Level II : Nursing Home (BQ1i+BQ2i) * BSTAYi BDEMi = ----------------------- 365 * BOCUi . BQ1i = OLDi * HADLi * ALONi * HIADLi BQ2i = OLDi * HADLi * FAMi * OBEDi Predicted number of demand for Total Elderly Persons were 668 by the year 1998, 802 by the year 2000 and 1,055 by the 2005. 4. The Level III : Nursing Home COLDi * HDISi * CUTILi * CSTAYi CDEMi = ------------------------------------ + CQi/10 365 * COCUi Predicted number of demand for Total Elderly Persons were 1,899 by the year 1998, 2,311 by the year 2000 and 3,003 by the 2005. 5. Predicted number of bed demand of long-term care facilities in the year 1998 according to Levels were 4.3% among elderly persons in Taegu by Level I, 0.5% by Level II and 1.5% by Level III. Number of elderly persons in current long-term care facilities were 458 in LevelI I,284 in Level II. 6. Deficit number of bed demand of long-term care facilities were 4,833 in Level I, 384 in Level II , 1,899 in Level III for the elderly persons in Taegu Metropolitan City.

Recently, the hospitals in Korea has positively changed one way or another. Therefore hospital managers must focus on the nurses' role in terms of consumers' perception of overall image of hospitals and the degree of satisfaction of the consumers To achieve the purposes, the questionnaire was developed and distributed to 280 people who had a direct experience with nursing services subjected hospitals in Seoul at the time of screening. among them, 229 responses were turned out to be useful and used for final analysis. The measurement instrument for hospital nursing service quality evaluation was modified from the SERVQUAL model originated from Parasuraman, Zeithaml, and Berry(1988). For data analysis, SPSS/ PC and PC-MDS program were used. The results were as follows : 1) The perception map showed that the seven subjected hospitals were divided into three groups. It could be interpreted that the hospitals in the same group had a strong competitive relationships. Because the nursing services' scores of hospitals C and E were higher than those of other hospitals, they could be served as a benchmark for the other hospitals. 2) The marketing place of hospital nursing services was divided by four. Since service generally had a strong point in nearby service market segment, Aiming an nearby hospital nursing services market segment by the hospital nursing services department was regarded as a good repositioning strategy. 3) When consumers evaluated the quality of hospital nursing services, they were greatly affected by the hospitals' overall image or other characteristics. Therefore, for improving hospital's nursing services, hospital nursing services department requires a great deal of labor to improve hospitals' overall image or other characteristics.
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In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining then based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC+ program. The results of this study are summarized as follows; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue(80.6%). 2) Main therapies for the terminal cancer patients were pain control(58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device(11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patents. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.
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The purpose of this study was to describe the operation, staffing, and services provided at adult day care centers in Korea.
The study was a cross-sectional descriptive survey. The subjects were 209 centers among 280 centers registered in Korea (response rate 74.6%). The data was collected from August to December in 2006.
48.8% of centers were located in a city area. The centers were based on the Social Model 65.5% of the centers were open Monday to Friday, an average of 7~8 hours per day. Dementia, stroke or frail elderly could use the center, and 57.4% of centers were used for dementia and stroke elderly together. The enrollment of elderly was 13.5. The number of total staff was 8.27, the number of RN's and social workers was 0.67, and 2.54 respectively. The social services(Meal preparation 98.6%, Special event 98.1%, Transportation, 97.1%) were provided more than the health services(Physical therapy 98.1%, ADL training 95.2%, Counseling 84.7%, Vaccination 82.8%, Health monitoring 78.9%, Health education 78.5%, Bathing 66.1%, and Speech therapy 28.2%).
These results suggest we have to develop a health-focused adult day health care model based on the needs of elderly and their families. Nurses will have an important role in adult day health care.
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The purpose of this study was to identify factors influencing the outcome of psychosocial rehabilitation for persons with chronic mental illness and to suggest a hypothetical model of psychosocial rehabilitation which is based on the relationship between influencing factors and then to test its fitness empirically.
Data was collected from persons with a chronic mental illness using a self-report questionnaire, and from their case managers using an observed rating questionnaire. A total of 220 cases were used in the final analysis, and a hypothetical model was verified through covariance structure analysis using LISREL.
1) The fitness indices of the model were χ2=133.77 (df=48, p=.00), GFI = 0.93, AGFI = 0.87, RMR = 2.32, NNFI = 0.95 and NFI = 0.95. Twelve paths among fifteen proved to be significant. 2) Psychosocial rehabilitation was influenced directly by symptoms, daily living skill and self-concept, and was influenced indirectly by the psychosocial rehabilitation program service. Psychosocial rehabilitation accounted for 32% of variance of these factors.
This study is expected to contribute to understanding the psychosocial rehabilitation phenomena. Besides it will provide basic information for developing strategies of bio-psycho-sociological interventions and evaluations in regard to influential factors of psychosocial rehabilitation.

Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System(GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis(ESDA) with GIS technology.
One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology.
Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I= 0.1841, 0.1675).
Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.
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The purpose of this study was to analyze and assess the current situation of Korea's school health education program and to establish measures to efficiently carry out school health education in Korea.
The survey was conducted through the internet with the health educators of elementary, middle, and high schools nationwide to assess the current condition of school health education programs, and 2,459 samples were collected which accounted for 23.4% of the total respondents.
According to school health educators on the enforcement of health education, the higher the education became, the less the health education was enforced. The enforcement rate was 96.9% in elementary schools, 76.7% in middle schools, and 67.3% in high schools. The major reasons were found as difficulty in securing class time (54.5%) and other excessive workloads (20.9%). As a result of the health education awareness survey, over 99% answered that health education is needed, over 80% answered that the education requires independent health textbooks, and over 95% answered that health educators are suitable for the person in charge of the education.
This study will be a useful in establishing a detailed policy on enhancing school health education in the future.
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This study was aimed to examine how subjects' characteristics and nursing service quality influence hospital revisiting intent, to compare perceptions of patients with those of nurses.
The questionnaire was developed and distributed to 300 patients and nurses at six general hospitals in a provincial city, Korea. For data analysis, the SPSS/PC program was used.
The nursing service quality's scores of patients is 3.61, that of nurses is 3.77, and there is a significant difference. The hospital revisiting intent's score of patients is 4.84, that of nurses is 4.61, and there are no significant differences. In subjects' characteristics, patients perceive that the hospital is the only different factor, and place hospital revisiting intent at 3.6%. Nurses perceive that education level and position are different factors, and place hospital revisiting intent at 3.3%. In nursing service quality, patients perceive that 2 attributes explain hospital revisiting intent at 17.8% and 2 factors explain it at 16.5%; whereas, nurses perceive that 2 attributes explain hospital revisiting intent at 15.3% and 3 factors explain it at 12.2%.
There are perception gaps between consumers and providers. So nursing and hospital managers must recognize these facts and provide various marketing strategies to overcome them.
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The purpose of this study was to analyze death attitudes of students majoring in the human service area, such as nursing science, education, and social welfare.
The Q-methodology which provides a method of analyzing the subjectivity of each item was used. The 38 selected Q-statements from each of 42 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program.
Four types of death attitudes for research subjects in nursing, education, and social welfare areas were identified. Type I is fatalistic admission, Type II is pursuit of existential life, Type III is uncertainty of life after death, and Type IV is separation-connection between life and death.
The results of the study indicate that different approaches of death educational programs are recommended based on the four types of death attitudes.
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This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds.
The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale.
There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was ‘the responsiveness’, and in the perceived performance, the highest was the ‘assurance’. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction.
To improve the nursing service quality at small-medium hospitals, strengthening the ‘assurance’ factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.
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This study focused on analysing costs per visiting nursing care based on nursing activities in a public health center.
The Easley-Storfjell Instrument(1997) was used for a prospective descriptive analysis of self-records for workload data from 10 visiting nurses during 4 weeks on all nursing activities. In addition, analysis of the 478 visiting nursing records and cost data from 5 home visiting departments in public health centers during one year of 2003 was done.
The workload of visiting nurses by the type of model was identified as follows: Type I showed that caseloads made up 32.9 % of all nurse activities, and type II showed that the caseloads made up 45.8 %. Second, The cost per visit in type I was 33,088 won and 31,323 won in type II. Third, the estimated budgets were 1,902,436 won to 12,057,696 won for the type I model. and 4,151,316 won to 17,432,712 won for the type II model for one year.
This study's results will contribute to baseline data used to establish on infrastructure for visiting nursing program and visiting nursing agencies based on the budget of visiting nursing services.
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This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs.
This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data.
The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility.
Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.

The purpose of this study was to measure the functional status of stroke patients cared for in different long-term care settings.
We assessed all stroke patients in two home health care agencies, four nursing homes and one geriatric hospital in Korea (n=171) using the Resident Assessment Instrument (RAI), which comprises Activity of Daily Living (ADL), urine incontinence, bowel incontinence, a Cognitive Performance Scale (CPS),and being understood and understanding others. Data was collected by face-to-face surveys with patients.
The mean ADL score, urine incontinence score, bowel incontinence score, CPS, and being understood score and understanding others score were lowest for the patients receiving home health care, and highest for the patients in nursing homes. Low scores described poor and high scores good functional status. The results showed significant differences in physical and cognitive function scores between the three groups of patients.
This study suggests that there may be large differences between the patients in these three types of long-term care settings. These findings can be used to help develop and implement efficient long-term care programs.
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The purpose of this study was to develop a tool that measures the quality of nursing service, to measure the quality of nursing service perceived by consumers, and to identify the gaps between ideal and actual nursing services.
A questionnaire was developed and distributed to 300 people who had been hospitalized in one of six general hospitals with quality of nursing services in five provincial cities in Korea. For data analysis, the SPSS/WIN(ver 10.0) program was used.
The 20 attributes included in the instrument of quality of nursing service is abstracted into 2 factors : tangibility and intangibility. In quality analysis, 15 of 20 attributes are minus scores, meaning that those nursing services are perceived as generally low. However among the minus scores' attributes, only two attributes are significant statistically. Gaps between importance and performance of the nursing service exists in 19 among 20 attributes.
Nursing service quality (performance-expectation) needs to be improved, and Gaps (importance-performance) reduced. In addition, a tool measuring nursing service quality has to be developed so nurses can deal successfully with the quality and gaps of nursing service perceived by consumers.
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This study was conducted to identify health problems and support received from the health and welfare service using MDS-HC(Minimun Data Set for Home Care) in the aged living at home.
Eighty-one elderly persons were selected from those listed in community-welfare service centers in Seoul and Kyunggi Province between December 2002 and January 2003.
Eleven health problems per elderly person on average were identified, and the frequent care needs were in order: preventive health measure, health promotion, visual function, depression & anxiety, communication disorders, social function, pain, environmental assessment, oral health, cognition and falls. The number of health problems by the level of ADL was ‘ ADL 1(Independence)’ 9.87, ‘ ADL 2(Partial independence)’ 12.78, ‘ ADL 3(Dependence)’ 13.73. Utilization of formal health & welfare services among the elderly was ‘ meals on wheels’ 40.7%, ‘ home helper’ 38.2%, ‘ visiting of social welfare worker’ 21.0%, ‘ physical therapy’ 19.6%, ‘ day care center’ 12.3%, ‘ volunteer's service’ 9.9%, ‘ home visiting care’ 3.7%, ‘ occupational therapy’ 3.7%, and ‘ speech therapy’ 2.5%.
The results suggest that using the MDS-HC 2.0 is applicable to help decide criteria for both health and welfare service supplied to the elderly.
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This study was performed to measure the nursing service perceived value by consumer and providers, and to investigate the relationship among nursing service, general satisfaction and hospital revisiting intent, and to examinate the tools that measures nursing service's reliability, construct validity and usefulness.
The questionnaire was developed and distributed to 300 patients and 210 nurses at three general hospitals. For data analysis, SPSS/PC program was used.
The nursing service perceived value by providers is higher than that by consumers. There are distinctive difference in the expectation, and importance and performance values of the nursing service perceived. In examination of the relationship among nursing service, general satisfaction and hospital revisiting intent, nursing service has a deep relationship with general satisfaction, but doesn't have relationship with hospital revisiting intent. The tool that measures nursing service has a good reliability and construct validity. In analysis on the usefulness between the tools, SERVPERF tool is more useful than SERVQUAL tool.
The nursing service perceived value by consumer is different that by providers, and the tool that measures nursing service has a good reliability and construct validity. The SERVPERF tool is more useful than SERVQUAL tool.
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The purpose of this study was to explore the link between health and welfare service and barrier's factors by reviewing the connection between the public health center's visiting nurse and social welfare center's social workers
A survey by mail or a face-to-face interview of 151 visiting nurses in 25 public health centers and 48 social welfare workers in general social welfare centers in Seoul, was preformed from Feb. 12, 2001 to Mar. 15, 2001. The data were analyzed with frequency, percentage, mean value, paired t-test and independent t-test using SPSS/WIN 7.5 program.
1. ‘ The necessity and degree of cooperation with social welfare workers of visiting nurse’ scored average 4.49 and 3.19, and ‘ The necessity and degree of cooperation with visiting nurse and social welfare workers’ scored average 4.81 and 3.15 on the five-point scale ; there was a significant difference between the two variable in visiting nurse and social welfare workers. 2. In barrier's factors which health and welfare service offer to, visiting nurses showed statistically significant higher score than social welfare staff ; ‘ job factor’, ‘ resource factor’, ‘ clients factor’, ‘ individual ability factor’
In order to provide link system that hold clients in common in public health center and social welfare center, it is recommended a case management team should be constructed and educate visiting nurses for case manager.
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As comprehensive nursing care service has gradually expanded, it has become necessary to explore the various opinions about it. The purpose of this study is to explore the large amount of text data regarding comprehensive nursing care service extracted from online news and social media by applying a semantic network analysis.
The web pages of the Korean Nurses Association (KNA) News, major daily newspapers, and Twitter were crawled by searching the keyword ‘comprehensive nursing care service’ using Python. A morphological analysis was performed using KoNLPy. Nodes on a ‘comprehensive nursing care service’ cluster were selected, and frequency, edge weight, and degree centrality were calculated and visualized with Gephi for the semantic network.
A total of 536 news pages and 464 tweets were analyzed. In the KNA News and major daily newspapers, ‘nursing workforce’ and ‘nursing service’ were highly rated in frequency, edge weight, and degree centrality. On Twitter, the most frequent nodes were ‘National Health Insurance Service’ and ‘comprehensive nursing care service hospital.’ The nodes with the highest edge weight were ‘national health insurance,’ ‘wards without caregiver presence,’ and ‘caregiving costs.’ ‘National Health Insurance Service’ was highest in degree centrality.
This study provides an example of how to use atypical big data for a nursing issue through semantic network analysis to explore diverse perspectives surrounding the nursing community through various media sources. Applying semantic network analysis to online big data to gather information regarding various nursing issues would help to explore opinions for formulating and implementing nursing policies.
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This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review.
We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers.
Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach.
As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.
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The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress.
A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ2 test, t-test, and Heckman selection model analysis were conducted using SAS 9.3.
Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89,
The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.
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This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI).
Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour.
After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation.
Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center driectly should be implemented for patients and/or caregivers.
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In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program.
The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income.
Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010.
The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.
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This study was performed to investigate the relationship among reciprocity, emotional labor, nursing service quality and intent to leave, and to identify factors influencing nursing service quality and intent to leave.
This study was a cross-sectional survey. Participants were 300 nurses working at five general hospitals in two provincial cities in Gyeongsang Province, Korea. From May 1 to June 30, 2014, data were collected using structured questionnaires and analyzed with SPSS/PC ver 20.0 programs.
There were relationships between reciprocity and nursing service quality, and intent to leave, and between emotional labor and intent to leave. Participants' general characteristics, reciprocity and emotional labor explained 48.4% of variance in nursing service quality and participants' general characteristics and these two independent variables explained 31.9% of intent to leave.
These findings indicate that from the perception of hospital nurses, reciprocity and emotional labor are both very important factors to improve the quality of nursing service and decrease the intent to leave. So nursing managers should try to develop various personnel management programs focused on human emotions, and create a mutual respectable organizational culture and work environment.
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The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services.
A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program.
Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling.
The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.
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This study was conducted to develop key performance indicators (KPIs) for home care nursing (HCN) based on a balanced scorecard, and to construct a performance prediction model of strategic objectives using the Bayesian Belief Network (BBN).
This methodological study included four steps: establishment of KPIs, performance prediction modeling, development of a performance prediction model using BBN, and simulation of a suggested nursing management strategy. An HCN expert group and a staff group participated. The content validity index was analyzed using STATA 13.0, and BBN was analyzed using HUGIN 8.0.
We generated a list of KPIs composed of 4 perspectives, 10 strategic objectives, and 31 KPIs. In the validity test of the performance prediction model, the factor with the greatest variance for increasing profit was maximum cost reduction of HCN services. The factor with the smallest variance for increasing profit was a minimum image improvement for HCN. During sensitivity analysis, the probability of the expert group did not affect the sensitivity. Furthermore, simulation of a 10% image improvement predicted the most effective way to increase profit.
KPIs of HCN can estimate financial and non-financial performance. The performance prediction model for HCN will be useful to improve performance.
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This study was conducted to examine and compare satisfaction with Korean health care services for Americans, Chinese and Russians who resided in Korea.
A questionnaire was distributed to 252 participants (81 Americans, 89 Chinese, 82 Russians). Three focus group interviews were subsequently conducted in order to obtain a greater understanding of participants' experience and perspectives.
The average satisfaction score was 3.09, with Americans and Russians showing significantly higher scores than Chinese. Overall, participants reported higher satisfaction in 'Facility', 'Quality of care' and 'Nursing services' as opposed to 'Information/education'. 'Care with cultural respect' as well as communication related services. Data from the focus group interviews were categorized into 12 sub-categories, 7 categories and 2 themes. The two themes were common experience and contrasting experience. Common experience included 4 categories, 'Quality of care', 'Hospital facility and health care system', 'Language barrier' and 'Information and education'. Contrasting experience included 3 categories, 'Medical cost', 'Health care personnel' and 'Accessibility'.
Results of this study provide basic knowledge on foreign residents' satisfaction and experience with Korean health care services. Further research is needed with foreigners from different cultural backgrounds. Administrative and educational efforts are required to improve communication skills and cultural competency.
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This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries.
A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels.
The experimental group showed significant decrease in uncertainty (
Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.
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The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression.
The study was a pretest–posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n= 30) and the comparison group (n= 28). The research instrument was Reynolds Adolescent Depression Scale.
The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks.
The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curriculums by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.
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The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling.
Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis.
Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization.
The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/ or promotion of community awareness.
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Cost-benefit analysis is one of the most commonly used economic evaluation methods, which helps to inform the economic value of a program to decision makers. However, the selection of a correct benefit estimation method remains critical for accurate cost-benefit analysis. This paper compared benefit estimations among three different benefit estimation models.
Data from community-based chronic hypertension management programs in a city in South Korea were used. Three different benefit estimation methods were compared. The first was a standard deterministic estimation model; second, a repeated-measures deterministic estimation model; and third, a transitional probability estimation model.
The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively.
The transitional probability estimation model showed the most correct and realistic benefit estimation, as it traced possible paths of changing status between time points and it accounted for both positive and negative benefits.
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This study was to identify the current status of vaccination against the pandemic (H1N1) 2009 virus among university students from the fields of nursing and allied health from a local community and verify factors influencing vaccination.
The study included 227 students in the fields of nursing and allied health from a provincial university. Data were obtained from these participants between May 31 and June 11, 2010 by using self-report questionnaires.
The rate of vaccination against the pandemic (H1N1) 2009 virus for these participants was 14.5%. No difference was observed in this regard between majors and school year. Factors that influence vaccination against this virus included previous vaccination against seasonal influenza and participants' attitudes toward general vaccination.
The results suggest that for effective pandemic (H1N1) 2009 vaccination of university students from the fields of nursing and allied health, students who have not been vaccinated should be intensively managed. Developing a vaccination program that encourages a positive attitude toward vaccination is recommended.
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This study was done to assess the educational needs that should be considered in developing curriculum for staff in charge of public health services in public hospitals.
The participants in this study were staff in charge of public health services in 130 public hospitals. The Borich's Needs Assessment Model which analyzed the relation of 'required competence level' and 'present competence level', was utilized. Data were collected from October to November 2007 using a structure self-report questionnaire. The return rate was 66.9%. The Cronbach's alpha score was 0.959.
The mean scores for 'required competence level', 'present competence level' and Borich's need were 4.02, 3.44, and 2.30 respectively. According to public health service items, 'strategies to recognize the present condition and analyze problems' had the highest score for Borich's need, but 'establishment of annual or monthly objectives' had the lowest score for Borich's need.
Education was found to be very important for staff carrying out public health services. Ultimately the results of this study may be utilized to develop education program for staff carrying out public health services in public hospitals.
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This study was conducted to test the effects of a community health promotion project for farmers cultivating garlic. Bandura's self-efficacy theory (1986) and Chaskin's community capacity framework (2001) were used as the theoretical framework.
A nonequivalent control group pretest-posttest design was used. Study participants were 72 garlic farmers (intervention: 36, control: 36). The community health promotion project consisted of health promotion program and community capacity building strategies and was provided for 12 weeks (8 during farming off-season and 4 during farming season). Data were collected between February 23 and May 31, 2009 and were analyzed using chi-square test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 12.0.
For the experimental group, significant improvement was found for self-efficacy, farming related health behavior, physical fitness (muscle strength, muscle endurance, upper body flexibility, lower body flexibility, cardiovascular endurance, balance, agility), farmer's syndrome, and health related quality of life as compared to the control group.
The findings of the study indicate that the community health promotion project for garlic farmers is effective and can be recommended as a nursing intervention for health promotion of garlic cultivating farmers.
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The study was conducted to describe body shapes of school age children using the degree of obesity index (DOI) and body mass index obesity index classified by the Ministry of Education, Science and Technology (M-BOI) and Seoul Metropolitan Office of Education (S-BOI).
In this cross sectional descriptive study health screening data for school children collected in 2007 was used.
Data were analyzed for 2,193 4th-6th grade boys (52%) and girls who attended 4 schools in rural areas. DOI determined that only 44.3% of students had average weight. This proportion was much lower than the results of other methods (74.3-77.6%). All three methods defined girls (51.3-61.8%) as skinnier than boys. Skinny and average body shaped children classified by DOI and obese children classified by S-BOI were heavier and taller and presented higher degrees of obesity (DO) and BMI scores than by other methods. M-BOI and S-BOI presented statistically significant positive correlations with weight, height, DO and BMI, while DOI was not correlated with height.
BMI based body shape classifications provide a more rigorous classification of body shape which are favorable for school health professionals with limited resources and policy makers for internationally comparable references.
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