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In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the community.

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• Looking Back the Past 30 Years: Activities and Achievements of Community Health Practitioners in Rural and Remote Areas in Korea
  Chunmi Kim, Kyung Ja June
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Resourcefulness was analyzed by Walker and Avant's method to make a theoretical framework for nursing. Also, the appropriate Korean terminology was identified. "Resourcefulness" means the ability to use internal and external resources to eliminate or to control stress. 'Resourcefulness' is chosen to be the most appropriate term to reflect the concept of resourcefulness. Upon the concept analysis availability, controllability, confidence, and self-instruction were identified as the defining characteristics of resourcefulness. Contrary to other work, "availability" means the ability to use the social resources as well as the internal cognitive-behavioral resources. "Controllability" means the ability to delay or control immediate gratification of one's needs or to divert one's own mood in order to solve problem. "Confidence" is the self-efficacy belief in one's control ability. "Self-instruction" is the cognitive ability to instruct oneself positively. Resourcefulness is learned by active experience, vicarious experience, and formal or informal instruction or a need for change. As a result of the use of resourcefulness, the target behavior performed immediately and ultimately improve the quality of life or adaptation. Therefore, it is necessary to develop the instrument including the defining attributes identified in this study. Also, it is necessary to simultaneously analyze the related concepts of self-efficacy, self-control, and self-regulation for appropriate use.

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• Concept analysis of end-of-life care competency of long-term-care-hospital nurses: Using a hybrid model
  Sookyeon Son, Mi-Kyeong Jeon
  Journal of Korean Gerontological Nursing.2024; 26(1): 19.     CrossRef

This study was done to determine direct and indirect nursing time in nursing units in hospital to applied computer system and expect that those results contribute to measure efficiency of nursing practice and planning of nursing manpower. The design for study was a descriptive study. The study results are as follows. 1. Patients admitted to the Internal Medicine and General Surgery units were grouped into four: Group I, 32.9% of the total patients, consisted patients whose condition was considered minor: Group II, 26.1%, was of those whose condition was considered moderate, Group III, 41. 8%, moderate severe and Group IV, 29.2% the most severe. 2. Nursing intervention times by care type were as follows: four minutes spent for suction, eight minutes, for simple position change, ten minutes, for sheet change, seven minutes for a hot or cool compress, six minutes for dressing change, four minutes for I.M.injection, six minutes for patient health education and five minutes for body temperature check. 3. Direct care time by patient group revealed the following: Group I rquired 191.4 minutes, Group II required 331.1 minutes, Group III rquired 499.4 minutes, and Group IV rquired 1328.0 minutes. 4. The ratio of time for adequate nursing care and direct care time in the Internal Medicine and General Surgery units was 67.4%-83.4% and 94.7%-99.3% in the Intensie Care Unit. 5. Average daily direct care time per patient was 5.5 hours in the Internal Medicine unit and 11.5 hours in the Intensive Care Unit. 6. Time spent in indirect care was 48.3 minutes for computer recording, 34.8 minutes for giving and receiving patient information for shift duty, 28.0 minutes for eating and resting time, 26.6 minutes for transfering and identifying patients, 25.6 minutes for identifying Doctor's order, 23.9 minutes for recording vital signs. 7. Time spent in indirect care was 282.2 minutes by head nurses (charge nurses), 258.7 minutes by nurses and 261.6 minutes by nurse aids. 8. The average nurse's workload was 9.3 hours and daily indirect nursing time required 46.3%-50. 5% of above mentioned workload time. 9. The average daily indirect care time per patient was expected to be 57.7 minutes in the Internal Medicine unit and 3.3 hours in the Intensive Care Unit.

PURPOSE: The purpose of this study was to develop an instrument to measure family resilience for Korean families with a chronically ill child, and to test the validity and reliability of the instrument. METHOD: The items of instruments used based on the researchers' previous study of concept analysis of Korean family resilience. Nineteen item scales were developed with five domains. In order to test reliability and validity of the scale, data were collected from 231 families, who had a child with a chronic illness. Data was collected between August and September of 2001 in a 3rd level University Hospital in Seoul, Korea. RESULT: The results were as follows: As a result of the item analysis, 19 items were selected from the total of 37 items, excluding items with low correlation with the total scale. Five factors were evolved by factor analysis, which explained 56.4% of the total variance. The first factor 'Family strength' explained 28.5%, 2nd factor 'Family maturity' 8.7%, 3rd factor 'The ability to use of external resources' 7.0%, 4th factor 'Control' 6.6%, 5th factor 'The driving force for finance' 5.7%. The attributes in these factors were different with those identified by concept analysis of the family resilience in Korean families from the previous study. Cronbach's alphacoefficient of this scale was .8039 and Guttman spilt- half coefficient was .8184. CONCLUSION: The study support the reliability and validity of the scale. Because the main concept of family resilience was family strength, there were distinct differences in dimensions of family functioning scales.

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• Family management structural model for children with atopic dermatitis
  Sunyeob Choi, Hyewon Shin
  Journal of Pediatric Nursing.2024; 77: e401.     CrossRef
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  Youna Chang, Jiyoung Lim, Hye Won Yoon
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• Concept Analysis of Resilience in Patients with Cardiovascular Diseases
  Su-Jin Shin, Duk-Yoo Jung, Eun-Hee Hwang
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• To Holroyd E (2005) Commentary on Lee et al. (2004)
  Insook Lee, Eun‐Ok Lee, Hesook Suzie Kim, Young Sook Park, Misoon Song, Youn Hwan Park
  Journal of Clinical Nursing.2006; 15(5): 654.     CrossRef

PURPOSE: The purpose of this study was to develop the instrument to measure family functioning for Korean family with a chronic ill child, and to test the validity and reliability of the instrument. METHOD: The items of instrument were consisted based on researchers' previous study of concept analysis of the Korean family functioning. Twenty six item scale was developed with six domains. In order to test reliability and validity of the scale, data were collected from the 231 families, who have a child with a chronic illness. Data was collected between August and September in 2001 in a General Hospital in Seoul, Korea. RESULT: The results were as follows:As a result of the item analysis, 24 items were selected from the total of 26 items, excluding items with low correlation with total scale. Six factors were evolved by factor analysis. Six factors explained 61.4% of the total variance. The first factor 'Affective bonding' explained 15.4%, 2nd factor 'External relationship' 11.8%, 3rd factor 'Family norm' 10.5%, 4th factor 'Role and responsibilities' 8.3%, 5th factor ' Communication' 7.9%, and the 6th factor 'Financial resource' explained 7.3%. Cronbach's alpha coefficient of this scale was .87 and Guttman spilt- half coefficient was .84. CONCLUSION: The study support the reliability and validity of the scale. There were distinct differences in dimensions of family functioning scales developed in the U. S.

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• Factors influencing self-management behaviors in older people with multiple chronic conditions based on the individual and family self-management theory: A cross-sectional study
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• Family functioning according to clusters of family management styles in Korean families of children with chronic atopic disease: A cross-sectional study
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• To Holroyd E (2005) Commentary on Lee et al. (2004)
  Insook Lee, Eun‐Ok Lee, Hesook Suzie Kim, Young Sook Park, Misoon Song, Youn Hwan Park
  Journal of Clinical Nursing.2006; 15(5): 654.     CrossRef

PURPOSE: To evaluate the emergency medical protocols and need assessment through the
case
report METHOD: The study investigated the emergency call system through the 1339 emergency patients information center in 1997. Results: The emergency calls tend to follow general trends of the type of cases : abdominal pain (13.5%), unconsciousness(12.0%), traffic accidents (7.4%), bleeding (6.6%), respiration difficulty (5.9%). This was all collected through emergency medical protocols injury and poisoning (22.3%), symptom (51.6%), others (26.1%).
CONCLUSION
The results suggest that a specific training program for emergency medical dispatchers should be established, and emergency medical dispatcher managers must review the cases on the basis of emergency medical protocols every year. Emergency medical services, furthermore, will continue to raise the standard for emergency medical dispatching.

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The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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