The aim of this presentation is to share with the thoughts and insights learned as the program responds to the needs of the community as well as to gather reactions, comments, suggestions, and recommendations for a more effective, and efficient approach in the development of community based psychiatric programs as wells as to identify points of entry for PPA and its members.
COMMUNITY MENTAL HEALTH SERVICES

1. Instruction. Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project on order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was meeded. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myum. 2. Survey Method. An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing technique for three days. The team consisted of a public health nurse, four nurse-aides, a asnitarian and four health extension workers who are working in our project. The survey was carried out during the period November 1971 to March 1972. 3. Project area. 1) Population of Soyang-Myum was 11,668 ; male, 5,962 and female, 5,706. Sex ratio : 104.5. 2) Households : 1,858. 3) Family size : The average household consisted of 6.3 persons. 4) Education level of householder. a. Illiterate 13%. b. No schooling but able to read 10%. c. Preschool Children 19%. d. Primary School 47%. e. Middle School 7%. f. High School 3%. g. College or University 1%. 5) Occupational distribution of householders. a. Farmer 67%. b. Laborer 13%. c. Office worker 4%. d. Merchant 4%. e. Industrial worker 2%, f. Unemployed 8%, g. Miscellaneous 2%, 6) Religious affiliation. a. No religion 74%, b. Buddhist 12%, c. Protestant 10%, d. Catholic 4%. 4. Survey results. Living Environment : a. Home ownership 95%, b. Kinds of roofing. Straw-thatched house 84%, Tile-roofed house 10%, Slate-roofed house 5%, Other 1%. c. Floor space, Less than 6 pyong 10%, 6-10 pyong 53%, 1-15 pyong 24%, 16-20 pyong 9%, More than 20 pyong 4%, d. Radio ownership 80%. Environment : a. the source of drinking water. public well 49%, private well 30%, drainage water 9%, steam water 8%, well pump 3%, water distribution system 1%, b. Distance between well and toilet. more than 16 meter 38%, 6-10 meter 31%, 11-15 meter 14%, Less than 6 meter 17%. c. The status of well management. Bad 72%, Fair 26%, Good 12%. d. General sanitary of well management. Bad 37%, Fair 51%, Good 12%. e. House drainage system. had no house drainage 77%. Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods. loop 68%, oral pill 16%, vasectomy 4%, condom 1%, tubal ligation 1%, two or more methods 10%. Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26%, 6 times 11%, 5 times 11%, 4 times 9%. b. The place of delivery. own house 88%, hospital 1%, others 11%, Treatment of general sickness. a. The place of treatment, Soyang Health Center 31%, Hospital(Private or otherwise) 26%, Pharmacy 14%, Herb medicine 5%, Private care 5%, No treatment 12%, Miscellancous 7%. b. Usual causes of disease. Unknown 46%, Tuberculosis 29%, Neuralgia 8%, CVA 3%, Bronchitis 3%, Others 11%.
Bronchitis ; Child, Preschool ; Community Health Services ; Community Medicine ; Condoms ; Contraceptive Agents ; Surveys and Questionnaires ; Drainage ; Drinking Water ; Education ; Family Characteristics ; Family Planning Services ; Female ; Fertilization ; Health Surveys* ; Humans ; Male ; Maternal Health ; Neuralgia ; Nurses, Public Health ; Ownership ; Pharmacy ; Protestantism ; Sanitation ; Sex Ratio ; Steam ; Sterilization, Tubal ; Tuberculosis ; Vasectomy ; Vital Statistics ; Water

PURPOSE: The purpose of this study was to investigate the effects of using a social skills training program to address problem behaviors, social skill, and peer relationship in children using a community child center in a vulnerable area. METHODS: The research design was a non-equivalent control group pretest-posttest quasi-experimental study. Participants in the experimental group were 25 children, recruited from a community child center in G-city. Participants in the control group were 25 children, recruited from a community child center in S-city. Data were collected from September, 2014 to January, 2015. Outcomes were measured using the Child Problem-Behavior Screening Questionnaire (CPSQ), Social Skill Rating System (SSRS), and Peer Relational Skills Scale (PRSS). The experimental group participated in the social skills training weekly for 10 weeks. Statistical analysis was performed using the SPSS 18.0 program. RESULTS: Significant differences were found in problem behaviors, social skills, and peer relationship scores between the two groups. CONCLUSION: This social skills training program was found to be effective in reducing problem behaviors and improving the social skill and peer relationship of these children, and is recommended for use in community health services as an effective nursing intervention for children in vulnerable areas.
Child* ; Community Health Services ; Education* ; Humans ; Mass Screening ; Nursing ; Peer Group ; Research Design ; Social Behavior*

In accordance with the Republic Act (RA) 11036, also known as the Mental Health Act of 2017, the Department of Health (DOH) was tasked to "establish a balanced system of community-based and hospital-based mental health services at all levels of the public health care system from the barangay, municipal, city, provincial, regional to the national level." It is also expected that the Local Government Units (LGUs) "promote deinstitutionalization and other recovery-based approaches to the delivery of mental health care services."1 Even before RA 11036 was enacted, the Davao Center for Health Development (DCHD) had already facilitated the establishment of several Community-Based Mental Health Programs (CBMHPs) in rural health units (RHUs) within the region since 2015. These programs are guided by six principles–coordinated level of referral system for better patient care, optimizing the expertise of the regional mental hub to guarantee rational use of drugs, community-based patient care for a more cost-effective treatment, capitalizing family and patient's support groups for better patient outcomes, optimizing innovative long-acting injections for better compliance and decreased relapse, and neutralizing the stigma against schizophrenia to improve mental health.2 The aim of this article is to recommend health care policies based on the report on observations and lessons learned from the implementation of the CBMHPs by the DCHD in four municipalities in Davao Region.
Community Health Services ; Mental Health Services

In order to develop some indicies for the evaluation of village health worker's activities and to find out personal characteristics and other factors that affect the activities, an interview survey was conducted to thirty seven village health workers (VHW) in Sunwon, Naega and Bulun townships in Kangwha county, where the Community Health Project of Yonsei University, College of Medicine, has been implemented for the past ten years. In addition, daily activity records of the VHW's were also analyzed. The results are summarized below: First, meeting attendance rates, number of regular family visits, number of antenatal care visits and number of family planning visits were identified as the most meaningful criterion for the evaluation of the village health worker's activities. Second, personal factors that significantly affect the village health worker's activities were identified as age, educational background, living with in-laws, religion, presence of preschool child in the family, holding leader's position of village woman's association concurrently, and duration serving as a VHW. The more aged and the more educated VHWs were the more effective. Those VHWs who were living with in-laws, without preschool child in the family, holding the leader's position of the village woman's association, and the longer service duration were the more effective. Other factors that affect the VHW's activities were the number of households in the target village and the number of natural villages in the target villages. It showed that the smaller the size of number of households and natural villages, the higher the degrees of the effectiveness of the VHW.
Child, Preschool ; Community Health Workers ; Family Characteristics ; Family Planning Services ; Humans

BACKGROUND: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. OBJECTIVE: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. METHODS: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. RESULTS: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. CONCLUSION: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.
Community Pharmacy Services ; Counseling ; Education, Pharmacy ; Health Promotion ; Humans ; Korea* ; Pharmaceutical Services* ; Pharmacies* ; Pharmacists ; Prescription Drugs ; Prescriptions ; Quality Improvement ; Self Medication ; Social Values

PURPOSE: The purpose of this study was to identify the effects of occupational health service(OHS) for the aged workers in small workplace. METHOD: A single group of pretest-posttest design was used. 608 aged workers of 253 small workplace who had one out of 4 risk factors were randomly selected. The OHS consisted of education, medical checkup, and counseling. Also information was provided by a visiting nurse 4-5 times every 4-5 weeks from March to November, 2009. The data were collected by interview, self report, and monitored by a nurse. RESULTS: The OHS led to significant reduction of the mean systolic and diastolic blood pressures of 6.46mmHg and 5.22mmHg, each respectively. The mean total cholesterol, glucose, and BMI were also reduced significantly by 6.35mg/dL, 5.91mg/dL, and 0.31kg/m2. And stages of health behavioral change were moved from 1,2,3 stages to 4,5 stages significantly. CONCLUSION: The OHS showed an effective intervention to improve the aged workers' health in the small workplaces. Therefore, The OHS by visiting a nurse can be a good strategy to extend to small & medium-sized companies having no in-site health manager.
Aged ; Cholesterol ; Community Health Nursing ; Counseling ; Education, Medical ; Glucose ; Health Behavior ; Humans ; Occupational Health ; Occupational Health Services ; Risk Factors ; Self Report

PURPOSE: The purpose of this study is to investigate working time of nurses in urban public health center branch, especially for nurses for visiting health service and chronic disease management. METHOD: Daily note, which was developed by this research team, was distributed to nurses at 7 urban public health center branches to be filled out them for 2 weeks during 2 month from June 2007 to August 2007. We analyzed 121 daily notes recorded by visiting nurses and 65 daily notes written by chronic disease management nurses were analyzed. RESULTS: The total working time for visiting nurses at urban public health center branches was 589.85 minutes per day on the average. They spent 147.13 min in actual visiting nursing services, 149.36 min in documenting, 66.94 in preparing, 77.69 min in transferring, and 11.84 min in referring. The total working time for chronic disease management nurses at urban public health center branches was 582.92 minutes per day on the average. They spent 148.77 min in actual chronic disease management services, 120.62 min in documenting, 42.46 min in group education, 37.38 in preparing, and 10.38 min in referring. CONCLUSION: Based on the results of this study, it is recommended to improve documenting systems and to increase community resources linkage were recommended through the results of this study. The results of this study are expected to be used to plan staffing at urban public health center branches in the future.
Chronic Disease* ; Education ; Health Services* ; Korea ; Nurses, Community Health ; Nurses, Public Health ; Nursing Services ; Public Health*

PURPOSE: The purpose of this study was to explore ethical problems that cause moral distress in nurses and affects the quality of care provided by community mental health nurses working in community mental health settings. METHODS: Three focus group interviews were held with 14 nurses working in 3 community mental health centers in Korea. Qualitative descriptive methods and qualitative content analysis were used. RESULTS: Data analysis found 5 domains (decision making, communication, resources, safety, advocacy), 9 categories (personal information sharing issues, ethical insensibility, collisions between principles and practice, institutions unprepared in ethical problems, ethical dilemma in interactions with clients, problems with the evaluation system, problems with the budget structure, problems with the lack of safety measure, and problems with role limitation as a professional) and 11 subcategories. CONCLUSION: Results of this study suggest a) a need for further research on identifying ethical conflicts arising in community mental health fields, and b) on what nurses actually do when they deal with ethical conflicts, c) efforts to develop ethics support programs such as ethics education, training and reflection meetings to enhance nurses' ethical sensitivity, d) consideration of a supportive environment and culture that prioritizes ethical concerns in practitioners as well as administrators.
Administrative Personnel ; Budgets ; Community Mental Health Centers ; Education ; Ethics ; Focus Groups ; Humans ; Information Dissemination ; Korea* ; Mental Health Services ; Mental Health* ; Nursing ; Qualitative Research ; Statistics as Topic

This study was to develop the home care nursing network system for low income and vulnerable health people by utilizing wire- wireless network and mobile computing in order to record and send patients' data in real time, and connect the headquarter office and four local community health centers. The methods were the Method/1 and Prototyping were adopted to develop the main network system. Results were: 1) home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis, dementia/mental disorder, and chronic arthritis were added in 12 domains of nursing problem field with nursing assessment/intervention algorithms. 2) upgrading PDA system by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX - 1X base construction in order to reduce a transmission hour and the transmission failure.
Arthritis ; Community Health Centers ; Home Care Services* ; Modems ; Nursing*