• Title/Summary/Keyword: CARE guidelines

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A Study on Eating Habits, Life Styles and Nutrition Care of Diabetic Outpatients

  • Chang, Kyung-Ja;Nam, Moon-Suk
    • Journal of Community Nutrition
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    • v.1 no.2
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    • pp.133-139
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    • 1999
  • The purpose of this survey was to investigate eating habits, life styles and nutritional care of diabetic outpatients and to provide basic data for developing individualized nutritional care and diabetic education programs. This survey was carried out by nutritional counseling with a questionnaire and checking medical record. Information about the general characteristics of the subjects, eating habits, health-related life styles and attitude and perception of subjects to diet therapy was gathered from 200 randomly-sampled diabetic outpatients at a University Hospital located in Inchon. All data were analyzed by Statistical Analysis System(SAS) software. The results are summarized as follows : Female subjects were 63.5% of total subjects and 65.5% of total subjects were 50 years or more. The average Body Mas Index(BMI) of male and female subjects were 23.06kg/㎡ and 25.02kg/㎡ respectively and 44% of all subjects wee obese. Among subjects, type II diabetic patients were 81.0% and 82.5% of subjects had suffered from diabetes for more than one year. Also 41% subjects had diabetic history in their family. More than half of the subjects had nutrition education concerning diabetes. Also 75.5% of them thought that nutrition education was effective. The most important guideline in diet therapy was to eat cooked rice with dietary fiber-rich grains. Therefore, it might be necessary to develop nutrition education program adjusted according to diabetic patient's needs and life styles, which may increase feasibility of self-care and implementation of management guidelines.

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Job Analysis of Medical Care Client Managers based on DACUM (데이컴 (DACUM)기법을 이용한 의료급여관리사의 직무분석)

  • Choi, Jeong-Myung
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.3
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    • pp.299-307
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    • 2011
  • Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

Nutritional Support for Neurocritically Ill Patients (신경계 중환자의 영양 집중 치료)

  • Jeong, Hae-Bong;Park, Soo-Hyun;Ryu, Ho Geol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.71-80
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    • 2018
  • Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

Effects of an Integrated Health Improvement Program Based on Primary Health Care Posts on Depression, Social Support and Quality of Life during the COVID-19 Pandemic (코로나-19 동안 보건진료소에서의 통합형 건강증진 프로그램의 우울, 사회적 지지, 삶의 질에 대한 효과)

  • Yee, Hyeyoung;Kim, Younkyoung
    • Journal of Korean Academy of Rural Health Nursing
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    • v.17 no.1
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    • pp.23-33
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    • 2022
  • Purpose: This study was conducted to identify the effects of an integrated health improvement program for the elderly based on primary health care posts during the COVID-19 pandemic. Methods: A single group pretest-posttest design (n=16) was employed to evaluate an integrated health improvement program that took place twice a week for 11 weeks. The program was conducted in a small group of no more than 10 people in compliance with the guidelines to prevent COVID-19 infection. The program consisted of various contents such as making letters using blocks, health education, and talking about one's memories. The data were analyzed using the Wilcoxon signed rank test. Results: Following the program, social support (Z=-3.50, p<.001) and quality of life of the elderly (Z=-3.74, p<.001) were significantly improved among depression, social support and quality of life. Conclusion: The integrated health improvement program based on primary health care posts, considered in this study, was useful to improve the social support and quality of life of the elderly in the community, and needs to be applied to a larger number of elderly people throughout the community.

The art of diabetes care: guidelines for a holistic approach to human and social factors

  • Muhammad Jawad Hashim
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.218-222
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    • 2023
  • A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

A Case Study on Care Workers' Experiences of Coping with Falls among Community-Dwelling Elders (재가노인 방문요양보호사의 낙상관련 대처 경험에 관한 연구)

  • Lim, Sun-Young;Park, Hye-Sun;Ma, Ryewon
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.99-110
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    • 2021
  • Purpose: The purpose of this study was to understand the experience and meaning of falls among care workers caring for the elderly. Methods: The participants comprised 10 care workers in Seoul and Gyeonggi Province, South Korea. The data collection period was from September to November 2020, and the data were obtained through individual in-depth interviews. The collected data were analyzed using the content analysis method of qualitative research. The main interview questions were as follows: First, in the event of a fall, "can you tell us about your experience and how you dealt with the fall?; second, "can you tell us about your role and the role of family members or the center that manages falls that occur outside of nursing visits.", third, "can you tell us about the difficulties in managing falls based on your experience?", and fourth, "how are falls that occur during nursing visits managed?" Results: As a result of analyzing the experiences of nursing care workers of falls while caring for elders in their homes, five main themes were derived. These were understanding the characteristics of the elderly at home, understanding possible emergency situations, providing caring services, minimizing physical harm, and delivering clear information. Conclusion: A significant finding of this study was that care workers who visit and provide care to elders at home confirmed the need for standard guidelines on appropriate responses in the event of a fall at home and the importance of managing emergencies arising from falls among elders at home. These results highlight the need for the development of emergency response education programs, such as programs on fall care among nurses and care workers who provide care to the elderly, and for enhanced understanding of the fall risk of elders who live at home.

A Study on the Nurse's Due Care in Medical Malpractice (의료과오시(醫療過誤時) 간호사의(看護師)의 주의의무(注意義務)에 관한 연구(硏究))

  • Kang, Sun-Joo
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.1
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    • pp.113-136
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    • 1999
  • There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

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Development of supplemental nutrition care program for women, infants and children in Korea: $NutriPlus^+$

  • Kim, Cho-Il;Lee, Yoon-Na;Kim, Bok-Hee;Lee, Haeng-Shin;Jang, Young-Ai
    • Nutrition Research and Practice
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    • v.3 no.3
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    • pp.171-179
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    • 2009
  • Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in $NutriPlus^+$ aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the $NutriPlus^+$ in 2008.

Radiation Doses and Quality Assurance in Cone Beam CT(CBCT) (임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량)

  • Choi, Yong-Suk;Kim, Gyu-Tae;Hwang, Eui-Hwan
    • The Journal of the Korean dental association
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    • v.52 no.3
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

Study of the oriental medical literature for traditional childbirth (전통적 출산법에 대한 문헌적 고찰)

  • Youn, Seong-min;Kang, Han-ju;Jeong, Woo-seok;Jang, Myeong-jun
    • Journal of Korean Medical Ki-Gong Academy
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    • v.11 no.1
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    • pp.117-143
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    • 2009
  • The community of women into society in various fields is expanding, and married late, and accordingly, the first child birth is increasing age. Accordingly, dystocia has also increased. Listed in the literature that the traditional method of birth seemed to oriental medical interpretation of one of the ancient wisdom of the predecessors to explore. The result of this study is summarized as follows. 1. Child birth custom divide into childbirth preparation, childbirth and postpartum care. Postpartum care divide into preparation of the birthplace, food for pregnant woman and birth preparation of the necessary things. 2. Preparation of the birthplace of the court case and that qeen is three months, one month before that in the case of concubines were installed. The difference in manners, and actual number but the configuration of the same item was prepared. In the private, birthplace is installed husband's home or parent's home. 3. Rice and seaweed is food for pregnant woman. San Miguel (产 米), sangwak (山 藿) specifically called was selected by Keep elaborate. 4. 1 month before birth to baby clothing is usually prepared. For the safe of a paturient woman and a baby, magical prescription was practiced in so-guk-so(昭格署) in early chosun dynasty. After so-guk-so(昭格署) abolished magical practice was stopped. Then Wore old clothes based on dong-ui-bo-gam(東醫寶鑑) 5. Im-san-ye-zi-bub(臨产豫智法) specifically to instruct the royal birth is the birth of guidelines. Im-san-ye-zi-bub(臨产豫智法) cosist of birth place, abdominal pain Precautions, food, care after childbirth, remove the plecenta posion, method of cut navel, bath, protection. Through various court records of the situation, according to the guidelines are properly applied based on dong-ui-bo-gam(東醫寶鑑).