• Title/Summary/Keyword: Care need

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Experiences with Rapid Appraisal to Assess Health and Social Needs in Primary Care (Primary care에서 지역사회 건강과 사회적 요구사정을 위한 Rapid appraisal 경험)

  • Cho, Myung-Sook
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.299-307
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    • 2001
  • 본 연구의 목표는 rapid appraisal의 사용을 통한 지역사회의 건강과 사회적 요구들을 알아내고 이들의 우선순위를 파악하여 지역주민과 써비스 제공자들 사이에 활동계획을 만들기 위함이다. 자료 수집은 Rapid appraisal의 정보피라미드를 통한 primary care team에 의해 3개의 자원들인 지역사회내 기존자료들과 지역 내에서 많이 사용해왔던 반 구조화된 면담지, 방문과 크리닉을 통한 직접 관찰로 자료수집을 하였다. 반 구조화된 면담지는 pilot study하고 검증한 후 사용하였다. 자료수집 대상은 Northern General hospital내에 등록되어진 100가구의 도시영세민 주택에 거주하는 자로 하였다. 결과로 면담자 들과 focus groups은 지역사회 내 지역건강요구들을 만나고 알아내며 건강뿐만이 아닌 사회적인 많은 변화가 요구되는 건강관련 우선순위를 알아내는 첫단계로써 rapid appraisal의 사용이 유용하다. 결론적으로 Rapid appraisal은 지역사회 내 Primary care에서 muti-displinary approach를 촉진하여 건강에 영향하는 다양한 요인사정의 질적인 방법으로 변화를 위한 행동 계획을 세우는데 좋은 평가 방법으로 확인되었다.

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Restructuring Primary Health Care Network to Maximize Utilization and Reduce Patient Out-of-pocket Expenses

  • Bardhan, Amit Kumar;Kumar, Kaushal
    • Asian Journal of Innovation and Policy
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    • v.8 no.1
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    • pp.122-140
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    • 2019
  • Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.

Factors associated with the person-centered care competence of nursing students (간호대학생의 인간중심간호 역량에 미치는 영향요인)

  • Park, Ju Young;Woo, Chung Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.1
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    • pp.48-56
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    • 2022
  • Purpose: The main purpose of this study was to identify factors influencing person-centered care competence in nursing students. Methods: The study was conducted in two universities located in the D and J cities of South Korea. Participants were 130 senior nursing students who had experienced clinical practice for at least 3 months. Data were collected from September 7-10, 2019, using a structured questionnaire and analyzed using a hierarchical multiple regression with SPSS/WIN 23.0. Results: The Factor influencing person-centered care competence was compassion competence (β=.49, p<.001) and the explanatory power of this variable was 30% (F=10.98, p<.001). Conclusion: According to the results of this study, nursing faculties need to develop programs and learning content to enhance learners' compassion competence for promotion of person-centered care competence.

Awareness and needs for integrated care convergence education among some health students (일부 보건계열 학생들의 통합돌봄 융합교육에 대한 인식 및 요구)

  • Hye-Eun Cho;Ji-Yeon Lee;Jong-Hee Han
    • Journal of Korean society of Dental Hygiene
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    • v.24 no.1
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    • pp.79-89
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    • 2024
  • Objectives: This was carried out to develop an integrated care convergence curriculum. Methods: An online survey was conducted on 312 public health college students, and frequency analysis, t-test, ANOVA, and chi-square test were conducted. Results: Awareness of convergence education (2.55) and experience of convergence education (10.3%) were low, but those with education experience had high awareness of integrated care and convergence education (p<0.001). The need for education (3.07) and manpower training (3.14) were both high, and the preferred training content was first aid (3.57). Conclusions: Additional research is needed on the development of integrated care convergence curriculum.

Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study

  • Hyosin Kim;Signe Peterson Flieger
    • Journal of Hospice and Palliative Care
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    • v.26 no.2
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    • pp.42-50
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    • 2023
  • Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Canonical Correlation between Korean Traditional Postpartum Care Performance and Postpartum Health Status (산후조리 수행과 산후 건강상태간 정준상관관계)

  • Ahn, Suk-Hee
    • Journal of Korean Academy of Nursing
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    • v.35 no.1
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    • pp.37-46
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    • 2005
  • Purpose: The purpose of this longitudinal study was to examine the relationship between postpartum care performance and postpartum health status. Sample: The study subjects were 82 mothers who delivered full-term infants at 3 hospitals at P city. Data were collected for their health status at the postpartum unit and the sample was followed up to 6 weeks postpartum to collect postpartum care performance and health status. Results: Mothers rated postpartum care performance as moderate to high and especially rated the maternal role attainment the highest. Mothers experienced 4 physical symptoms and moderate levels of fatigue. In addition, they experienced moderate levels of positive affect and low levels of negative affect at both times. Canonical correlation revealed that ostpartum care performance was related to postpartum health status with 2 significant canonical variables. The first variate indicated that mothers who performed hospitality, physical and emotional recovery, self-caring, and role attainment well showed higher positive affects, lower negative affects, fewer physical symptoms, and lower levels of fatigue. The second variate showed that the greater the performance of caring and physical and emotional recovery, the fewer physical symptoms and lower levels of fatigue. Conclusion: Although Korean traditional postpartum care performance was related to postpartum health status, the further study is needed to identify the causal relationship between them. Nurses need to integrate the perspective of westernized postpartum care and Korean traditional views of postpartum approach to maintain and promote women's health.

The Effects of Elderly Diabetes Mellitus Patients' Self-care Behavior and Health Conservation on Cardiovascular Risk Factors

  • Sung, Kiwol
    • Research in Community and Public Health Nursing
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    • v.26 no.2
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    • pp.150-159
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    • 2015
  • Purpose: This study was performed in order to identify the relationships among self-care behavior, health conservation, and cardiovascular risk factors and to examine the influence of self-care behavior and health conservation on cardiovascular risk factors among Korean elders with diabetes mellitus. Methods: The participants were 105 elders with diabetes mellitus using senior welfare centers and elderly leisure houses in Daegu. Data were collected through interviews during the period from April to May in 2014. Self-care behavior was measured with Kim's (1997) Self-care Behavior Scale, health conservation with Sung's (2005) Health Conservation Scale, and cardiovascular risk factors with the Arizona Heart Institute Cardiovascular Risk Factor Questionnaire. Collected data were analyzed through one-way ANOVA, independent t-test, Pearson's correlation, and stepwise multiple regression using the SPSS/WIN 19.0 program. Results: A negative correlation was found between self-care behavior and cardiovascular risk factors, and between health conservation and cardiovascular risk factors. Self-care behavior explained 6% and health conservation did 49% of variance in elderly diabetes mellitus patients' cardiovascular risk. Conclusion: The results indicate that, in order to reduce cardiovascular risk factors among Korean elders with diabetes mellitus, we need nursing interventions for increasing health conservation and self-care behavior.

Pediatric Nurses' Perceptions related to End-of-Life Care and Turnover Intention (아동의 임종에 관한 간호사의 인식과 이직 의도)

  • Baek, Sook Young;Kang, Sook Jung
    • Child Health Nursing Research
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    • v.24 no.4
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    • pp.353-363
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    • 2018
  • Purpose: The purpose of this study was to investigate pediatric nurses' perceptions regarding in end-of-life care and turnover intention. Methods: A cross-sectional descriptive study was performed among 111 hospital nurses. Pediatric nurses' perceptions of obstacles and supportive behaviors were measured using the Pediatric Nurses' Perceptions of End of Life Care Questionnaire which was translated into Korean and turnover intention was measured using the Korean Nurse Turnover Intention Scale (K-NTIS). Results: The supportive behavior with the highest perceived magnitude was 'Physicians who are compassionate, but very clear about prognosis.' The obstacle with the highest perceived magnitude was 'Instigating painful treatments when there is no hope of recovery.' Pediatric nurses' perceptions of obstacles in end-of-life care showed statistically significant differences depending on whether nurses received end-of-life care education (t=2.02, p=.046). The perception of obstacles in end-of-life care was positively correlated with turnover intention (intensity r=.28, p=.002) (frequency r=.20, p=.027). Conclusion: These results suggest that pediatric nurses' perception of obstacles and supportive behaviors in end-of-life care need to be assessed when considering turnover intention. Furthermore, psychological counseling should be offered to nurses to prevent burnout and reduce moral distress which is correlated with the turnover rate.

An Analysis of Needs for Community Space and Child-care Supporting Services in Urban Dual Low-income Families (도시 저소득층 맞벌이 가정의 공유공간과 육아지원서비스에 대한 요구 분석)

  • Lim, Yeaji-Ji;Lee, Yeaun-Sook
    • Korean Institute of Interior Design Journal
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    • v.27 no.3
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    • pp.3-13
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    • 2018
  • Although the number of dual low-income families continues to increase, working mothers are suffering from difficulties from housework and child rearing due to the economic difficulties and poor residential environment. By understanding the needs about community space and child-care support services, this study will look into planning cooperative child-care environments for dual low-income families with infants and children. Through purposive sampling this research targeted 151 dual income families with an average monthly income level of 1-3 in Seoul. The collected data was analyzed by frequency analysis, descriptive statistics, and independent sample t-test using SPSS. The research results are as follows: According to the review, respondents responded positively to cooperative child-care. Out of the 20 general community spaces, the need for an indoor playground, recreation room, day nursery, separate garbage and reading room ranked high. Overall, 21 child-care community spaces and 11 child-care support services were generally rated highly.