Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.
Background: In this study, we tried to comprehensively explore clinical dental hygienist's experience of a prevention-based incremental oral health care program, which was pilot-operated by dental clinics, define prevention-based incremental oral health care as experienced in the field, and identify factors to be considered. Methods: This study conducted a focus group interview with five dental hygienists who participated in an ongoing oral management pilot project in 2016. The interview was conducted by a researcher, and the co-research team attended as progress assistants and recorded characteristics of the participants, main dictations, and non-verbal characteristics. All interviews were recorded and underwent thematic analysis to examine the questions of the study as the main axis. Results: As a result of the study, 65 meaningful statements were extracted by code, integrated into 24 sub-categories, and structured into 11 categories. Finally, four keywords were drawn: characteristics, facilitating factors, conflicting factors, and improvement measures for prevention-based incremental oral health care. Regarding prevention-based incremental oral health care in dental clinics, dental hygienists were highly aware of the physical and mental burdens of personalized treatment and education for each individual. They were responsible for the patient and for facilitating changes in the behavior of the client, leading to professional satisfaction. The dental team's cooperation and supportive attitude were found essential to continue oral health care in the dental clinic. Conclusion: Through dental team-based treatment philosophy sharing and collaboration, it is possible to provide prevention-based incremental oral health care in dental clinics. In future, it is necessary to develop a system for establishing a sustainable preventative management system for public health promotion.
The purpose of the study was to investigate the attitudes towards death and euthanasia of Nurses and Nursing students live in convergence era. The participants were 380 nurses and nursing students and data were collected from May until June of 2014. The data were collected by means of self reported questionnaires and analyzed using descriptive statistics t-test, one-way ANOVA and Scheffe test with the SPSS/WIN 18.0 program. The result showed that the fear of death of others with nursing students was higher than nurses (t=-3.34, p=.001) and nursing students supported euthanasia more than nurses(t=-3.06, p=.002). Among the death attitude, both of the nurses and the nursing students had the highest score 'fear of their own dying' and the lowest score 'fear of the dying of others'. Regarding attitude to euthanasia, both of them the most important factor was 'the right of the client'. These results suggest that death education program to deal with nursing services without ethical conflicts should be developed.
Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.
Concurrency control is one of the important factors to maintain consistent conditions of a game because most participants of the game should be shared information to play the game through a distributed network system. replay delay times should establish in every event and the received event should be saved and performed simultaneously for Concurrency Control. However, it is not easy to practice the event with same speed in environment having various moving speed. Therefore, expansion have to be provided. In other words, one of the most important factors of a game's efficiency is the process of bandwidth and delay. the process of concurrency control method based on scalable prediction for Multi-platform games would minimize the loss rate of a event and then would improve the interaction capacity of a game. It also might get reliability between clients. This paper analyzes some problems in terms of a layout of a game that integrates a cable and a wireless system. In addition, this paper provides methods to expand bandwidth and delay that might be an obstacle of a On-line game and to ensure reliability between a server and a client.
Purpose: The purpose of this study was to evaluate the achievements of the project, and also to find out its strengths and weaknesses. Method: This evaluative study employed system theory and analytic techniques by using criteria which were relevance, appropriateness, adequacy, progress, effectiveness and satisfaction for input, process, output, and outcome of program. Study subjects were participants in the home health care program implemented in G public health center in Inchon metropolitan city in 2003. Results: Input factors including recruitment personnel, and support organization development were not adequately met for the program. However. the goal and objectives of the project were really appropriate for the community needs as well as government's policy. For the Process evaluation, home health care record form and computer data base had not progressed as scheduled, but overall program activities were finished on time. However, cooperation between organizations in the health center during service activity were not supportive. Managerial ability of program charged personnel about coordination and integration of team members was not affirmative. Output and outcome evaluation showed that people improved self care ability were 221 (17.5%). and 71 (5.62%) of subjects were moved into category of possible self-care. Client's satisfaction for this project showed a high degree. Conclusions: Based on the above results support organization and staff personnel for this program should be developed. Also, a community network of resources should be established and case management services should be focused continuously in community based home health care.
Purpose: The purpose of this study was to evaluate the effectiveness of a sleep improvement program combined with an aroma-necklace on sleep, depression, anxiety, and blood pressure in elderly women living at home. Methods: A program consisting of a four-week (one hour per week) sleep improvement intervention plus use of an aroma-necklace, was developed based on Cox's Interaction Model of Client Health Behavior. 70 elderly women were assigned to the experimental (n=35) or control group with no intervention (n=35). Data from 62 participants (32 in the experimental and 30 in the control) were analyzed using the SPSS 21.0 program. Women in the experimental group were instructed to constantly wear the aroma necklace filled with marjoram and orange oil until the program was completed. Sleep quality, sleep duration, sleep satisfaction, depression, anxiety, and blood pressure were measured to identify the effectiveness of the program. Results: Significant group differences were found in sleep quality (t=-5.10, p<.001), sleep duration (z=-3.10, p=.002), sleep satisfaction (z=-4.13, p=<.001), depression (t=2.53, p=.015), and anxiety (z=-2.47, p=.014). No differences were found in the systolic or diastolic blood pressure. Conclusion: The results indicate that a sleep improvement program combined with an aroma-necklace was effective in improving sleep disturbances in elderly women living at home. Nurses may contribute to improving sleep among elderly women by applying this program to aged women living in various environments.
Purpose: This study was done to evaluate the formal education program provided by the Korean government for care workers for frail elderly people. Methods: This study was a cross-sectional survey in which 438 certified care workers who had completed the education program participated. Data were collected from June to October 2009, using a self-report questionnaire consisting of satisfaction with, and understanding of the education program. Results: The participants had a mean age of 46.7 yr, 87.9% were female and 58.2% were high school graduates. For the theory part of the education, the highest score for understanding was for 'supporting household & activities of daily living' while the lowest score for understanding was for 'care for death and dying'. For the practical education, the highest score for understanding was for 'talking with the client' and the lowest score was for 'first aid & basic life support'. There was a significant difference in satisfaction and understanding of the theoretical and practical parts according to educational level. Conclusion: Continuing education programs are needed for care workers for elders, both in the theoretical and practical areas. Also the content of programs should address the weak points of this formal education program.
The objective of this study was to explore the elements and effects of integrated care interventions for the elderly, and to describe the roles of social workers on the multidisciplinary teams. A rapid systematic review was conducted through a database-based search and a manual search. The main findings are as follows: First, Key elements of integrated care for the elderly were case management, individual multidisciplinary care plan, service characteristics, centrality of client needs, patient education, and self-management. Second, In terms of care experience and health of the elderly, and economic analysis, although the results were mixed, there were some positive effects on program participants compared to the control groups. Third, social workers have been found to serve as case managers, care managers, care coordinators, and direct service providers. Based on these results, educational and policy implications were suggested.
Recently, epidemic of covid-19 causes rapid increase in demand for untact video conferences. In existing server-client based video conference systems such as Zoom, Google Meet, etc., the server generates the conference key and controls the access rights of meeting members and their contents with it. In this case, the server can fabricate or repudiate the meeting. So, the privacy of the meeting members is not guaranteed. It's necessary to make the conference key distribution scheme where all participants can verify the trustfulness without help of the server. The smart contract is the program stored to the blockchain. Its contents cannot be altered due to the property of the blockchain, and everybody can verify the execution results of it. In this study, we propose the smart contract based conference key distribution scheme. The proposed scheme is consisted of smart contract deployment, conference key generation and verification stages. The smart contract replaces the role of existing trustful server and the meeting members can generate the conference key according to the protocols implemented on it. The proposed scheme can be applied to the video conference systems and only the meeting members can access the conference key.
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