Objectives: This paper is intended to illustrate and to discuss the organization and functioning of community resident groups (CRGs) in a community-based participatory health promotion program for healthy aging. Methods: CRGs were convened in 12 government-subsidized apartment communities for low-income seniors in Pennsylvania, U.S.A., to promote healthy aging. Researchers facilitated CRG meetings following a 6-step process of community empowerment and utilizing a social ecological model for assessment and planning. Almost 200 project-related documents were qualitatively analyzed using matrix analysis principles such as cross-classification of multiple dimensions to identify patterns in the data and matrix building for displaying such patterns. Results: CRGs were venues at which apartment building residents could interact, discuss health priorities, and become change agents in their building. CRG members' community health priorities were about their daily living, including building conditions, poor access to fresh food, and unhealthy resident relations. Specific patterns arose in analysis indicating that leadership withing the CRGs, consistency of meetings and participants' attendance, and ability to link health concerns to daily experience impacted the CRGs' capability to identify and accomplish their goals. Conclusion: Community health issues and solutions to those issues identified by CRGs were unique to community contexts and interests. Consistent participation by community members, a consistent pattern of group activities such as monthly meetings, and having established leadership to manage CRG activities were prominent characteristics of community group functioning.
Objectives: The nurse visiting health service named Customized Visiting Health Care Program(CVHCP) requires the service innovations incorporating community support into a local service network. The purpose of this study was to assess the community network in CVHCP and inform improvement in this network. Methods: We used Social Network Analysis(SNA) in one CVHCP at H city. Network links were generated by self-administered questionnaires by the 14 community resource centers who quantified their links to all other 25 agents on the list. Links were analyzed by a dichotomous scale for any experience of collaboration and a scored scale of 0 to 3 for level of collaboration using UCINET v6. Results: A list of 14 agents was generated, and local network was dominated by the Public Health Center and a local welfare center named Unlimited Care Center(UCC). According to centrality score, UCC was the most prominent agent, and Public Health Center was the most influential agent, being a link in the pathway flow between other agents for 9.5% of contribution. CVHCP scored lower rank of prominent with 30.8% of other agents reported referring to it. Conclusions: Social network analysis provides a useful network description for informing and evaluation service network improvement in maximizing its service for the CVHCP.
Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.
Oriental public health programs have been introduced for the purpose of providing comprehensive oriental health care services to community people including vulnerable classes, increasing the accessibility of oriental medicine and the public benefit, and further more elevating the health promotion and the quality of life of community people. Promoting these programs since 2002 in earnest, it is evaluated that it has made a lot of performances. In the other side, it showed many problems and policy issues also. This study is accomplished to analyze the problems made since the system was introduced and until now, 2007, and with this analysis, to examine policy issues and the reasonable recommendations for its development Major problems are as follows. First, fundamental notions and identity of oriental public health programs are not positioned accurately. Second, the infra-structure construction for effective propulsion of business is insufficient. Third, it is short of the capacity for program implementation of oriental public health doctors, related manpower, and health centers. Fourth, oriental health promotion programs that can fulfill the various health needs of community people are deficient. Fifth, active aid of the government and the oriental medical world as well as legal and systematical support for oriental public health programs is insufficient. As a result, to solve the problems and induce the successful settlement of the program, the policy recommendations such as (i) the fundamental notions of the program and establishment of approach strategies, (ii) reinforcement of the foundation of the program implementation, (iii) capacity enhancement of the manpower of the program implementation, and (iv) effective building of supportive system of the program are presented.
Cho, Yoo Hyang;Do, Eun Young;Kang, Kyung Sook;Kim, Young Me;Kim, Younkyoung;Rou, Farrah;Lee, Chong Mi;Choi, In Hee;Choi, Hee Chung
Research in Community and Public Health Nursing
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v.28
no.3
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pp.347-356
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2017
Purpose: The purpose of this study was to provide basic evidence to improve community health nursing practice education by analyzing the current status of actual operation, program outcomes and evaluation methods, and the level of achieving learning goals. Methods: Data were collected through an e-mail survey from 155 professors teaching community health nursing in April 2016. Out of 45 responses in total, 42 cases were used for analysis (response rate 29.0%). Results: Community health nursing practice was a 3-credit course in most of the schools (66.7%) and included a practice at public health centers without exception. The most common diagnosis classification system was OMAHA (81.0%). The core fundamental nursing skills evaluated during the practice were subcutaneous injection, vital signs, oral administration, and intradermal injection. Among the subjects of community health nursing practice, the area with the highest potential for achieving learning goals was primary health care provision (4.4/5) and the area with the lowest potential was disaster management (2.4/5). Conclusion: The results of this study show that there would be active efforts to complement and improve several problems of the community health nursing practice among the community health nursing practice instructors for more effective and qualitative community health nursing practice.
Purpose: To explore the barriers and solutions of immunization programs for children among vulnerable classes in the position of service providers in Community health centers. Method: Data were collected through focus group interviews with 3 groups (17 providers), and were analyzed according to the analytic method of Morgan (1998) and Krueger (1998). Results: The following five categories were identified: difficulties in obtaining a list of children among vulnerable classes, difficulties in first contact with them, difficulties in up-to-date immunization, various difficulties according to the types of vulnerable family and suggestions of solution. These results indicated that there are many difficulties in providing expanded immunization service for children among vulnerable classes in terms of manpower, cooperation of departments in public health centers and linkages between health and welfare. Finally, the characteristics of the types of vulnerable family need to be elucidated. Conclusion: To increase immunization rates among children of vulnerable classes, policies need to be prepared at the public health organization itself and the linkages between health and welfare and need for hiring additional personnel.
Purpose: This study was to develop an effective evaluation tool for evaluation of hypertension prevention and management program(HPMP) in community health posts (CHPs). Method: Evaluation tool composed from the literature review, the field visiting, and the in-depth interviews with the community health practitioners. Result: The evaluation tool had four domains, each with different maximum points:, hypertension prevention (35), hypertension management (40), environment of the CHPs(10), and evaluation system of the HPMP(15). The first domain was hypertension prevention with sub-domains of health education, and early detection of patients with hypertension. The second domain was hypertension management with sub-domains of management of health records of patients, education and counseling, and treatment and follow-up of patients. The third domain was the environment of the CHPs with subdomains of accessibility of CHPs to residents, accessibility of general health data to the public, and availability of health information to the public by multimedia. The fourth domain was the evaluation system of the HPMP with the subdomains of planning of program, formative evaluation, process evaluation, and summative evaluation. Conclusion: The newly developed evaluation tool will contribute not only to plan and set goals for evaluation of HPMP in CHPs.
Journal of The Korea Institute of Healthcare Architecture
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v.29
no.2
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pp.17-26
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2023
Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.
Purpose: This study was conducted to investigate health problems and factors related to work impairment of nurses working at community health centers. Method: Data were collected from May 2008 to July 2008 using a structured, self - reported questionnaire for general characteristics, work-related characteristics, health problems and work impairment. The subjects were composed of 434 nurses from 25 community health centers in Seoul. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis. Results: For present health problems, shoulder, back and neck pain were ranked the highest at (54.6%), followed by cold, GI trouble, and visual disorders. The average score of work impairment was 24.71($\pm7.14$) out of 50.0. Multiple regression analysis revealed that the major factors that affect work impairment were age and number of health problems, and that these factors explained 15% of the work impairment. Conclusion: Age and number of health problems are the factors that have the greatest influence on work impairment. These findings indicate that the health condition of nurses at community health centers must be considered to improve the overall quality of nursing service.
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