Purpose: To identify the effects on tuberculosis mortality of a tuberculosis control program conducted at 108 community health centers in terms of structure and process. Methods: The dependent variable was tuberculosis mortality, and the independent variables were the structure(type of centers, staff, nurses, doctors, budget) and process(chest X-ray checking, immunization, case detection, health education, patients registering & managing) of the tuberculosis control programs at the community health centers. Data were analyzed using descriptive analysis and stepwise regression analysis. Result: Tuberculosis morality was positively correlated with type of centers(rural area)(p<0.01), but negatively correlated with type of centers(large cities) (p<0.01), (middle cities)(p<0.05), staff FTE(p<0.05), and number of nurses(p<0.05). Regression analysis indicated that type of centers(rural area)($\beta$=0.457) and case detection($\beta$=0.234) had a significant effect on tuberculosis mortality. Conclusion: Ultimately, this study will provide information to improve the effectiveness of tuberculosis control programs in community health centers.
The Korean government enacted the National Health Promotion Act in January, 1995 and proclaimed its regulations and rules in September 1995, which became the basis of the national health policy. The health promotion programs consist of education for health, prevention of diseases, improvement of nutrition, and practice of healthy life style as defined in that Act. The Community Health Act was amended in 1995, which included implementing nutrition services in community health centers. The purpose of this report is to summerize the nutrition services conducted in 32 community health centers. the main nutritional activities were as follows : 1) nutritional guidance by counseling and education for pregnant or lactating women, infants, preschool children, and those with chronic diseases, 2) collection, analysis, and interpretation of data collected from the community, on background conditions and target population for the assessment of community needs, 3) evaluation of nutritional status of population in the community 4) nutritional guidance for mass feeding in different institution including schools and welfare institutions. In order to meet the government's expectations and desires, the community health centers have made continuous efforts to put nutritional activities into practice in the community. However, there are constraints, such as relative staff shortages, lack of funds, and information which hampers the nutritional activities.
Lee Taewha;Lee Chung-Yul;Kim Hee-Soon;Ham Ok-Kyung
Journal of Korean Academy of Nursing
/
v.35
no.3
/
pp.461-468
/
2005
Purpose: The purpose of the study was to compare community residents' perceptions, participation, satisfaction, and behavioral changes between a health promotion demonstration health center and general health center. Method: The design of the study was ex-post facto that compared community residents in demonstration health centers and general health centers. The sample included 2,261 community residents who were conveniently selected from demonstration (792 participants) and general health centers (1,496 participants). Result: The results of the study were as follows: 1) Perception and participation rates of exercise, nutrition, and hypertension management programs were significantly higher in the participants of demonstration health centers than those of general health centers.; 2) Satisfaction rates of all programs except the smoking cessation program were significantly higher in the participants of demonstration health centers than those of general health centers. However, only the exercise rate among risk behaviors of participants was significantly higher in demonstration health centers than general health centers. Conclusion: Systematic efforts for health promotion were effective not only in improving the community's awareness, participation, and satisfaction of the program, but also in changing health behaviors. This evidence should be used to foster and disseminate health promotion programs toother health centers to improve community residents' health status and quality of life.
Purpose: The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues. Methods: Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?" Results: The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.' Conclusion: The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.
Journal of Agricultural Extension & Community Development
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v.18
no.3
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pp.591-629
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2011
The purpose of this research is to examine how the village community centers are being used and find how to improve leisure activities of elders in rural areas by using them. In order to achieve the purpose of this research, we did convenience sampling from elders using 92 village community centers in one of the counties in Gyeong-gi province, and did field survey to 343 persons. The collected data was analyzed by SPSS 18 program, and the results are as follows: The survey on population sociological peculiarity of elders using village community centers shows that most of elders are over 70 years old. As for health conditions, there are more elders who are physically weaker than healthy elders. And the survey shows that most of the elders are suffering from illness such as hypertension, arthritis, neuralgia, and indigestion so such programs related to health are critically required. First, the survey on using village community centers by elders in rural areas shows that they think the village community centers are important for them and use them often. Most of respondents said that they use the village community center so as to meet friends, to enjoy leisure, and to spend time in rural areas where they have difficulty enjoying cultural facilities. Meanwhile, some people dislike to use the village community centers mainly because there is few programs for leisure or each one has a different personality or they don't have enough money to pay for the membership fee. Second, according to the survey on leisure for the elders in village community centers, there are few leisure programs. For men, they spend time by playing Baduk, Janggi, Hwatu and drinking. Meanwhile, women spend time by meeting with friends, listening to radio and TV watching. There are almost nothing to improve leisure activities such as hobby, recreation and health etc. Male elders using centers are suffering from health problems, economic difficulty, and lack of leisure activities, meanwhile, female elders are suffering from loneliness, health problems, and economic difficulty. Third, according to the survey on improving the leisure program of village community center, elders preferred health related programs to improve leisure activities. The most necessary leisure activities in village community center are hobby classrooms, health programs and group travelling. They preferred health related programs for leisure in village community center. Based upon the reality described above, improving the village community centers as leisure facilities is considered to be important for the welfare well of elders in rural areas.
Objectives : The purpose of this study was to examine the oral health programs for children of the low income classes in order to prevent oral health problems and to provide the effective oral health programs in community children's centers. Methods : The subjects were 464 teachers in community children's centers in Seoul, Incheon, Gyeonggi-do, Chungcheongbuk-do, and Jeollabuk-do. Results : There were differences between the regions(p<0.05) in oral health guidance among teachers in municipal and provincial community children's centers. The oral health education was considered as the most important thing in those who had more than 6 years career(71.8%), and followed by those having less than five years career(61.3%) and those having two years career(53.8%)(p<0.05). Although many children registered the program and newsletter was sent to the children's homes, but 70% of the children did not brush their teeth regularly(p<0.05). Regardless of region, gender, teaching career, and number of enrolled children, 90 percent or more people found that it necessary for community children's centers to collaborate with dental clinics. There were gender differences between the male and female(p<0.05). Male accounted for 42.4% response rate and female accounted for 36.4%. Approximately About 48.5% of male and 61.6% of female thought that the oral health program is the most important thing(p<0.05). Conclusions : The development of the customized oral health program is the most critical factor to the oral health behavior change in the children in the community children's centers and public dental clinics.
Persons with disabilities have increased and among others, number of them in the community is at the high proportion. But they have a difficulty in physical, psychological adjusting and they don't be offered appropriate, sufficient rehabilitation services. Therefore, Community-Based Rehabilitation Services in Health Center be needed. With these backgrounds, this study was conducted to examine factors in relation to job performance of community-based rehabilitation program in Health Centers, and the factors are characteristics of district nurses, internal factors, external-environmental factors. This study provides guidelines for effective management for rehabilitation program. Subject in this study were 122 Health Centers randomly chosen. Data were collected from September, 16, 1998 to October, 9, 1998, and the data for analyses were ones of 105 respondents. The instrument of this study was job performance of community-based rehabilitation program is modified WHO guidelines. Credibility of instruments was 0.73-0.95 in main study. The summary of results was as follows. First, the mean of job performance of com munity-based rehabilitation program was 2.33 of full score 4.00. Significant differences were not obtained on the job performance among areas. Second, stepwise multiple regression analysis revealed that the most powerful predictor to job performance was community-based health program. The number of volunteer workers, the score of cooperation with other institution, the number of visiting nurse, the number of facilities for person with disabilities are accountable factor to the job performance of community-based rehabilitation program. In conclusions, for all the people with disabilities, Health Centers are necessary to promote community-based rehabilitation program and to increase participation of community residents and to cooperate with other institution.
Journal of agricultural medicine and community health
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v.32
no.3
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pp.125-138
/
2007
Objectives: This retrospective study is to identify related factors of treatment success of patients with tuberculosis at community health centers. Methods: The subjects of this study were 1,417 patients with tuberculosis treated in 28 community health centers. The predictors of tuberculosis treatment success were analyzed in terms of 2 areas, which were characteristics of patients and health centers(TB control program). The characteristics of patients consist of 2 factors, such as demographic & diagnosis and treatment. The present conditions of health centers consist of 3 factors, location of centers, resources, and community activities. Data were analysed using X2- test and logistic regression methods. Results: The significant differences between success group and failure group were sex(p=0.003), age(p=0.013), job(p=0.000), type of patients(p=0.001), past history(p=0.029), BCG injection(p=0.009), sputum culture examination(p=0.017), period of treatment(p=0.000), location of center(p=0.001), population per staff(p=0.015), FTE(p=0.027), education days of staff(p=0.005), BCG injection rate(p=0.001), case detection rate (p=0.003), and health education provision rate(p=0.044). Then these variables were analysed using logistic regression analysis. Significant positive factors of treatment success were occupation(95% CI:1.3-6.1), periods of treatment(95% CI:1.5-2.2), center in large city(95% CI:1.2-16.7), center in middle city(95% CI:2.1-24.3), job education related TB(95% CI:1.02-1.3), and BCG injection rate(95% CI:1.1-303.4). Significant negative factors of treatment success were male(95% CI:0.1-0.5) and treatment after default(95% CI:0.005-0.5). Conclusions: Tuberculosis is still one of serious diseases in Korea, because it causes highest mortality rate among OECD countries. This study may provide information to improve treatment effectiveness of tuberculosis at community health centers.
Community Health Planning has been used in public health centers for over 10 years, but little is known about its effect and how it is utilized by public health centers. This paper examines the effect of Community Health Planning on public health centers'organizational performance through the use of the Structural Equation Modeling(SEM) technique. We conducted e-mail surveys of chiefs, people in charge of planning and other staff members in all the public health centers in the country. The instrument measured self-evaluated levels of Community Health Planning, implementation and the effect on the public health centers. The model of the SEM technique has five latent constructs: requirements of planning, plan formulation, implementation, organizational capacity and performance. The SEM technique validated the instrument used in the study and exhibited a relatively good fit. Results of this study were as follows. First, the requirements of planning have positive effects on plan formulation. Second, plan formulation has positive effects on organizational capacity but plan implementation doesn't. Third, there was no statistically significant path between plan formulation, implementation and performance. Fourth, organizational capacity has positive effects on performance. Consequently, this study revealed that Community Health Planning has a positive influence on organizational performance through organizational capacity.
The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.
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