• 제목/요약/키워드: Community health practitioners

검색결과 141건 처리시간 0.029초

Progress in the Direct Application of Pharmacogenomics to Patient Care: Sustaining innovation

  • Burckart, Gilbert J.;Frueh, Felix W.;Lesko, Lawrence J.
    • 한국약용작물학회:학술대회논문집
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    • 한국약용작물학회 2006년도 Proceedings of The Convention of The Korean Society of Applied Pharmacology
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    • pp.23-39
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    • 2006
  • The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of supporting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

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원격진료 실시에 수반되는 법적 쟁점들에 대한 고찰 (Legal Issues To Be Considered Before Implementing Telehealth in South Korea)

  • 이원복
    • 의료법학
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    • 제22권1호
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    • pp.57-90
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    • 2021
  • 의료인이 직접 환자를 진료하는 형태의 원격진료가 현행 의료법에서 허용이 되는지 여부와 의료법상 허용을 떠나 정책적으로 허용하는 것이 바람직한지의 문제가 오랫동안 논란이 되어 왔다. 그러다가 코비드19라는 인류가 드물게 겪는 팬데믹 상황으로 인하여 우리나라에서 한시적으로 허용이 되었고 외국에서도 이용이 폭발적으로 증가하면서 다시 관심을 받고 있다. 원격진료의 허용 여부에 관하여는 이미 많은 논문이 존재하지만, 막상 원격진료가 실시될 경우 그에 수반되어 발생할 수 있는 부수적인 법적 쟁점들에 관하여는 논의가 부족했던 부분이 있어 이 글에서 다루었다. 필자는 국민건강보험의 수가정책, 환자 본인 확인, 의약품 비대면 구매, 진료장면 녹화에 관하여는 입법적으로 미리 정비를 하는 것이 바람직하다고 보았고, 원격진료에 필요한 시설 기준은 오히려 법제화를 하면 현실에 뒤떨어지거나 변화에 대응하는 탄력성이 떨어지므로 법제화를 하지 않고 대신 의료인이 의료기기법상 승인을 받은 원격진료용 기기를 사용하는 것으로 충분하다고 판단하였으며, 끝으로 원격진료의 맥락에서 발생한 의료사고의 책임이라든가 개인정보 보호는 기존의 민사법이나 개인정보 보호법으로 이미 충분한 대응이 되므로 별도의 특칙을 제정할 필요는 없다는 결론을 내렸다.

Ethnobotanical survey and threats to medicinal plants traditionally used for the management of human diseases in Nyeri County, Kenya

  • Kamau, Loice Njeri;Mbaabu, Peter Mathiu;Mbaria, James Mucunu;Gathumbi, Peter Karuri;Kiama, Stephen Gitahi
    • 셀메드
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    • 제6권3호
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    • pp.21.1-21.15
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    • 2016
  • In Kenya, traditional knowledge on herbal medicine has remained a mainstream source of maintaining wellbeing for generations in many communities. However, the knowledge has been eroded in the course of time due to sociocultural dynamics virtually advanced by Christianity and formal education especially in the Kikuyu community. The study documented current ethnobotanical knowledge and threat to the traditional knowledge on medicinal plants among the Kikuyu community. A survey was carried out in Mathira, Tetu, Kieni, Othaya, Mukurweini, and Nyeri Town constituencies. Thirty practicing herbalists were purposively sampled; 5 per constituency. Data was obtained through semi - structured questionnaires and analyzed both qualitatively and quantitatively. A total of 80 ailments treated using 111 medicinal plant species distributed within 98 genera and 56 families were documented. Prevalent communicable diseases treated using herbal medicine included; gonorrhea (17.5%), malaria (15%), respiratory infections (12%), colds (10%) and amoebiasis (10%). Non-communicable diseases were; joint pains (11.1%), ulcers/hyperacidity (8.7%), high blood pressure (8.7%), intestinal worms (11.1%) and arthritis/gout (10%). Frequently harvested plant materials were; roots, barks and leaves. The study concluded that, traditional medicine practitioners in Nyeri County possessed wide knowledge of herbal medicine but this knowledge was on the verge of disappearing as it was largely a preserve of the aged generation. The study recommended massive campaign about the benefits of using herbal medicine in the study area. Further pharmacological studies are recommended on the mentioned plant species aimed at establishing their efficacy and safety as well as standardization as potential drugs.

Identifying psychological predictors of adherence to a community-based lifestyle modification program for weight loss among Chinese overweight and obese adults

  • Leung, Alice Wai Yi;Chan, Ruth Suk Mei;Sea, Mandy Man Mei;Woo, Jean
    • Nutrition Research and Practice
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    • 제13권5호
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    • pp.415-424
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    • 2019
  • BACKGROUND/OBJECTIVES: Existing evidence on lifestyle modification programs for weight loss is limited by the high attrition rate of such programs. Identifying predictors of adherence to a lifestyle modification program could result in program improvement. However, little is known about behavior-specific adherence and its psychological predictors. This study aimed to examine the psychological predictors of adherence after one-month participation in a community-based lifestyle modification program among Chinese overweight and obese adults in Hong Kong. SUBJECTS/METHODS: A total of 205 Chinese overweight and obese adults aged $38.9{\pm}10.5years$ completed the study. Data were collected at baseline and after one month using self-reported questionnaires, which assessed knowledge (self-developed scale), motivation (Treatment Self-Regulation Questionnaire), stage of change (Stage of Exercise Scale) and self-efficacy (Self-Rated Abilities for Health Practices Scale). At one month, a 4-day dietary recall and the International Physical Activity Questionnaire-Short Form were used to assess dietary and physical activity (PA) adherence. Food and PA diaries were examined to indicate self-monitoring. Program attendance was tracked between baseline and one-month follow-up. RESULTS: After one month, participants reported high dietary adherence, attendance, and adherence to self-monitoring but low PA adherence. Multiple regression analyses suggested that diet self-efficacy (baseline) and nutrition knowledge (one-month change) were independent predictors of dietary adherence score at one month, whereas autonomous PA motivation (baseline) and PA self-efficacy (both baseline and one-month change) were independent predictors of PA adherence score at one month. No significant psychological predictor was identified for attendance or self-monitoring. CONCLUSIONS: The results suggest that the effect of psychological factors on adherence differs between diet and PA adherence outcomes. To promote adherence, practitioners should assess self-efficacy, knowledge, and motivation at the beginning of a weight-loss program and explore behavior-specific strategies to improve knowledge and self-efficacy. The results of this study have direct implications for program improvements.

Rogers 이론에 근거한 가족양상 사정지침개발 (Development of a Family Pattern Appraisal to Guide a Rogerian Nursing Practice)

  • 이광옥;한영란;김희정
    • 대한간호학회지
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    • 제25권4호
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    • pp.751-773
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    • 1995
  • We, clinical nurse specialists practising and guiding student practice in a Community health nursing clinic, wanted to develop a family pattern appraisal consistent with Rogers' conceptual system, the nursing model guiding our practice. We use Rogers' model because it is harmonious with the traditional Korean view of the one human, natural and cosmic world. The purpose of our research was to contribute to science - based nursing practice, not only, one helpful model, but also a model of how to use, in guiding practice, a conceptual system which reflects nurse practitioners' philosophy of nursing, is intellectually satisfying, and enriches meaning in daily nursing life. The research objectives were to review the literature on Rogers' model and analyse it according to Kim's five - level analytical framework, to explore Rogers' definition of family, to review appraisals based on Rogers' model, and to develop a family appraisal which is culturally appropriate for use in our community. This work including the use of the appraisal and its refinement with families in our practice which was done during 1994 and 1995, in Seoul, in the Capital of the Republic of Korea. At the highest level of analysis, Rogers conceptual system emphasizes acausality and multidimentional meaning ; the world view is characterized by process, movement and wholeness. The epistemology Is one of holism and the knowledge base includes all forms of experience, from sensory to mystical, objective, and subjective. At the metaparadigm level, nursing focuses on the unitary human being and the environment. At the level of nursing philosophy, the model identifies human being, nursing, nurse, and illness and health. At the paradigm level the model assumes the irriducibility of the human to parts, noncausality and continual change. Rogers' practice methodology consists of pattern manifestation appraisal and deliberative mutual patterning. Under-standing patterns and patterning of people is the key to helping them achieve their potential. At the theory level, the basic assumptions, key concepts, and homeodynamic principles were identified. Rogers states the family energy field is an undividable, four-dimensional negentropic energy field which is in a larger envircinmental field show-ing such characteristics as cannot be predicted by knowledge of individual family members. Based on the word of Rogers scholars, we chose Rogers' correlates of patterning to understand the family unit as a whole-frequency, rhythms, motion, time perception, sleeping-waking beyond waking, pragmatic -imaginative-visionary to develop the appraisal. We, also used some of Barrel's (1988) criteria including interpersonal network and professional health care access and use, and Cordon's (1982) criteria including self perception - self concept modified to fit the family. Our family Pattern appraisal included 1. Influencirg data, 2. Professional health care access and use, 3. Family self perception-self concept, 4. Family interpersonal network, 5. Sleep-wake-be-yond waking, 6. Pragmatic-imaginary-visionary, 7. Family frequency and rhythm, 8. Family motion, 9. Family time perception. The appraisal was used with four families and modified to eliminate overlap and to make it possible for the family member to express themselves more easily. We plan to gain more experience with the appraisal toward further development of the tool.

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〈사례보고〉 경상남도 지역 간 건강불평등 완화사업: 건강플러스 행복플러스 사업 (〈 Field Action Report 〉 The Strategies to Address Regional Health Inequalities in Gyeongsangnam-Do: Health Plus Happiness Plus Projects)

  • 정백근;김장락;강윤식;박기수;이진향;조선래;서기덕;주상준;오은숙;김승진;조성진;김승미;염동문;심미영
    • 농촌의학ㆍ지역보건
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    • 제37권1호
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    • pp.36-51
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    • 2012
  • '건강 플러스 행복 플러스 사업'은 경상남도의 높은 표준화사망률을 감소시키고 지역 간 건강불평등을 완화하기 위하여 표준화사망비가 구조적으로 높은 40개 읍면동을 대상으로 수행되는 사업이다. 본 사업은 영국의 헬스 액션 존 사업의 방법론을 기반으로 하여 참여, 파트너쉽, 자원의 집중을 사업의 기본 원칙으로 설정하고 2010년부터 시작되었으며 2017년까지 진행될 예정이다. 총 사업비는 56억원이며, 2010년에는 17개 읍면동, 2011년에는 12개 읍면동, 2012년에는 11개 읍면동에 사업이 개시되었거나 개시될 예정이다. 2010년 사업의 경우, 사업대상지역인 17개 읍면동에 예산이 배정되었고, 관련 수단 및 지역 차원의 사업진행 틀을 만드는 과정을 거쳤다. 또한 사업대상지역의 건강결정요인을 파악하기 위하여 지역 사회조사를 실시하였으며 사업에 대한 교육훈련지원 및 기술지원을 위하여 교육훈련지원단과 사업운영지원단이 설치되었다. 그 결과 사업 인력들과 코디네이터에 대한 교육이 실시되었으며, 사업대상지역에는 사업팀과 사업추진위원회가 결성되었다. 지역사회조사 이후에는 지역사회조사결과 보고회를 통하여 지역의 건강결정요인과 건강수준을 지역주민들과 함께 공유하였으며 최종적으로 사업 관련 주민자치조직인 건강위원회가 17개 읍면동에서 출범하였다. 본 사업은 지역사회 참여 및 파트너쉽의 구축과 관련하여 아직 해결해야 될 과제들이 많으나 원칙에 근거한 사업이 지속적으로 진행될 수 있다면 경상남도의 건강불평등 완화를 통한 표준화사망률 감소 및 사업대상지역 주민들의 안녕 수준 향상에 기여할 수 있을 것으로 판단된다.

농촌여성(農村女性)의 건강실태(健康實態)에 관한 연구(硏究) (The Health Status of Rural Farming Women)

  • 박정은
    • 농촌의학ㆍ지역보건
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    • 제15권2호
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    • pp.97-106
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    • 1990
  • 1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

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한국 치유농업의 현황 및 특성 분석 (Analysis on the Present Status and Characteristics of Agro-healing in Korea)

  • 김경미;문지혜;정순진;이상미
    • 농촌지도와개발
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    • 제20권4호
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    • pp.909-936
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    • 2013
  • 이 연구는 최근 네덜란드와 벨기에 등 농업분야 선진국에서 관심과 투자가 증대되고 있는 치유농업(Agro-healing)의 개념을 정립하였고, 우리나라 치유농업의 현황 및 특성 분석을 통해 발전 방안을 제시하였다. 연구목적 달성을 위해 치유농업 선진국의 정책과 제도, 조직, 관련 법, 인력 등에 대한 문헌분석(내용분석)을 하였으며, 농업, 건강, 교육, 원예 및 동물 매개치료, 민간, 농업정책 집행 분야별 전공 교수, 연구원, 대표 및 담당자 9인으로 구성된 전문가 포커스 그룹 인터뷰를 진행하였다. 또한 치유농업 분야 종사자 165명을 대상으로 설문조사를 실시하였다. 연구결과 우리나라 치유농업의 개념은 '농업 농촌자원(식물, 동물, 농촌환경, 농촌문화) 또는 이와 관련된 활동 및 산출물을 통하여 모든 국민의 심리적 사회적 신체적 인지적 건강을 도모하는 산업 및 활동'으로 정의하였으며 정립된 개념과 연계하여 치유농업의 목적, 자원, 대상을 설정하였다. 또한 우리나라 치유농업의 정착과 발전을 위한 제언을 제시하였다.

한국 전문간호사의 업무 성과 (Job Performance by Advanced Practice Nurses in Korea)

  • 김미정;김영경;신수진
    • 성인간호학회지
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    • 제26권6호
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    • pp.630-641
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    • 2014
  • 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.

COVID-19 상황에서 고혈압 기저질환자의 칫솔질과 손 씻기 실천율과의 관련성 (The Relationship between Tooth Brushing and Hand Washing in Hypertensive Patients amidst COVID-19 Pandemic)

  • 김지현;김민영
    • 한국융합학회논문지
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    • 제13권5호
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    • pp.501-508
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    • 2022
  • 고혈압을 비롯한 기저질환자의 COVID-19 발생률과 사망률이 높다고 밝혀지고 있다. COVID-19 대유행 상황에서 건강관리를 위해서 손 씻기만큼 칫솔질은 매우 중요하다. 이에 본 연구의 목적은 고혈압 기저질환자의 칫솔질과 손 씻기 실천율과의 관련 요인을 파악하기 위하여 수행되었다. 지역사회건강조사 2020년 원시자료를 이용하여 만 40세 이상 고혈압 기저질환자 62,762명을 대상으로 분석하였다. 연구결과 여성, 연령이 낮을수록, 교육수준이 높을수록, 외출 시 마스크 착용자, 점심식사 후 칫솔질 실천자에서 손 씻기 실천율이 높게 나타났다. 칫솔질을 실천한 고혈압 기저질환자에서 손 씻기 실천율이 더 높은 것으로 나타나 구강위생과 개인방역 사이의 연관성을 확인하였다. COVID-19 감염에 취약한 기저질환자에게 감염병 예방 행태 실천율을 높이기 위한 지속가능한 방안 마련이 필요할 것으로 사료된다.