• 제목/요약/키워드: Comprehensive Care

검색결과 848건 처리시간 0.033초

소득계층별 보건의료이용의 양적.질적 차이 분석 -광주.전남 지역주민을 대상으로- (Quantitative and Qualitative Difference in the Utilization of Health Care - Based on the Survey of Gwangju-Jeonnam Residents)

  • 김정주;오주환;문옥륜;권순만
    • 보건행정학회지
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    • 제17권3호
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    • pp.26-49
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    • 2007
  • The purpose of this study is to analyze the equity of health care utilization by income groups in terms of both quantity and quality of care, which is measured by expenditure, type of care, and type of health care institutions. Equity in health care utilization is measured by HIwv index, based on the survey of 1,480 Gwangju-Jeonnam residents. Health care utilization in terms of the probability and quantity of outpatient and inpatient care show equitable or pro-poor inequitable distribution, whereas the distribution of health care expenditure, which can account for the quality of care, is pro-rich inequitable, implying that the better off tend to use more expensive medical care. In terms of the types of care, simple visits for basic care show equitable distribution, whereas the distribution of the utilization of traditional tonic medicine, comprehensive health examination, CT, MRI, and ultrasound is pro-rich inequitable. Utilization of general hospitals and traditional health institutions show pro-rich inequitable distribution, hospitals and dental care institutions equitable, and physician clinics and public health centers pro-poor inequitable.

체외막산소공급(ECMO) 치료 환자의 간호 중재에 대한 체계적 고찰 (A Systematic Review of Nursing Interventions in Patients with Extracorporeal Membrane Oxygenation (ECMO))

  • 박수민;조관웅
    • 대한통합의학회지
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    • 제12권3호
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    • pp.237-247
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    • 2024
  • Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.

Development of Educational Components of Managerial Cost Accounting for Nurses

  • Lim, Ji Young;Noh, Wonjung
    • 가정∙방문간호학회지
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    • 제26권1호
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    • pp.81-90
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    • 2019
  • Purpose: In accordance with changes in the healthcare environment, it is necessary to understand managerial cost accounting for nurses. This study aimed to develop educational components of managerial cost accounting for nurses. Methods: This study is comprised of a comprehensive literature review, nominal group technique using focus group interview, audit by an expert group, and priority analysis. Results: The comprehensive literature review identified 15 educational components of managerial cost accounting. In the nominal group technique, the participants finally agreed on eight educational components of managerial cost accounting for nurses. The average content validity index of these components was 0.99. "Activity-based costing" scored the highest for relative importance (15.7%). Conclusions: These results can be used to develop an education program to strengthen nurses' managerial cost accounting competencies. Furthermore, it will be helpful to use a basis for the development of cost management curricula for nursing students and on-the-job training courses of nurse managers and executives.

농어촌보건기관 일차보건의료 서비스 전달체계 개편안 논의의 문제와 대안 (Reform of the Primary Health Care Delivery System in Rural Areas)

  • 나백주
    • 한국농촌간호학회지
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    • 제1권1호
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    • pp.5-10
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    • 2006
  • Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

우리 나라 가정.방문간호 사업을 위한 가정간호요구 사정도구 개발 - 자가간호개념에 근거한 가정간호진단을 중심으로 - (Development of a Home Care Need Assessment Tool - Focused on Home Care Nursing Diagnoses based on Self Care -)

  • 소애영;조병희
    • 지역사회간호학회지
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    • 제13권3호
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    • pp.433-443
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    • 2002
  • Objectives; The purpose of this study was to develop a framework for home care and a Home Care Need Assessment Tool. Method 1. Identifying common domains in the provision of home care. 2. Charts of 253 home care clients were reviewed to obtain a classification of the nursing diagnoses. 3. A focus group methodology was used to develop the domains. 4. The tool was applied to 439 home care clients.(Kappa value=0.460-1.000, sensitivity, 0.444-1.000: specificity, 0.743-1.000). 5. Some refinements and extractions of the defining characteristics and related factors were made based on the results of the focus group. Results Home Care Need Assessment Tool consists of three parts; -Part I : factors related to basic conditions -Part II : a screening component that enables home care nurses to assess 30 multiple domains of 53 nursing diagnoses. -Part III : summative nursing diagnoses and nursing need intensity for the clients. Conclusion This tool provides a comprehensive assessment that helps the recognition of many strengths as well as problems of the clients. It will be usefully utilized in scheduling home care nursing plans and evaluating client outcomes.

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의료분쟁조정위원회의 역할조정을 통한 국제진료 활성화 방안 (A Study on the Promotion of Medical Tourism Through the Role of Medical Dispute Resolution Committee)

  • 김기홍
    • 한국중재학회지:중재연구
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    • 제27권4호
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    • pp.61-72
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    • 2017
  • In this study, the Commission proposed the mitigation of remedies by improving the role of medical disputes and preventing medical disputes. Medical disputes include a comprehensive description of medical malpractice, medical negligence, medical malpractice, and medical malpractice. Medical negligence refers to the neglect of medical care due to careless medical care in the treatment of patients, leading to patient injury and death. An inappropriate response in the process of international treatment could result in international trials and a decline in international credibility. In cases where medical disputes arise, health care is strictly necessary to determine the truth or absence of medical malpractice, and these expertise and experience are usually provided by emotion. With the neutral and objective emotions provided fairly and impartially, medical care expertise and experience can be fair, and the medical disputes can be resolved peacefully if the parties are trustworthy. The Health Care Dispute Mediation Committee should focus on enhancing the professionalism, objectivity, and reliability of medical care.

Pediatric postintensive care syndrome: high burden and a gap in evaluation tools for limited-resource settings

  • Chaiyakulsil, Chanapai;Opasatian, Rapee;Tippayawong, Paweethida
    • Clinical and Experimental Pediatrics
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    • 제64권9호
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    • pp.436-442
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    • 2021
  • This article aimed to summarize the impact and burden of pediatric postintensive care syndrome (PICS-p) in the physical, mental, cognitive, and social health domains after a review of the current pediatric literature in MEDLINE and PubMed. We also aimed to elucidate the limitations of the current evaluation tools used in limited-resource settings. PICS-p can impact a child's life for decades. Most validated tools are time-consuming, require qualifications, and expertise, are often limited to older children, and can evaluate only one domain. A novel, simple, and comprehensive surveillance tool can aid healthcare providers in the early detection and intervention of PICS-p. Further studies should validate and refine the parameters that will enhance the outcomes of pediatric intensive care unit survivors.

가정전문간호사의 대체요법에 대한 인식 (A Study on the Home Care Nurses' Perception of the Complementary & Alternative Therapy)

  • 장경자;김현리
    • 가정∙방문간호학회지
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    • 제13권1호
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    • pp.24-32
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    • 2006
  • The purpose of this study is to predict the degree of taking the complementary & alternative therapy in the home care nursing service and provide basic data for the application of it. To accomplish this, degree of general recognition of the complementary & alternative therapy, experiences, degree of concern, applicability of the therapy, and educational need should be studied. This study is a descriptive research survey on the home care nurses working at 73 medical centers out of 125 nationwide who provide hospital based home nursing care. The data was collected from Sep. 20, to Oct. 20, 2004 by ChoiHeyran's questionaries (2002). The data was analyzed by the frequency and the percentage. The results of this study are as follows ; 1. The degree of pre-cognition on the complementary & alternative therapy is very high. Information about the therapy was mostly obtained through medias. Home care nurses understand that he desirable treatment is to practice medical treatment and complementary & alternative therapy simultaneously. While 50% of them have already practiced complementary & alternative therapy among their patients. The most commonly used therapy is Acupressure. And Home care nurses have open and positive attitudes about the complementary & alternative therapy as to answer they aye ready to recommend it to their patients. 2. Over half of the Home care nurses met patients taking complementary & alternative therapy. 94.5% of them think scientific diagnosis on the effect of the therapy. advice from the doctor. and the special working staff is required to apply it on to the home care nursing. 3. 68.5% of the Home care nurses have taken education on the therapy through general comprehensive instructions and supplementary. Most of them want to have a opportunity education on the therapy because they want to provide comprehensive nursing and diversified nursing service. The preferred educations are Hand acupuncture, Acupressure & Massage and Aromatherapy, in that order. Based on the above results, the followings are recommended. 1. A study that stipulates the types, applications, and efficiency assessment of the complementary & alternative therapy practiced by Home care nurses in the home care nursing care procedure. And systematic and scientific nursing intervention be developed.

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