• Title/Summary/Keyword: Death education program

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A Study on Patients' Satisfaction and Service Utilization in the DRG Based Payment System - Patients who Experienced Cesarean Section Before and After the Demonstration Program - (DRG 지불제도에서 환자의 의료서비스 만족도와 제공량에 관한 연구 - 시범사업 전.후 제왕절개 분만 경험 산모를 대상으로 -)

  • Kim, Ji Sook;Park, Hayoung
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.190-202
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    • 2000
  • Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

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A Study on Effect of Individual Education about Chemical Therapy for Preventing Cancer on Quality of Life of Patient Who Suffers From Cancer (항암화학요법에 관한 개별교육이 암 환자의 삶의 질에 미치는 효과)

  • Choo, Yeun-Hwa;Kim, Kyung-Hee
    • Asian Oncology Nursing
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    • v.4 no.2
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    • pp.103-109
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    • 2004
  • The disease occurrence rate of the cancer is rapidly increased and It is becoming the main factor for the death The chemical therapy for preventing the cancer is recently used for many patients and thus extended the life of the patients. However, the side effect caused by the medical substances when performing the chemical therapy for preventing the cancer and the consequent mental and social problem are incurred to deteriorate the quality of the life. Therefore, it is needed to help the patient In order to reduce the above problems, and so this study was executed in order to examine the effect of the individual education on the quality of the life of the patients who are treated by the chemical therapy for preventing the cancer. The study was performed from Jan. 19. 2004 to Apr. 18. 2004 for the patients who were firstly treated by the chemical therapy for preventing the cancer in a university hospital located in the downtown in Seoul. The individual education on the chemical therapy for preventing the cancer was provided to 40 patients of the experimental group. The study plan is the experimental plan before and after the sole group, and it is the beginning experimental plan. The title of the booklet on the chemical therapy for preventing the cancer is "Cancer, The more you know, the more you can be cured", and the book was composed up of the side effect of the chemical therapy for preventing the cancer, treatment way for the side effect, and guide of the daily life. The survey with the questionnaire sheet was distributed to the experi- mental group before the education, the survey sheet was made out when they were hospitalized for 3-4 weeks after the education, and the data were examined by using SPSS statistical program with making our the survey questionnaires and the change of the quality of the life before and after the education of the patients who are treated by the chemical therapy for preventing the cancer was analyzed by using the parred t-test. The research result was verified that it has the meaningful that the quality of the life for the physical field, mental field, social field, and spiritual field after the individual education. The suggestion concluded by the above research result is as follows. First, there is the limitation to interpret the result since it was the beginning experimental plan for the sole group. Thus, it is suggested that the similar experimental plan should be executed with the expansion of the research subject and also with the contrast group. Second, it is suggested that the study on the change of the quality of the lifeaccording to the support of the individual education and family of the patients who are treated by the anti-cancer therapy.

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Qualitative content analysis of journals of cadaver practice experiences in nursing students

  • Hyunjung Lee
    • International journal of advanced smart convergence
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    • v.12 no.3
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    • pp.109-118
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    • 2023
  • This study attempted to identify the experiences of nursing students' participation in cadaver practice and provide a basis for understanding students' experiences in cadaver practice, which can be reflected in the development of programs for them. By applying the content analysis method according to the guidelines by Krippendorff to analyze the meaning of the experience of participating in cadaver practice among 80 nursing students who participated in cadaver practice at K University in W-si, Gangwon-do, a total of 4 areas, 13 categories, and 25 meaningful statements were derived. The categories included "worried," "surprised," and "fear" in the anxiety domain; "interesting," "knowing," and "focused" in the immersion domain; "value of life," "gratitude and remembrance," "thinking about donation," "facing death," and "precious body" in the reflection domain; and "motivation" and "sense of accomplishment" in the growth domain. The results of this study will help to understand the physical and psychological reactions that nursing students may experience during cadaver practice, and will provide a basis for developing various strategies such as counseling, education, and reflection programs in conjunction with cadaver practice to help nursing students cope with stress, develop a sense of ethical responsibility, and develop a positive self-image as nursing students in order to be successful in cadaver practice. This study is also significant because it provides a basis for preventive program interventions for experiences related to the negative effects of cadaver practice.

A Study on the Relations between Health - Promoting Behaviors and Self-Efficacy / Perceived Health Status (중년기 성인의 건강증진행위와 자기효능감 및 지각된 건강상태와의 관계 연구)

  • Lee, Mi-Young;Choi, Mi-Hye;Chung, Yeon-Kang;Her, Eune-Hee
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.140-153
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    • 1999
  • This study is designed to furnish basic data for development of health -care program to promote health of the middle-aged adult by making the middle-aged adult an object who have radically increasing death rate because of chronic degenerative diaease, finding out the executive degree of health -promoting behaviors, and verifying the relation between self-efficacy/perceived health status and health -promoting behaviors. The results are as follows. 1) The hypothesis that 'the higher the self-efficacy, the better the health -promoting behaviors' was supported on a meaningful level(r=.30l, p=.000) 2) The hypothesis that 'The health-promoting behaviors will have differences according to the perceived health status' was supported on a meaningful level in the sections of the control of stress(p=.000), the self-achievement (p=.000), the exercise(p=.002), the control of interpersonal relation(p=.014) and the eating habit(p=.061) and was rejected in the sections of drinking' smoking(p=.787), heath-responsibility (p=.061). The fact that executive degree of health -promoting life-style have correlation with self-efficacy was found out and we need to develop health-education program to promote self-efficacy.

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Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study (중환자실 간호사의 임종간호 어려움과 임종간호 교육요구 조사: 혼합연구방법)

  • Kim, Hyun Sook;Choi, Eun Kyoung;Kim, Tae Hee;Yun, Hye Young;Kim, Eun Ji;Hong, Jin Ju;Hong, Jeong A;Kim, Geon Ah;Kim, Sung Ha
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.87-99
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    • 2019
  • Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

Doctor's and Nurses' Perception and Experiences of DNR (DNR(Do-Not-Resuscitate)에 대한 의사와 간호사의 경험 및 인지도)

  • Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.3
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    • pp.255-264
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    • 2005
  • This study is a descriptive research in investigating the perception of doctors and nurses with regard to DNR, and data were collected through survey questionnaires. The period of collecting data was between July 15 and October 30, 2004, distributing 128 questionnaires to 128 participants, and a total of 110 questionnaires from 55 doctors and 55 nurses were collected (86%)among 70 different hospitals. The collected data were analyzed using SAS program to get real number and percentage, and were also analyzed with $X^2$-test. The Study Results are as follows: 1. Respondents who agreed with the necessity of DNR was 97.27%, the reasons of DNR necessity were 59.20% of 'impossibility of recovery in spite of lots of efforts,' and 35.20% of 'for the purpose of choosing a comfortable and dignified death,' and 97.2% of respondents answered that it was necessary to give explanation of DNR to serious case patients, terminal patients and their family. 2. Problems derived from DNR decisions were 44.44% of 'lack of treatment and nursing,' 21.11% of 'guilty conscience about failing to do best efforts,' and 71.57% of CPR implementation right after DNR decision. 3. Reasons of implementing CRP for patients with DNR decision were 50.94% of 'for the presence of family and relatives at the point of patient's death,' 20.76% of 'guardian's change of DNR decision,' and 16.98% of 'no communication for the consent after DNR decision.' 4. With regard to who was to make DNR decision? there was a difference in the opinion between doctors' and nurses' group while the group of doctors chose 'by the consent of the family and the doctor in charge,' and the group of nurses chose 'patient's intension,' and with regard to Have you received DNR related education? and Will people who want DNR increase if there is explanation given? there was a difference between the two groups. 5. In the catholic institutions, respondents of 71.7% said that it was necessary to take DNR depending upon the situation, and 73% said that they had performed DNR before. 6. In the institutions with over 500 beds, 91.92% of respondents said that there should be an establishment of guideline book as a written format to implement DNR. From the results of this study, it was found that DNR was implemented and executed broadly in clinical fields in the absence of necessary instructions and/or guideline, and that DNR order was placed to the group of doctors who got less opportunity for proper education than did that of nurses.

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The Study of a Strategic Plan for Building Experience-Space Facilities for a National Safety System (국민안전의식 체계화를 위한 체험공간 시설확보 방안에 관한 연구)

  • Kim, Tae-Hwan
    • Journal of the Korean Society of Hazard Mitigation
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    • v.3 no.1 s.8
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    • pp.149-155
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    • 2003
  • The reason of source for a tragic death by the occurrence of an event is $\ulcorner$unobservant of safety rule,$\lrcorner$ $\ulcorner$negligence of staff,$\lrcorner$ $\ulcorner$deficiency of responsibility$\lrcorner$ and $\ulcorner$deficiency of safety value$\lrcorner$ and for certain reason that is insufficiency of space for safety education also think little of a people, unobservant of safety rule, selfishness and so on. It makes new and specific plan that is simulation room before I compare the inside and outside of the country for a nation the reform of consciousness. Next, go ahead with a plan for about safety-simulation room. The Government can support to plan if it make a proposal to center of Government. It should be make a people of safety system, and it build the safety-simulation room $1{\sim}2$ in the city or county. And, the city cannot build the big safety-simulation room the reason are size of building and money. Accordingly, it will be make a system and installation for different type of safety-simulation room for about calamity, disaster and different type of accident in Korea. It must be build the building of space that should be make a space of knowledge and information by many books and media, develop of education program from life-safety.

A Study on the Application of the Korean Valuation Weights for EuroQoL-5 Dimension (EuroQoL-5 Dimension 한국 가중치 모형의 적용 연구)

  • Lee, Young-Hoon;Choi, Jin-Su;Rhee, Jung-Ae;Ryu, So-Yeon;Shin, Min-Ho;Kim, Jin-Hee
    • Korean Journal of Health Education and Promotion
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    • v.26 no.1
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    • pp.1-13
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    • 2009
  • Objectives: This study was conducted to estimate the health-related quality of life (HRQOL) using EuroQoL-5 Dimension (EQ-5D) and to identify its related factors among urban-dwelling adults. Methods: The data for this study were obtained from 1,134 subjects aged $20\sim91$, who participated in 'Survey on the health status and demand for health' in two cities of Korea (Dong-gu, Gwangju and Suncheon-si, Jeollanamdo). The HRQOL was measured using the EQ-5D instrument and EQ-5D index scores were calculated by two Korean valuation study model using time trade-off method. Results: The mean EQ-5D index scores for all subjects were $0.865{\pm}0.218$ (model A), and $0.921{\pm}0.170$ (model B). The EQ-5D index score was significantly different according to demographic and socioeconomic characteristics (gender, age, marital status, education, occupation, income, and health security system), self-rated health condition, health-related psychological assessments (enough sleep, fatigue rate, stress rate, and degree of satisfaction on the residence). The results of multiple linear regression showed that age, marital status, income, coverage of medical insurance, self-rated health condition, and fatigue rate were significantly related common statistical factors of HRQOL in two Korean valuation study model. Conclusion: Among the adults residing in urban environment, the HRQOL was significantly lower on the subjects with following conditions: higher age, being alone without a spouse as a result of death, divorce or separation, low income, medical aid program, poor self-rated health condition, and chronic fatigue. In order to improve the urban adults' quality of life, healthcare policy and health promotion program must be developed with considerations to factors related to the HRQOL.

Nursing Students' Perception of Well-dying and Knowledge for Advanced Directives (간호학생의 웰 다잉에 대한 인식과 사전연명의료의향서에 대한 지식)

  • June, Kyung Ja;Jeong, Sohyeon;Ahn, Heeji;Hong, Yekyung;Lee, Yoonjin;Kim, Yoonah;Jo, Sooyeon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.14 no.1
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    • pp.1-7
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    • 2019
  • Purpose: The purpose of this study was to describe nursing students' perception of well-dying and knowledge for Advanced Directives. Methods: Nursing students from one university were selected for the research and a survey was carried out during March and April, 2019. A total of 133 nursing students participated in this study. Data were analyzed using t-test, ANOVA, $x^2$ test with SPSS statistics 21.0. Results: According to the results, the mean score for perception of well dying was $3.00{\pm}0.31$, and knowledge for Advance Directives was $9.05{\pm}2.20$. Perception of well-dying was significantly different by grade group. Knowledge for Advance Directives was significantly different by pre-education experience. Conclusion: In order to improve the nursing students' knowledge for advanced directives, it is necessary to develop education program and provide them through the total school years.

The Demands on Parish Nursing Services by Pastors in Busan (부산지역 목회자의 교구간호사업 요구조사)

  • Sohn, Sue-Kyung;Kang, Kyung-Ja;Lee, Jj-Hyun;Lee, Young-Eun;Park, Choon-Hwa
    • Research in Community and Public Health Nursing
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    • v.13 no.1
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    • pp.182-196
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    • 2002
  • The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

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