Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.
Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.
Mi Jeong Heo;Ji Ho Suh;Kyle L. Poulsen;Cynthia Ju;Kang Ho Kim
Molecules and Cells
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제46권9호
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pp.527-534
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2023
Liver ischemia-reperfusion injury (IRI) is the main cause of organ dysfunction and failure after liver surgeries including organ transplantation. The mechanism of liver IRI is complex and numerous signals are involved but cellular metabolic disturbances, oxidative stress, and inflammation are considered the major contributors to liver IRI. In addition, the activation of inflammatory signals exacerbates liver IRI by recruiting macrophages, dendritic cells, and neutrophils, and activating NK cells, NKT cells, and cytotoxic T cells. Technological advances enable us to understand the role of specific immune cells during liver IRI. Accordingly, therapeutic strategies to prevent or treat liver IRI have been proposed but no definitive and effective therapies exist yet. This review summarizes the current update on the immune cell functions and discusses therapeutic potentials in liver IRI. A better understanding of this complex and highly dynamic process may allow for the development of innovative therapeutic approaches and optimize patient outcomes.
The purpose of this study was to identify nursing diagnoses and nursing interventions that are found in the home health care patients, and to establish a basis for a standardized Nursing Intervention List that would help nurses doing home health care nursing. For this study, the records of 150 home health care clients who were discharged, from the Home Health Care Center at Yonsei Medical Center, between January to July. 2001 were analyzed. Of the 43 nursing diagnoses recorded for these clients are 43, the most frequent diagnoses were in the area of Exchanging. There were 2.814 nursing interventions which is a mean of 4.73 nursing interventions Per diagnosis. We confirmed that most of the interventions were related to 'education' and 'advice'. We present a Home Health Care Nursing Intervention List that was developed based on the results of this study. It has the five 5 criteria of the ICNP classification, Observing, Management, Performance, Caring, and Informing.
Aloe vera has several beneficial health effects as it interacts with probiotics and is also a source of prebiotics, antioxidants, and other bioactive materials. Thus, there has been increasing interest in the development of beverages containing Aloe vera. In this investigation, sensory qualities were estimated by fortifying oil isolated from Aloe vera in non-dairy and dairy products at different concentrations (fortified with 1% increments from 0% to 5%). Because of the strong aroma and strong yellow color of aloe oil, the sensory quality values estimated in this study were generally low. However, the samples fortified with 1% aloe oil exhibited the best sensory quality values compared with the control. Consequently, the results of this study are valuable as preliminary findings to determine the various sensory qualities of kefir fortified with aloe oil. To improve sensory qualities in the future, it is necessary to estimate the optimal lowering of the concentration of fortified aloe oil, and assess whether aloe oil exhibits various biofunctional activities at different concentrations.
The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.
Purpose: The aim of this study was to evaluate the effects of oral health care programs in 3 school-based oral health care center among primary schoolchildren. Methods: School-based oral health care programs included fluoride mouth rinsing, pit and fissure sealing for permanent premolars and molars, fluoride gel application and chewing of xylitol candy. All of the programs were carried out by one dental hygienist among 'D' primary schoolchildren in Daegu city under the supervision of a dentist. Baseline dental examinations were completed and preventive care was implemented for 544 children during one year. All of the children visited a school-based oral health care center every three months for a regular check-up. The final oral examination was conducted from March 15 to April 1, 2004. The data analysis data was made on the basis of SAS 8.01. Mean differences between 2003 and 2004 data were compared by paired t-test. Corresponding p-values were considered significant at values less than 0.05. Results: The DMF rate and DFT index were reduced to 8.0% and 8.4% during one year respectively, but there were no statistically significant differences. The DMF rate was significantly reduced (16.3%) after a one year program of school-based oral health care practice. The DMFT(Decay Missing Filling Tooth) index was also reduced compared to 2003 throughout the entire grade. Conclusion: School-based oral health care programs can reduce the prevalence of dental caries prevalence among schoolchildren during one year. This program also improved the oral health capacity of schoolchildren. It is recommend that the school-based oral health care program should be extended to every primary school in Korea.
Purpose: The purpose of this study was to determine the effect of an education program promoting attitude, knowledge, and practice of safety for teachers in child care centers. Method: This education was provided at one public health center in Kyunggi Province. One group pretest-post test design was used, and knowledge on safety and emergency care, practice of safety, health belief and self confidence on safety practice were assessed from 74 teachers. Theoretical framework for this program was Pender's health promotion model. Result: After two hours group education session on safety management, knowledge on safety and emergency care was significantly increased and perception on the main cause of injuries was significantly changed. Practice on safety was significantly related to the knowledge, health belief and confidence on safety, and social support. Conclusion: The education program for teachers in child care centers regarding the child safety and emergency care was effective in promoting knowledge and perception on the main cause of injuries of infants.
Wozencraft, Colin;Tucker, Rodney O.;Howell, Stephen
Journal of Hospice and Palliative Care
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제15권4호
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pp.188-192
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2012
Palliative medicine has shown demonstrated benefit for patients with serious illness, their families, and hospital systems. As such, the demand for palliative care services is growing at a fast pace, and health care facilities frequently struggle to develop and implement effective and sustainable methods of providing this care. As with any new system, challenges and barriers naturally exist to instituting palliative care. Undertaking careful assessment, planning, and resource allocation can provide the greatest likelihood of success when developing these novel yet much needed models of care. This summary paper offers a qualitative overview of the potential benefits and the rationale to implement robust palliative care systems. We briefly review the history of palliative medicine in the broadest sense and address several seminal works from the US palliative care literature. Core practices to establish and advance palliative medicine are suggested. Commentary is provided on some of the particular barriers to palliative system development that may need to be addressed in the context of Korean medical culture. Collectively, we hope this overview can contribute to a framework within which such research and development can occur, leading to increasingly effective and sustainable palliative medicine in Korea.
Purpose: To identify factors that affect the job stress of visiting nurses at health centers in Seoul, Korea, who perform home care services. Methods: Data were collected in the period from November 20 to December 10, 2008, from 206 visiting nurses working at 25 health centers in Seoul metropolitan city. Self-report questionnaires of the Organization-Based Self-Esteem (OBSE) and the Korean Occupational Stress Scale (KOSS) were used. Data were analyzed by the SPSS win 15.0. Results: Several findings were obtained from the study. First, the mean of job stress was 52.4 points, which was higher than that of Korean women. Second, it was shown that by the sub-domain of job stress, the mean value belonged to the top 50% in the four sub-domains of physical environment, job demand, interpersonal conflict, and organizational system. Additionally, it belonged to the top 25% in the sub-domain of job insecurity, wherein the job stress was the highest. Third, the self-esteem of the nurses had the most significant effect on their job stress. Conclusion: Stress related to job insecurity was the highest among the visiting nurses at health centers in Seoul who perform the custom home care service thus, institutional support is urgently needed to alleviate such stress and secure their employment.
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