Park, Mi-Hyang;Kim, Hyun-Joo;Lee, Bo-Woo;Bae, Seok-Hwan;Lee, Jin-Yong
한국의료질향상학회지
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제22권1호
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pp.41-57
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2016
Objectives: This study aimed to investigate how many healthcare professionals experienced near misses, what types of near misses occurred most often, and healthcare professionals' opinions about near misses at one university hospital in Korea. Methods: The authors developed a questionnaire including 26 core types of near misses and 4 questions about preventability and reporting barriers. The survey was conducted from Oct. 31st to Nov. 18th 2011, about 3 weeks, using a self-administrated questionnaire that was administered to 697 healthcare professionals (registered nurses, pharmacists, technicians, and nurses aides) who worked at a university hospital. Medical doctors and employees working in the department of administration were excluded. Results: About half of hospital workers experienced at least one or more near misses during the past one year. The drug dispensing process was the most common subcategory of near misses. Among the 26 items, patient falls was highest. Over 95% of respondents reported that the near miss they experienced was preventable. Also, more than half of respondents did not report the near miss and the main reason for omission was fear of blame. Conclusion: Regarding patient safety issues, a near miss is a very significant factor because it can be a potential adverse event. Therefore, we should grasp the size of the problem through tracking and analyzing near misses and should make an effort to reduce them. To do so, we should check whether our reporting system is well designed and functioning.
This study sought to find out the level of perception of postpartal care and the meaning and opinion of traditional postpartal care (Sanhujori) from health professional. The subjects were 188 health professionals who work at University hospital, clinics, Oriented clinics, and midwifery clinics in Seoul and Chung-Buk, Korea. Data were collected from 8th April, 1999 to 6th May, 1999. The data were analyzed through the SPSS program by use of frequency, percentage, t-test, ANOVA and Scheffe test as a post hoc contrast, $x^2$-test, and stepwise multiple regression. The results of the study were as follows: mean age of the subject was 33.0 years and female was 58.0%. Occupation of the subject was nurse 28.7%, doctor 22.3%, midwife 21.3 Korean Oriental doctor 27.0%. Mean period of career was 7.6 years and the subject who experienced Sanhujori was 54.3%. The subject who did not know 6 principles of Sanhujori was 73.9%. In the opinion on traditional Sanhujori method 68.1% of respondents expressed that Sanhujori is scientific postpartal care which fits Korean people's physical constitution and culture. On the opinion of effective postpartal care in 97.9% of respondents expressed that it is to in hospital postpartal care and traditional Sanhujori perform it according to Korean culture constitution. On the opinion of Sanhujori, 96.6% of respondents expressed that it is necessary to understand Sanhujori with consideration which was adapted to Oriental culture and to verify it through continual study. On the opinion of the effect of the level of performance of Sanhujori upon women's health life, 43.2% of respondents expressed that the level of performance of Sanhujori has great effect on women's general health, including postpartal recovery, Sanhujori prevention, and so on. On the opinion of Sanhujori of women who undergo Caesarean operation, 57.7% of respondents expressed that women who undergo Caesarean operation perform Sanhujori with more attention. On the opinion of Sanhujori center (sanhujorwon), 56.3% of respondents expressed that the center is necessary for women's health and health professional are required to manage the center scientifically. On considering the level of importance of post care according to occupation, midwife showed highest level of importance of traditional Sanhujori doctor the lowest level. Midwife showed the hi level of importance of postpartal care and K Oriental doctor showed the lowest level of importance of women's postpartal care. On considering the relationship between the level of importance of postpartal care and general characteristics, sex, career, clinical department and whether they know 6 principles of Sanhujori or not were statistically significant at the level of 5%. In the stepwise multiple regression analysis, the main influencing variables on the level of importance of postpartal care were occupation, sex, and clinical department. In conclusion, this finding confirmed that professionals were considering the traditional Sa importantly for women's health. Above all things necessary for health professional to integrate concept of traditional Sanhujori into practical nu intervention program, to apply it to profes practices in order to reestablish effective integrative postpartal caring system, and to Sanhujori scientific through performing continual research.
Purpose: Focus group interviews were conducted to explore the current status and barriers of health care services in nursing home from the viewpoint of staffs taking care of nursing home residents. Methods: A qualitative thematic analysis using the focus group interview method was used. A total of 32 health care professionals (19 nurses and 13 social workers) from thirteen nursing homes in South Korea attended (5 focus groups) in 2014. Results: The two main themes were identified: 'minimal health care services that left personal care needs unmet' which has three subthemes of 'stereotyped and fragmented care by types of care providers', 'medically-oriented health care services' and 'health care services mixed with social or recreational programs'; and 'barriers to proper and timely care in nursing homes' with four subthemes including 'unmet care needs due to cognitive dysfunction or lack of expression', 'care guides or tools not suitable for long-term care facilities', 'health care needs that are beyond the facility's care boundary', and 'care delay due to lack of understanding on the older adult's status'. Conclusion: The findings from this study should help health care policy makers to recognize the factors that influence health care services and provide direction for nurses and other staffs involved in supporting health care services for nursing home residents.
Purpose: The purpose of this study was to examine the relationships of knowledge, attitudes, and self-efficacy related to palliative care among health care providers (doctors and nurses) in order to provide a basis to develop a training program for health care providers. Methods: A correlational and descriptive study design was used. Participants were recruited from a university-affiliated hospital located in Daejeon and an e-nurse community. After IRB approval, data were collected from July 12, 2018, to September 30, 2018. A total of 169 responses were finally analyzed using version SPSS 24. The data were analyzed in terms of descriptive statistics (frequency and percentage or mean and standard deviation, as appropriate), the t-test, analysis of variance (with the Duncan post hoc test), and Pearson correlation coefficients. Results: Knowledge, attitudes, and self-efficacy were significantly higher in those who had received palliative care training or had been exposed to awareness-raising initiatives. There were positive relationships among knowledge, attitudes, and self-efficacy, with small to moderate effect sizes. Conclusion: Palliative care training for health care professionals is necessary to meet patients' needs. Such programs should take into account not only knowledge about palliative care, but also ways to improve empathy and resolve ethical dilemmas. Interprofessional training would be an excellent option to share therapeutic goals and develop communication skills among multidisciplinary team members.
Child is a being and provides the genetic continuity of parents and society, and therefore the fitness of these children for survival, growth and development towards reproduction, is of significance to parents and society. The aim of health care for high-risk children is not only to minimize or eliminate health problems, but also to optimize their fitness. Considering that the health care of children is influenced by available resources of parents and society, and sociocultural values and paradigms in a given environment of evolutionary adaptedness (EEA), child health care professionals need to understand factors affecting the optimal fitness of children with risks. This paper introduces a new integrated theory for health care in high-risk children, entitled, Health for Optimal Fitness of High-Risk Children. Five main components were identified with associate concepts or midrange theories affecting heath for optimal fitness of high-risk children; EEA, optimal fitness, health problems, investment resources, and anthropological values. It may provide an integrated perspective on health of high-risk children in both the proximately biomedical approach and ultimately evolutionary approach as optimizing their fitness. Further study is needed to develop substantial statements between components with existential examples.
Purpose: There has not been decisional consensus in the concepts and the ways of postpartum cares between Western and non-Western cultures though the importance of postpartum period has been emphasized by the multitude of health professionals. In this study, we investigated the differences in recognition concerning postpartum care among Koreans, Korean residents in America, and Americans (hereafter, K, KA, A). Methods: We used questionnaire of women who had given birth from last 6 weeks to less than 13 years. The women consisted of three groups;104 K, 44 KA, and 44 A. Results: In the perception survey concerning postpartum care, every three group thought that postpartum care was important. However, there were differences in understanding how it would affect women's health, and what they did in the period. K significantly agreed with the content and the importance of postpartum care. The investigation concerning seven categories of postpartum care showed that K group performed the 6 categories except consuming medication beneficial for the postpartum care. KA group performed in a low rate and A group performed two categories in a significantly low rate two categories; avoiding cold stimulation and keeping the body warm. Conclusion: Based on this study, it should be suggested that there were common points and differences among the recognition concerning postnatal care in three groups. Therefore, health professionals make efforts in understanding diversities on postnatal care and providing the adequate services reflecting each mother's needs and recognition.
Objectives: The purpose of this study was to investigate the present conditions and problems of oral health care in senior citizens with dementia using a qualitative research method, through focused group interviews. Methods: Data was collected for approximately one month from May 2019. The subjects were divided into two groups: care workers and family caregivers. Fifteen participants were included in the study. Results: In-depth interviews with the care workers revealed the following three categories: characteristics of senile dementia patients, oral health care in senile dementia patients, and oral health care education. In-depth interviews with the family caregivers revealed the following four categories: characteristics of senile dementia patients, oral health care in senile dementia patients, oral health care education, and burden of care. The central themes common to both the care workers and family caregivers were the challenges owing to the characteristics of senile dementia patients, poor health condition of the senile dementia patients, difficulty in oral health care of the senile dementia patients, the desire to receive oral health care education and related information, and to access the information more easily. Additional central themes specific to the care workers were, the applicability of the intervention programs, variability between the facilities, and the problems of oral health care education. An additional central theme specific to the family caregivers was the burden of care. Conclusions: It is necessary to provide oral health care education and information to care workers and family caregivers of senile dementia patients, and to manage and support the dental health professionals ready to care for senile dementia patients. In addition, support to the family caregivers should not be limited only to the financial aspects, but also consider the psychological and emotional difficulties.
Community involvement is to be the keystone of primary health care, Unfortunately, efforts to promote it failed in many countries. Author inquired into the reasons why such efforts fail, and the alternative strategies for effectively promoting it in Korean situation today. In doing so, the concept of community involvement is clarified as an amalgamation of two different concepts; one is that of the community development, and the other is that of approaches for overcoming the alienation of the people from the health care process. Stategies of community involvement in Korea so far followed the line of the community development, e.g. village health worker. It loses, however, the feasibility as Korea has experinced so cial and economic developpment. The strategies of the second line of thought is now more feasible; empowering the people by providing more information and enhancing comitment to health, improving acceptabilty of community involvemt on the part of the health professionals and the bureaucrats, and building the mechanism of community involvement into the health policy-making process.
Objectives: Individuals' self-reported unmet needs are an important indicator of heath care of their society. Using data from the Canadian Community Health Survey (CCHS) Cycle 1.2, we examine unmet needs for mental health care in Canada and discuss its implications to health education. Results: The most frequently reported reason for unmet needs was barriers to acceptability issues, which stem primarily from lack of knowledge of mental health, negative attitudes towards mental disorder, and mistrust of mental health professionals. Unmet needs for mental health care appeared an especially serious issue among the young. Also, individuals who reported unmet needs tended to have some ill health behavior such as illicit drug use that could be their coping mechanism. On the other hand, emotional and informational support factors have shown an important mitigating effect on unmet needs. Conclusions: These findings of unmet needs pose a major challenge to health education. To effectively address unmet mental health care needs, it is recommended that the focus of relevant policies and programs should be on enhancing a multi-level mental health education strategy including efforts on individual, environmental and professional level education.
Purpose: The purpose of this study was to identify the differences in preference for terminal care between hospitalized patients and nurses. Methods: A cross-sectional descriptive design was used in 79 patients and 107 nurses. The data were collected from August to October 2011, using the Preference for Care near the End of life Scale - Korean Version (PCEOL-K) with 5-point scale of 26 items. The reliability of the tool was Cronbach's ${\alpha}=.74$. Results: The mean score (SD) of PCEOL-K's sub-dimensions in nurses' priority was: (a) pain $3.70{\pm}0.63$, (b) spirituality $3.63{\pm}0.61$, (c) family $3.40{\pm}0.70$, (d) autonomous decision making $2.30{\pm}0.66$, and (e) decision making by healthcare professionals $2.14{\pm}0.64$. In patients' priority, the $M{\pm}SD$ score of each sub-dimension was: (a) pain $3.86{\pm}0.65$, (b) family $3.83{\pm}0.57$, (c) decision making by healthcare professionals $3.37{\pm}0.85$, (d) spirituality $3.01{\pm}0.80$, and (e) autonomous decision making $2.43{\pm}0.63$. Results indicated significant differences between nurses and patients regarding decision making by healthcare professionals (t=-11.28, p<.001), family (t=-4.66, p<.001), and spirituality (t=5.71, p<.001). Conclusion: The PCEOL-K of patients was higher than nurses'. A terminal care program for hospitalized patients at the end of life should be planned according to the results of PCEOL-K in nurses and patients.
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