• 디지털융복합연구
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• 제15권9호
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• pp.435-441
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• 2017

본 연구는 미국에 거주하고 있는 한인 노인을 대상으로 현재 뉴욕 시에서 시행하고 있는 데이케어 프로그램(Adult Day Care Program)의 일환인 치료 레크리에이션의 신체적, 정신적 효과를 평가하고자 시행되었다. 연구 방법은 비동등성 대조군 사후 실험 연구로 2017년 2월부터 4월까지 진행되었다. 본 연구에 참여한 대상자는 실험군 35명, 대조군 35명이었으며 이 중 66명의 자료를 분석하였다. 본 연구에 참여한 대상자의 평균연령은 79.4세 이었으며 미국에 거주한 기간은 평균 24.6년 이었다. 치료 레크리에이션 프로그램은 데이케어센터에서 제공하는 프로그램으로서 본 연구결과, 데이케어센터 치료 레크리에이션에 참여한 노인의 일상생활 수행능력, 우울 및 외로움에 효과가 있는 것으로 나타났다. 따라서 향후 문화적 감수성을 고려한 노인 대상 다양한 치료 레크리에이션 프로그램이 개발, 운영되어져야 할 것이며 이에 대한 효과를 평가하기 위하여 근거기반 연구가 수행되어져야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제57권2호
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• pp.96-107
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• 2024

Objectives: While several food assistance programs in the United States tackle food insecurity, a relatively new program, "Food is Medicine," (FIM) initiated in some cities not only addresses food insecurity but also targets chronic diseases by customizing the food delivered to its recipients. This review describes federal programs providing food assistance and evaluates the various sub-programs categorized under the FIM initiative. Methods: A literature search was conducted from July 7, 2023 to November 9, 2023 using the search term, "Food is Medicine", to identify articles indexed within three major electronic databases, PubMed, Medline, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Eligibility criteria for inclusion were: focus on any aspect of the FIM initiative within the United States, and publication as a peer-reviewed journal article in the English language. A total of 180 articles were retrieved; publications outside the eligibility criteria and duplicates were excluded for a final list of 72 publications. Supporting publications related to food insecurity, governmental and organizational websites related to FIM and other programs discussed in this review were also included. Results: The FIM program includes medically tailored meals, medically tailored groceries, and produce prescriptions. Data suggest that it has lowered food insecurity, promoted better management of health, improved health outcomes, and has, therefore, lowered healthcare costs. Conclusions: Overall, this umbrella program is having a positive impact on communities that have been offered and participate in this program. Limitations and challenges that need to be overcome to ensure its success are discussed.

• 한국의료질향상학회지
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• 제12권2호
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• pp.93-112
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• 2006

This study reviewed published studies on interventions used by hospitals, health insurance programs, or governments to improve use of medicines in foreign countries. Interventions to improve use of medicines are classified into two categories: 1) information strategies-dissemination of educational materials, group education, one-to-one educational outreach, drug utilization review, and feedback; 2) managerial strategies- formularies, prior authorization, and financial incentives. Dissemination of educational materials, which is a common intervention, was unsuccessful in changing physicians' prescribing behaviors. Problem-based small group education was more likely to change behaviors than didactic large group education. One-to-one educational outreach(academic detailing) was among the most effective strategies used to change prescribing behaviors. Prospective drug utilization review (DUR) program was more successful in improving use of medicines than retrospective DUR program. Feedback intervention has been reported to be ineffective to change behaviors. Formularies are frequently used to control medication use by most health insurance programs. Financial incentives provide physicians economic incentives according to appropriateness of prescribing. However, few published studies have assessed the efficacy of formularies or financial incentives. Prior authorization requires physicians to get authorization from health insurers before prescribing a certain group of drugs which is usually of high costs or risk. There is no magic bullet for quality use of medicines. Multifaceted interventions that help to predispose, enable, and reinforce desired behaviors are more likely to be successful.

• 보건행정학회지
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• 제25권4호
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• pp.253-255
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• 2015

The concept of precision medicine-prevention and treatment strategies that take individual variability into account-is hot issue of US in the year 2015. Precision medicine is a new concept that approach patients individually by there characteristics, such as genome, life style, environmental exposure, etc. For developing the precision medicine, National Institute of Health of US has been prepared the Precision Medicine Initiative Cohort Program, at least 1 million people cohort. The US President Obama announced the Precision Medicine Initiative on 30th January 2015. He announced that he will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients. Most medical treatments have been designed for the 'average patient.' As a result of this 'one-size-fits-all-approach,' treatments can be very successful for some patients but not for others. This is changing with the emergence of precision medicine, an innovative approach to disease prevention and treatment that takes into account individual differences in people's genes, environments, and lifestyles. Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient's health, disease, or condition, and to better predict which treatments will be most effective. The healthcare researcher should prepare the new medicine era such as bio-information technology convergence, big data study.

• 대한간호학회지
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• 제44권5호
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• pp.534-541
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• 2014

Purpose: This study was done to examine the actual state of influenza vaccination among pregnant women and factors affecting vaccination rate. Methods: Data were collected using self-report questionnaires. Participants were pregnant women who participated in a prenatal education program at an acute care hospital in 2013. Data collected from 218 pregnant women were analyzed using the SPSS 18.0 Program. Results: Only 48.6% of the pregnant women had received vaccination when the influenza was prevalent. Statistically significant factors affecting the influenza vaccination rate among pregnant women were vaccination experience in the previous year, knowledge and attitude about vaccination, and gestation period. Conclusion: Results indicate that the influenza vaccination rate among pregnant women is lower than that of elders, healthcare workers, and patients with chronic diseases, who have been considered to be the mandatory vaccination recipients. Therefore, it is necessary to develop programs and policies which provide information including safety of vaccines for pregnant women and to induce positive attitudes towards vaccination for these women, in order to ultimately improve the vaccination rate.

• 한국건강관리협회지
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• 제1권1호
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• pp.14-18
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• 2003

Although it has been well known that smokimg is one of the major cause of various disease and conditions, the smoking rate is still very high in Korea. A variety of smoking cessation program are provided by public organization and also by healthcare institutions. In this social enviroment, the smoker's intension and trial rates for smokimg cessation increasing, but it is also true that the succes rate is low about 30%. Therefore this study was conducted to suggest the strategies for providing the effective smoking cessation programs by exploring the factors related to recognition and behavioral intention or programs. To explain the health behavior for smoking and smoking cessation programs, the behavioral model was constructed. The model is composed of five-stages such as recognition of the program, past exprience, present smoking status, intention for smoking, and behavioral intention for cessation programs. It is results that there were very low recognition and and purchase rates for most of smoking cessation programs. Evidenced-based and effective smoking cessation progrms need to be encouraged to smokers by medical doctors, and the strategies of eucationm public realtions, and advertisement are recommended. In addition, cotinuing legal and systematic supports for smoking cessation would lower the smoking rate and ultimately ontribute to the nation;s health promotion, Recognitionm Behavioral Intention.

• 보건행정학회지
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• 제28권3호
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• pp.233-239
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• 2018

A rapid decrease of total fertility rate to 1.08 in 2005 prompted the Korean government to plan and implement a '5-year plan for ageing society and population policy' starting from 2006. The 1st and 2nd 5-year plans had not shown any discernible impact on the fertility and the 3rd 5-year plan was launched in 2016. However, the fertility rate is going down further. The author reviewed the contents and assessment reports of the fertility promotion plan to suggest ideas for complementing the shortcomings of it. Author defined the major determinants of marriage and child birth as philosophy, politics, sense of value, social norm, culture, healthcare, and education. The plan was examined in view of these determinants. Transformation of Korea from an agricultural society to an industrialized society in a short period of time had brought about changes in most of the determinants of marriage and child birth; in particular philosophy and sense of value. These aspects were not put into consideration in the plan. Author suggested to launch a social education program for the general public to establish a sound philosophy of life, reform the sense of value on family, child birth and education, and cultivate the skill to draw a consensus through discussions on the social issues. A special program to promote marriage of women at the optimum age for child birth was proposed. The government should implement well balanced policy for economic development and labor. Multidisciplinary approach was recommended for these tasks.

• 한국치위생학회지
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• 제20권3호
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• pp.359-367
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• 2020

Objectives: The purpose of this study was to recognize the importance of dental hygienist's communication competence and to establish the basis for developing a program to improve communication competence. Methods: A survey was conducted on members who underwent participatory training in some trials in 2019, and a total of 348 people were analyzed. Results: Total communication competence was 3.63 points. The highest area was 3.88 points for understanding others' standards, and the lowest area was 3.27 points for escaping stereotypes. Most areas of communication showed statistically significant positive correlations, but in some areas, there was an inverse correlation. As a dental hygienist, it is necessary to provide systematic education for improving communication competence from college students. Conclusions: In addition, it is necessary to develop and implement a training program for improving communication competence of dental hygienists.

• 여성건강간호학회지
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• 제26권4호
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• pp.274-284
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• 2020

Purpose: The purpose of this study was to investigate the effects and characteristics of health care programs for pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: This study was conducted according to the Cochrane Collaboration's systematic literature review handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. We searched eight international and domestic electronic databases for relevant studies. Two reviewers independently selected the studies and extracted data. For each study, information on the research method, participants, characteristics of the program, and results were extracted using a previously established coding table. The National Evidence-based Healthcare Collaborating Agency's risk of bias assessment tool for non-randomized studies was used to assess the risk of bias of the included articles. A qualitative review of the selected studies was performed because the interventions differed considerably and the measured outcomes varied. Results: Out of 128 initially identified papers, seven were included in the final analysis. The risk of bias was evaluated as generally low. Health care programs for pregnant women with GDM showed positive effects on blood glucose control. Anxiety and depression were reduced, and self-management and self-care behavior, self-efficacy, and maternal identity improved. Conclusion: Our study provides clinical evidence for the effectiveness of health care programs for pregnant women with GDM, and its results can be used to support the development of health care programs for GDM. More well-designed research is needed on GDM, especially studies that deal with emotional stress and apply a family-oriented approach.

• 한국의료질향상학회지
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• 제29권2호
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• pp.64-84
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• 2023

Purpose:Plaster splints are routinely performed in the Emergency Department (ED) and avoidable complications such as skin ulcerations and fracture instability arise mainly due to improper techniques. Despite its frequent use, there is often no formal training on the fundamental principles of plaster splint application for a medical officer rotating through ED. We aim to use Quality Improvement (QI) methodology to reduce number of incorrect plaster splint application to improve overall patient care via a bundled educational solution. Methods: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act (PDSA) cycles, to decrease the rate of incorrect plaster splint application. A bundled education solution consisting of three sequential interventions (practical teaching session, online video lecture and quick reference cards) were formulated to specifically target critical factors that had been identified as the cause of incorrect plaster splints in ED. Results: With the QI intervention, our overall rate of incorrect plaster splints was reduced from 84.1% to 68.6% over a 6-month period. Conclusion: Following the QI project implementation of the bundled educational solution, there has been a sustained reduction in incorrect plaster splints application. The continuation of the training program also ensures the sustainability of our efforts in ED.