• Title/Summary/Keyword: Korean Medicine Chronic Disease Management Program

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A Study on Characteristics of Core Projects Described in 3rd Community Health Plans (제3기 지역보건의료계획서에 기술된 핵심사업의 특성에 관한 연구)

  • Kim, Dong-Moon;Lee, Weon-Young;Moon, Ok-Ryun;Kim, Chang-Yup
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.1
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    • pp.88-98
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    • 2004
  • Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health

Basic Study on the Significance of the Disease Pre-Sign According to the Body form Type (형상(形象) 유형(類型)에 따른 질병 전조(前兆)의 의의(意義)에 대한 기초 연구-내경(內經) 오형입(五型入)을 중심으로-)

  • Kim, Gyeong-Cheol;Lee, Yong-Tae;Ji, Gyu-Yong;Kim, Jong-Won;Lee, In-Sun;Kim, Jong-Hwan;Shin, Woo-Jin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.2
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    • pp.301-307
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    • 2009
  • In korean society, the chronic life style diseases are increasing. It is caused by the approach of the aged society and the highly increasing income. Accordingly the preventive side of the health promotion and management is very important. In the oriental medicine, the general disease pre-estimate and the management program are necessary. On this point, the sign forecast is very significant in connection with the disease pre-estimate in the preventive disease management side. The sign forecast according to the human shape type diagnosis is mainly the sign of the super-early stage, The difference of the shape type has the difference of the special affinity about the disease. Accordingly we can find the sign forecast from the latent disease in the early stage. In NAE-GYEONG(內經), the theory of "five body form's type" can be pre-estimated the latent tendency and the clue of the disease and the growing tendency of disease in relation to the Differentiation of Syndrome, In the disease pre-estimate side, the graspe and management of the sign forecast from the latent disease will be the part of the new development.

The Development Process and the Contents of the Self-management Education Program Integrated with Exercise Training (HAHA program) for Older Adults with Chronic Diseases (만성질환 노인을 위한 운동교실 통합 자기관리교육 프로그램(하하프로그램)의 개발과정과 내용)

  • Kim, Seon-Ho;Song, Mi-Soon;Park, Yeon-Hwan;Song, Wook;Cho, Be-Long;Lim, Jae-Young;So, Wi-Young
    • Journal of muscle and joint health
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    • v.18 no.2
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    • pp.169-181
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    • 2011
  • Purpose: This paper presents the development process and the final contents of the sellf- management education program integrated with exercise training (Healthy Aging Happy Aging, HAHA program) for community residing older adults with chronic diseases. Methods: The program evaluation methodology was applied which is an interactive program development process based on needs assessment, formative evaluation, process evaluation and outcome evaluation. The program was developed and revised while the program was implementing to 22 hypertension (HT) and 32 diabetic (DM) participants. Results: The final program has two sub-programs for HT and DM participants utilizing self-efficacy resources. They share four common components; 1) health screening of exercise risks, 2) weekly 1-hour group self-management education classes, 3) biweekly 1-hour group exercise training and 4) a mid-term individual counseling. Both sub-programs were 12-weeks long but have different education and exercise contents. Participants-rated mean satisfaction scores were 3.47/4 and 3.61/4 for HT and DM program respectively. Attendance rate were 83.1% ~ 92.3% for the classes. Conclusion: The HAHA program developed by multidisciplinary team which reflected participants needs was accepted well by participants evidenced by high attendance rate and perceived satisfaction level.

Factors Influencing Use of Smartphone Applications for Healthcare Self-Management: An Extended Technology Acceptance Model

  • Jo, Heui-Sug;Jung, Su-Mi
    • Korean Journal of Health Education and Promotion
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    • v.31 no.4
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    • pp.25-36
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    • 2014
  • Objectives: The self-management of chronic diseases is currently receiving much attention. This study applied an extended technology acceptance model (ETAM) to analyze the factors influencing acceptance of a healthcare smartphone application. Methods: Three hundred people living in Seoul and Gyeonggi who used smartphones were quota sampled. A telephone survey was conducted using a structured questionnaire based on ETAM. A path analysis was carried out using the AMOS 17.0 program, and the model was verified. Results: The analysis revealed significant factors of perceived usefulness (.374, p < .001), enjoyment (.210, p < .001), subjective norms (.168, p < .001), perceived costs (.146, p < .001), and innovativeness (.138, p < .001). Cost directly influenced intention to use health applications; self-efficacy and perceived ease of use indirectly affected intention through innovation and perceived usefulness. Conclusions: This study helped to identify the main factors that influence usage intention of smartphone applications. These findings could contribute to promoting the self-management of chronic disease through future health applications using smartphones.

Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis (의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과)

  • Ahn, Yang Heui
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.32-45
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    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

The Study on the Contents and Satisfaction of Oriental Medicine Examination Program (한방건강검진 프로그램의 내용과 참가자들의 만족도에 관한 연구)

  • Lee Eun-Kyoung;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.51-95
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    • 2002
  • 1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.

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Attitude towards Traditional Korean Medicine Use among Hemiplegic Patients after Cerebrovascular Accident (재활치료 중인 뇌졸중환자의 한의약의료에 대한 태도)

  • Han, Dong-Woon;An, Taek-Soo;Choi, Soo-Jeong;Kim, Ji-Woo
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.3
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    • pp.67-81
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    • 2011
  • Background : Complementary and alternative medicine has bee used to cardiovascular diseases. In recent years, many hospitals have tried to integrate complementary and alternative medicine(CAM) with conventional medical approaches for patients with chronic diseases. Recently, the prevalence of the use of traditional Korean medicine(TKM) among patients with chronic diseases, expecially, hemiplegia patients after cerebrovascular accident is increasing in Korea. To date, however, there were only few studies addressing the patients' attitudes, and utilization of TKM, compared to the well-documented escalating use of TKM among consumers in Korea. Objectives : The objective of this study was to analyze the prevalence of TKM use among hemiplegia patients after cerebrovascular accident and to determine what factors affect to use CAM among the patients. The study also aims to provide information on TKM and assist therapy selection among various CAM therapies for hemiplegia patients after cerebrovascular accident within health care system in which both practitioners of TKM and practitioners of modern Western medicine coexisted. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 32-items questionnaire. The subjects were one hundred fifty nine patients with chronic diseases who visited or admitted to health care facilities in a hospital in Seoul Metropolitan city, Korea. Data were analyzed using 'SPSS Statistics 18.0 Network Version(on release 18.0.1 of PASW Statistics)' program. Various statistical methods were used to obtain a profile for participants and the therapies most frequently used by hemiplegia patients of TKM. Logistic regression analysis was employed in order to determine the predicting variables of TKM use. Results : The prevalence of the use of TKM was 51.6%. The most common TKM therapies used by the patients included acupuncture(93.2%), herbal medicine(64.8%), and cupping(37.5%). Results of logistic regression analysis revealed that the variables significantly related with TKM use were gender, marital status, job, No. of visiting health care facilities/week. Conclusions : This study shows that the use of TKM among the hemiplegia patients is relatively high in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system in Korea.

Self-efficacy and Compliance in Patients with Chronic Heart Failure: The Effect of a Self-management Program using Decision Tree (의사결정 틀을 이용한 만성 심부전 환자의 자기관리프로그램이 자기효능, 자기관리 이행에 미치는 효과)

  • Kim, Cho-Ja;Kim, Gi-Yon;Jang, Yeon-Soo
    • Korean Journal of Adult Nursing
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    • v.16 no.2
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    • pp.316-326
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    • 2004
  • Purpose: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. Method: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesII to IV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. Result: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. Conclusion: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.

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The Development of Community Health Service for the Demented Elderly in Cooperation Between Private Medical Facilities and Public Health Centers (민간병의원-공공기관 협력을 통한 지역사회 치매환자 관리사업)

  • Oh, Jin-Joo;Kim, Kyung-Ae;Kim, Jae-Il
    • Research in Community and Public Health Nursing
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    • v.18 no.4
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    • pp.593-600
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    • 2007
  • Purpose: This research was carried out to present an ideal cooperative model between the public and private health sectors for the management of community dementia patients. Method: In this study a public-private cooperative council was formed, basic data for dementia patients and their families were collected, and a dementia service program was carried out in cooperation between the two sectors. Results: The survey data shows the majority of the registered patients were undergoing a chronic diseases which would make the dementia health service inefficient. The cooperative public-private council adopted the reinforcement of medical service to the public enrolled dementia patients. The intensive medical service program showed effects on the health status of the dementia patients. Conclusion: The results of this study pointed out that change of the health insurance program supportive to the private sectors to be made; a referral system for the public health sector to the private sector should be established; and expanding the capacity of the visiting health program in the public health sector is needed.

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Development of Customized Exercise Service Program for Elderly and Evaluation of Usability (노인 대상 맞춤형 운동서비스 프로그램 개발 및 사용성 평가)

  • Yo-Han, Song;Il-Hyun, Bak;Seon-Yeong, Kwak;Hyun-Min, Lee
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.4
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    • pp.151-160
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    • 2022
  • PURPOSE: To evaluate the usability of a kiosk-based healthcare service that provides a fitness evaluation and customized exercise program for elderly or chronic musculoskeletal system patients. METHODS: To evaluate the usability of the customized exercise service program, healthy adults (n=20) from Welfare B, located in Gwangju, were selected and studied. Subjective safety, operability, and satisfaction of individual users were obtained as data by distributing questionnaires to subjects who experienced this program and having them fill out the questionnaire. For descriptive statistics related to the survey, frequency analysis was used to determine the frequency and ratio of the variable values of the measurement items. RESULTS: As a result of the usability evaluation, the average score was 4.166, and the average score of each item was 4.025 for safety, 4.272 for operability, and 4.143 for satisfaction. Most users obtained high satisfaction and positive impressions. CONCLUSION: The HARUFIT service, a user-customized exercise program used in this study, can be developed into a device that can improve self-management ability and increase understanding of health care by providing customized exercise based on the results of physical fitness evaluation. It is possible to diversify health management methods and maximize the effect of exercise by making exercise a habit of chronic musculoskeletal disease patients or the elderly using these smart devices.