• Title/Summary/Keyword: Medical Services Law

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Tobacco Control Policies in Vietnam: Review on MPOWER Implementation Progress and Challenges

  • Hoang, Van Minh;Tran, Thu Ngan;Vu, Quynh Mai;Nguyen, Thi Tuyet My;Le, Hong Chung;Vu, Duy Kien;Tran, Tuan Anh;Nguyen, Bao Ngoc;Vu, Van Giap;Nguyen, Manh Cuong;Pham, Duc Manh;Kim, Bao Giang
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup1
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    • pp.1-9
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    • 2016
  • In Vietnam, the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect in March 2005 while MPOWER has been implemented since 2008. This paper describes the progress and challenges of implementation of the MPOWER package in Vietnam. We can report that, in term of monitoring, Vietnam is very active in the Global Tobacco Surveillance System, completing two rounds of the Global Adult Tobacco Survey (GATS) and three rounds of the Global Youth Tobacco Survey (GYTS). To protect people from tobacco smoke, Vietnam has issued and enforced a law requiring comprehensive smoking bans at workplaces and public places since 2013. Tobacco advertising and promotion are also prohibited with the exception of points of sale displays of tobacco products. Violations come in the form of promotion girls, corporate social responsibility activities from tobacco manufacturers and packages displayed by retail vendors. Vietnam is one of the 77 countries that require pictorial health warnings to be printed on cigarette packages to warn about the danger of tobacco and the warnings have been implemented effectively. Cigarette tax is 70% of factory price which is equal to less than 45% of retail price and much lower than the recommendation of WHO. However, Vietnam is one of the very few countries that require manufacturers and importers to make "compulsory contributions" at 1-2% of the factory price of cigarettes sold in Vietnam for the establishment of a Tobacco Control Fund (TCF). The TCF is being operated well. In 2015, 67 units of 63 provinces/cities, 22 ministries and political-social organizations and 6 hospitals received funding from TCF to implement a wide range of tobacco control activities. Cessation services have been starting with a a toll-free quit-line but need to be further strengthened. In conclusion, Vietnam has constantly put efforts into the tobacco control field with high commitment from the government, scientists and activists. Though several remarkable achievements have been gained, many challenges remain. To overcome those challenges, implementation strategies that take into account the contextual factors and social determinants of tobacco use in Vietnam are needed.

The Group Counseling Program for Terminal Cancer Patients and their Family Members in the Seoul National University Hospital (말기 암환자와 가족을 위한 집단상담 프로그램 - 서울대학교병원 경험의 분석-)

  • Lee, Young-Sook;Heo, Dae-Seog;Yun, Young-Ho;Kim, Hyun-Sook;Choi, Kyung-Sook;Yun, Yeo-Jung
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.56-64
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    • 1998
  • Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

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호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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The Single-Session Group Education for Advanced & Terminal Cancer Patients and their Family Members (진행암 및 말기암 환자와 가족을 위한 집단 교육 프로그램)

  • Lee, Young-Sook;Heo, Dae-Seuk;Kim, Mi-Ra;Kim, Won-Gyung;Choi, Jeong-Yun
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.64-72
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    • 2004
  • Purpose: This research aims to assess the effect of a single session of group education of hospice program at Seoul National University Hospital for the advanced and terminal cancer patients and their family members. Methods: Response to questionnaires from 89 participants were evaluated using SAS and CHISQ analysis. The questionnaires included the following items: 1) the characteristics of participants; 2) the characteristics of patients; 3) the difficulties of patient care; 4) the satisfaction with the program Results: The participants consist of 33 patients (37.5%) and 56 family members (56.2%). Diagnosis included mainly stomach, lung, breast, and colon cancer. Participants of family members consisted of spouse, parent, children, daughter-in-law, and siblings (in decreasing order). The participants were interested in the medical information, nutrition, pain and symptom management, and psychosocial adaptation. They had difficulties in emotional problem, nutrition and symptom management. Even though it was a single session of group education, the level of satisfaction was high (95%). Conclusion: This research shows that even the single session of the group education for the advanced and terminal cancer patients and their family members is very helpful by giving them the necessary information. In order to develop comprehensive care-giving services, more specific informations, more opportunities to participate in such sessions and longer question-answer time is required.

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The Characteristics of Population Flows in kwangju Metropolitan Area (光州 中心의 人口移動 特性에 관한 硏究)

  • Chouh, Hae-Chong
    • Journal of the Korean Geographical Society
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    • v.28 no.1
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    • pp.40-57
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    • 1993
  • This paper aims to show the various aspects of migration in Kwangju merropolitan area, southwestern Korea, for a period of years 1980-1985. Migratory patterns are spatially extensive in countryside around Kwanfju, and due to high accessibility to the metropolitan area urban implosion emerges in the city. In Chonnam province where Kwangju is loca-ted, all cities and counties except for such in-dustrial areas as Yochon, and Kwangyang are experiencing population losses in terms of net migration by survival rate methods. Kwangju is the exceptionally one of in-migration areas in Chonnam, though its central part(Dong-Gu) is also an out-migrated area. Predominantly in-migration urban areas have high proportions of a student age group between 15-19 years, and that reflects the importance of the educational factor in migration analysis. The municipal authorities of Kwangju are planning to block the way of the middle sxhool students who live in the outskirts of Kwangju to entrance to high school in the city. Thant may stir up migrations into Kwangju for the elementary and middle school students, because the city id expected to provide educational opportunities higher and better than remaining Chonnam areas. Population of Kwangju would, therefore, grow as the students migrate into the city. The findings on the residential intra-city movement in selected 5 Dongs indicate that implications of a short-distance movement re noteworthy; neighbour to neighbour, and the nearest stop in the way from the outer Kwangju as well. Trends in a short-distance movement are in accord with Ravensteins's "law of migra-tion". But in casw of the inter-provincial migra-tion to Kwangju, the number of in-migrants from remoter Seoul is more than that from nearer Chonbuk province. Therefore it supports the fact that the movement between capital region and far off local cities overcomes a distance barrier. The temporary mobility for a day has been increased as the standard of living has improved and it reaches a peak on weekend or on con-secutive holidays. The number of temporal movers to Kwangju from capital region and Yongnam area, southeastern Korea has a greatincrease in terms of the frequency of the passengers' mobility, in particular on Myongjol(the ethnic and traditional festival day) in com-parison with on weekdays. By comparison with two largest Myongjols, the number of movers is more on Chusok(The Full Moon festival on lunar August) than on Sol (lunar new year's day). Annual peak point of weekday movers appears in August because of summer vacation. But the lowest one appears in June, which is related to the busy farming season. A patients' move for medical services in on the increase with a change of living conditions. It is especially true in the industrial counties such as Kwangyang and Yochon. By way of conclusion, it should be pointed out that one of the problems we face in survey of migration volume by the survival rate method is that the survival rate somtimes exceeds the value 1.0, in normal states of which should be under 1.0. it may be due to the shortcoming from the census statistics. We should not give therefore too much stress on the importance of migrations or moves as an element of changes in spatial pattern. In cinclusion, the results of the study show some geographic facts as the followings: 1. One of the outstanding phenomena in all types of movement is the seletivity of ages. The most important factors are related to education and employment. 2. Short-distance movement is carried out in accordance with Ravenstein's law, but in case long-distance movement, in-migration from capital region is prominent in spite of remoten-ces. The gravity between large cities such as Kwangju and Seoul, which has a frequent human movenent, causes urban implosion of small cities between those cities. 3. The temporary mobility for a day, in con-trast to that of permanent movement, is more related to transportation, and its volumes and annual variations are a large-scale. 4. Passengers' mobility is high in industrial cities. And the scope of patients' mobility is narrower than passengers'.

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