Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.
Kim, Yoon-Sook;Kim, Moon-Sook;Hwang, Jee-In;Kim, Hye-Ran;Kim, Hyun-Ah;Kim, Hyuo-Sun;Chun, Ja-Hae;Kwak, Mi-Jeong
Quality Improvement in Health Care
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v.25
no.2
/
pp.2-15
/
2019
Purpose: The purpose of this study is to provide basic data for the development of the most appropriate and effective educational materials for patients and their caregivers through the educational experiences of patient safety officer. Methods: This study is a qualitative analysis that involves using the focus group interview to understand the patient safety education experience of the patient safety officer. Results: The patient safety education experience of the patient safety officer is divided into four topics: (1) patient safety education content (2) patient safety education method (3) patient safety education status (4) activation and improvement of patient safety education. Additionally, the study incorporated twelve subtopics: (a) falls (b) speak up (c) patient safety campaign (d) patient safety rounding and a one on one training (e) education through medical staff (f) education using broadcast, video, post, among others (g) a lot of education in patient (h) patients not interested in patient safety education (i) patient safety education is less effective (j) human and medical expenses support (k) provision of standardized educational materials (l) patient safety culture for patient participation. Conclusions: This study indicate that education for patients and the caregivers should be inclusive and protective of stakeholders from the risks involved in patient safety events. The experience of patient safety officer is necessary for patient safety education for both patients and the caregivers since it is the source of basic data for the future development of patient safety education.
Purpose: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. Methods: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. Results: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. Conclusion: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.
Purpose: University students happen to be in a transitional period at the beginning of one's adult life and thereby establish the basis for their health care. The negative lifestyles followed by students during this period can also affect their reproductive health. The purpose of this study was to identify lifestyle, reproductive health, gender differences and relationships between lifestyle and reproductive health in university students. Methods: We used a descriptive cross-sectional design. A total of 300 subjects were enrolled. Data were collected using structured questionnaires between October 11 and 25, 2017 and analyzed using SPSS 25.0. Subjects agreed to undergo a face-to-face interview, including administration of the Health Promotion Lifestyle Profile II (HPLP-II) and reproductive health (knowledge, attitude, and behaviors). Results: The mean age of the subjects was 21.4 years. HPLP-II and reproductive health behaviors were significantly different between the genders. The scores of physical activity and nutrition in females were significantly lower than males. The scores of safe sex and sexual responsibility in females were significantly higher than males, and the score of genital health management was significantly lower in females than males. High HPLP-II score was observed to be in correlation with high reproductive health attitudes and behaviors. Conclusion: The result revealed differences in lifestyle and reproductive health between both the genders. For improvement of reproductive health of university students, provision of lifestyle intervention including healthy nutritional habits and physical activity is imperative.
The purpose of this study is to achieve an understanding of psychosocial needs of elderly female residents living in the nursing home and their evaluation about psychosocial services from their perspectives. In-depth interview by constructivist inquiry was conducted to explore residents' needs. Purposive sampling was used to ensure that participants could communicate verbally and share their experience of living in the nursing home. 8 female residents who cognitively intact and aged 65 or over were invited to participate in this study. Data collection was conducted from January 1 to 5 in 2008. The interviews were recorded and transcribed. Constant comparison method was used for data analysis. Levels of psychological needs were identified as four categories-satisfied needs; unmet needs; hidden needs; lack of expression of needs. While nursing home generally focuses on medical care provision, residents' psychosocial needs tend to be relatively overlooked. The satisfaction of psychosocial needs is significant in guaranteeing well-being in later life.
This study was attempted to grasp the convergence relationship between nurse 's communication ability, emotional labor and organizational commitment. For this purpose, 106 nurses working at university hospitals were collected from August 1, 2016 to August 15, 2016. Communication skills were measured by Kim & Woo 's communication ability measurement tool, emotional labor was measured by Morris & Feldman' s tool, and organizational commitment was developed by Mowday et al. Data were analyzed by t-test, ANOVA, and Pearson's correlation. The results showed that the communication ability differed according to age (F = 5.78, p = 0.004), marital status (t = -4.06, p <0.001) and position (t = -5.35, p <0.001). There was a statistically significant correlation between communication ability and organizational commitment (r = 0.293, p = 0.002). This result suggests a convergence implication on the provision of basic data to improve organizational commitment of nurses in nursing practice field.
Kim, Sang-Soon;Kim, Jung-Nam;Park, Jung;Kim, Ok-Ran;Cha, Kyung-Mi;Kwak, Ou-Ke;Park, Kyung-Min;Choi, Yoon-Hee;Bak, Kyung-Shin
Research in Community and Public Health Nursing
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v.4
no.1
/
pp.67-76
/
1993
The purpose of this study was to find the status of health examination and health management of industrial companies located in Taegu and Kyung book areas. It will provide basic information for the provision of effective health management of industrial workers. 49 companies were selected as a study sample group, and data was collected by using a structured Questionnaire which was developed by the members of the Community Health Nursing Academy of Korean Nursing. The health managers of the companies filled out the Questionnaire. The data was gathered from Dec 20, 1992 to Jan 20. The results of the study was as follows : 1. The Study sample showed 85.7% manufacturing companies having 300 or more workers. 2. All the companies had health managers, and companies which had 1,000 or more workers had industrial physicians and nurses. Only 12.2% of the industrial physicians were full time employees, and almost all industrial nurses were full time employees. Except for industrial physicians and nurses, the proportion of hygienists (6.1%), nurses aids (4.1%), and environmental engineers (22.4%) with full time employment statuss was very low. The mean age of industrial physicians was 49.2 while that of industrial nurses was 27.2. The length of work experiences currently ranges for 1 to 3 years for all health workers: physicians, nurses, hygienists, and environmental engineers. 3. Health examination and follow up care 94.31% took general health examinations. Of those, the proportion of the workers, who were determined as C grade(in need of close examination) was 43.86%. The proportion of the workers who were determined as D grade was 22.19%. 13.28% of the workers evaluated at the D grade were taken as a gauge for temporary leave from work. While 8.7% and .09% of them were taken as gauge for a change in job, and or shortening work hours respectively. The proportion of workers who must have taken special examination was 65.04% and of those the proportion of the workers who actually took, the examination was 98.55%. 75% of the workers who were recommended for follow up care were given follow up care. The special examinations were done the most frequently to detect the effects of physical agents (59.2%). Direct notice to individual workers was used the most frequently as a method of notification after a special examination (61.2%). The length of time taken to receive the result of a special examination was less than 1 month (38.9%) and 36.7% had taken up to two months (36.7%.). Most results of special examination were obtained within 2 months. The referral rate of consulting special examination by health managers was estimated at 95.9%. 4. 89.8% of the companies had. their own company dispensaries and 75.5% of those. had separate dispensaries. 32.7% of the companies designated local clinics for health management of workers. Industrial nurses performed health examination the most frequently(1.4 points). Health appraisal for work places were. done the least(0.83 points).
Aim: Studies have shown effects of surgery, radiation and chemotherapy on quality of life in cases of gynaecological cancer. Very few studies are available examining the quality of life of individuals in Turkey who have been diagnosed with gynaecological cancer and undergoing treatment. Method: This study was performed to evaluate the quality of life of such patients using the EORTC-QLQ-C30 Quality of Life Index. Chi-square Yates, Mann-Whitney-U tests and variance analysis used for statistical analizing. Results: The EORTC-QLQ-C30 Quality of Life Index mean points for "general well-being and quality of life" of the patients were found to be $60.5{\pm}25.0$. In the sub-groups of the Quality of Life Index determined fatigue ($60.1{\pm}24.8$), economic difficulties ($46.9{\pm}33.3$), pain and loss of appetite ($42.9{\pm}27.8$; $42.9{\pm}34.0$) and insomnia ($40.1{\pm}34.0$) were the symptoms most reported to have a negative effect on quality of life. Statistical significance was noted for marital status and income status (p<0.05) but not educational level. Conclusion:Determination of quality of life of women with a diagnosis of gynaecological oncological disease who are undergoing chemotherapy enables provision of a more comprehensive and higher quality of care.
Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.
This study aims to investigate the impact of a mobile-based human coaching healthcare service provided for diabetic patients by nurses on their self-management ability. This study collected data from 311 persons who were diagnosed with diabetes from all over the country, and the collected data were analyzed through SPSS Win 23. The results of the study are summarized as follows: First, it was found that the utilization of a glucose meter by the provision of the mobile-based human coaching healthcare service was men group, and there was a statistically significant difference (${\chi}^2=6.059$, p= .048*). Second, there was a positive correlation in the utilization between the glucose meter and an activity tracker band by the provision of the mobile-based human coaching healthcare service, which was statistically significant (r=.660, p< .001). Third, as a result of checking the changes of the utilization of the glucose meter by the provision of the mobile-based human coaching healthcare service, it was maintained between 79% and 41% from Week 1 through 49. In conclusion, this study partially confirmed that the mobile-based human coaching health service was easily accessible and cost-effective in enhancing the participants'self-healthcare ability.
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