• Title/Summary/Keyword: Primary Care Clinic

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보건진료소에서의 말기 암 환자 간호사례 (Case Report of Terminal Cancer Patient by Community Health Practitioner)

  • 정미경
    • 한국농촌간호학회지
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    • 제15권1호
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    • pp.30-40
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    • 2020
  • Purpose: This study was done to describe a community health practitioner's nursing case management for a terminal cancer patient registered in the public health post. Methods: For this purpose, data were collected through the patient and family through home visits, health clinic offices, and phone calls. The nursing process was carried out from August to November 2019. Results: The patient suffered the most from anorexia and lack of energy. Also he expressed psychologically uncertainty about disease and death anxiety caused by long-term treatment. In order to reduce the death anxiety, Community Health Practitioner (CHP) asked him to express his life stories and listened to him. CHP provided information of appropriate medications and alternative foods for symptoms such as gastrointestinal disorders and anorexia to the patient and family. Observing the situation of the patient and family, CHP guided the patient and family to prepare for death and has confirmed to them that the process was not with the patient alone. Conclusion: CHP's this experience has shown the possibility for CHP to help the terminal cancer patient and family to prepare peaceful death in their communities.

턱관절 및 안면통증 클리닉에서 편두통 진단을 위한 ID Migraine 설문지의 이용 (Use of the ID Migraine Questionnaire for Migraine in TMJ and Orofacial Pain Clinic)

  • 김성택
    • 구강회복응용과학지
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    • 제22권1호
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    • pp.29-36
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    • 2006
  • As migraine pain represents a substantial personal and social burden worldwide, there has been a great deal of effort in developing a screening instrument for migraine. Lipton et al(2003) developed and validated the ID Migraine questionnaire, which is a self-administered screener for migraine in primary care, and it is brief and easy to use for a primary care provider. The aim of this study was to determine if the ID Migraine questionnaire could be applied successfully to assess the headache patients with temporomandibular disorders(TMD) and orofacial pain. This study found that nausea, photophobia and headache-related disability had the highest individual sensitivities and specificities, and the performance of the three-item screener was equivalent to that reported in a previous study. Although the sensitivity of the three-item screener in this study (0.58) was lower than in a previous study (0.81), the specificity (0.98) was higher and the positive predictive value was 93.9%. This suggest that the ID Migraine questionnaire is very efficient in this setting. In conclusion, the ID Migraine questionnaire, which is a three-item screener consisting of nausea, photophobia and headache-related disability, is effective as a self-administered report for detecting migraine headaches in patients with temporomandibular disorders(TMD) and orofacial pain.

농촌지역의 일차보건사업 개발을 위한 기초조사 연구 - 경기도 여주군 금사면 산북부락을 중심으로 - (A Baseline Survey on Development of Primary Health Care in the Rural Korea -Sanpuk Village, Kumsa-Myun, Yuju- Gun, Kyunggi-Do-)

  • 김명호;윤석우;이해숙
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.5-27
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    • 1987
  • It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.

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Factors Associated With Success or Failure of Quit Attempts: A Clinical Approach for Lung Cancer Prevention

  • Su, Tin Tin;Sallehuddin, Bin Abu Bakar;Murniati, Hj Hussain;Swinder, Jit;Sadat, Nabilla Al;Saimy, Ismail
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.175-179
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    • 2012
  • The objective of the study is to investigate the success rate of quit attempts and identify factors associated with success or failure of quit attempts in a quit smoking clinic. A cohort study was conducted with 495 smokers who enrolled in a quit smoking clinic from 2005 to 2008. The factors leading to quit smoking successfully were "being Malay", "having high blood pressure" "type of Nicotine Replacement Therapy" and "duration of follow up". In contrast, clerical staff had negative association to quit smoking. People who started smoking in their teenage years had a high risk of relapse. Integration of active follow up and tailor-made support programmes for quitters appear necessary in order to maintain their non-smoking status and encourage them to be permanent quitters. Integration of quit smoking clinics and primary care clinics could be another potential step for the success of quit smoking programmes.

학교구강보건실 운영이 아동들의 구강보건지식 및 행동변화에 미치는 영향 (Effects of School-Based Oral Health Programs among Schoolchildren : Focus on the Oral Health Knowledge and Behaviors)

  • 최순례;권현숙;송근배;이정화;강현경;최정미
    • 한국치위생학회지
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    • 제6권4호
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    • pp.455-467
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    • 2006
  • Demand for appropriate health care has gradually increased in Korea. In addition, developments of community- and school-based oral health programs have also focused oral health care for the oral health promotion. Especially, school-based oral health programs are the underpinnings of promoting oral health and preventing oral diseases among schoolchildren. School-based oral health programs have had three major components: oral health education, oral health services, and a healthful environments. These included oral health education(one-to-one communication, group communication, and use of mass communication), oral examination, fluoride mouthrinsing, pit-and-fissure sealants, fluoride gel application, mechanical plaque control, and chewing xylitol candy. In this study, we evaluate the effects of oral health programs among primary schoolchildren by comparing the oral health knowledge, oral health behaviors, and perception of caries prevention procedures. Data for this study were obtained from 699 primary schoolchildren at the two primary school in Daegu, Korea. One is experimental group, N primary school, that was established school-based oral health center under supervision of Nam-gu Public Health Center, the other is control group, N' primary school, that was yet to establish school-based oral health center. We surveyed children's oral health knowledge and behaviors, and perception of caries prevention procedures using self-administrated questionnaire and then analyzed differences of each item among two groups. The brief findings of this study were summarized as follows. There are several advantage to a comprehensive school-based oral health program. (1) School-based oral health programs facilitate and increase the effectiveness of teaching oral health subjects. (2) Schoolchildren are available for prevention or treatment procedure. (3) School-based oral health center may be less threating than private dental clinic. (4) With comprehensive school-based oral health programs the decayed, missing, and filled teeth(DMFT) of schoolchildren should demonstrate a substantial and steady decrease over time(Choi et al, 2004). In conclusion, treatment is not the answer to solving children's oral health programs; rather primary prevention is the key. Many countries and communities are focusing on hoe millions of underprivileged children can be provided with health care. Schoolchildren gain the knowledge and behaviors to attain and maintain good oral health in schools. For these reasons, the role of school-based oral health center is not only important but also a necessity.

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지역사회 기반 만성질환 관리모형 구축을 위한 연구방안 (Strategy of Research for Developing Model of Community Based Non-Communicable Diseases Control and Prevention)

  • 박윤형
    • 보건행정학회지
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    • 제26권1호
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    • pp.1-3
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    • 2016
  • The prevalence of non-communicable disease (NCD) has been continuously increasing due to population ageing, and the change in consumption and lifestyle patterns. Cancers, cerebrovascular diseases, and hypertensive diseases have been the major causes of deaths in the Republic of Korea since 1983. Numerous studies have suggested the need for a sustained comprehensive treatment tailored for individual patients and recommend the development of a systematic program to manage NCD patients to provide such care. It's necessary to develop the Korean model of the community based NCD prevention and control, consisting strategy of community movement, education for the NCD patients, and partnership the primary care clinic with public health organization to meet the needs in community people.

A Study on the Oral Health Literacy and Related Factors of Mother's in Some Areas

  • Kim, Mi-Jeong;Lim, Cha-Young;Son, Ju-Lee
    • 치위생과학회지
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    • 제21권1호
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    • pp.52-62
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    • 2021
  • Background: This study aims to provide basic data for development of the level-based oral health care program depending on the mother's oral health literacy by finding out how mother's oral health literacy can effect on the preschool children's oral health and behavior. Methods: The survey was conducted on 192 mothers who have preschool children and the data were analyzed by t-test, ANOVA, multiple regression analysis to identify differences in verbal and functional oral health literacy. Results: The study showed statistical significance (p<0.05) in educational level depending on differences in verbal and functional oral health literacy by sociodemographic factor. In differences in verbal and functional literacy depending on experience of education for oral health behavior and oral health, statistical significance (p<0.05) was showed highly on verbal and functional literacy in the case that subjects have an experience of education for oral health and their children have not been experienced of oral illness. And when it comes to the case that subjects have experience of education for oral health within one to two years, statistical significance was showed highly on verbal literacy. It showed that verbal and functional oral health literacy effects to oral health care behavior of children judging from results that the higher level of mother's verbal oral health literacy, the higher score of children's oral health knowledge, attitude and behavior. Conclusion: It is necessary to develop the systematic program which is appropriate for characteristics of each oral period in childhood depending on level of primary caregiver's oral health literacy, and systematic education should be preceded to enhance the literacy of the caregiver. It is considered necessary to improve the oral health care of children by developing a manual for oral health care education to enhance primary caregiver's oral health literacy.

A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • 대한간호학회지
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    • 제11권2호
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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60세이상의 노인들의 고혈압 치료기관별 비용효과 분석과 관리능력에 관한 비교연구 (A Research Study on 60Years Old People Management of Hypertension.)

  • 조현;문선순;정경임;현인숙
    • 한국보건간호학회지
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    • 제10권1호
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    • pp.95-105
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    • 1996
  • This study was uncertaken to find an effective management modality for patients with hypertension. Patients 60years or older were selected for this purpose from a general hospital and a welfare center in Pusan and from a public health clinic in Cheju Island. During the month of October in 1984. the management modality for hypertension. the incurred medical expenses. and knowledge about the hypertension were analyzed and compared. The following results were obtained: 1. The a erage total medical expense per year was highest at the general hospital followed by the public health clinic and the welfare center. 2. It was found that the patients chose the public health clinic for its low medical cost. the welfare center for its proximity as well as for its low medical cost. and the general hospital for its quality medical services Also. the study has shown that the prescription of drugs was the major service provided by the public health clinic whereas the blood pressure measurement. the prescription of drugs. and family planning were the primary service offered by the welfare center. Drug prescription and blood pressure measurement were two of the most important services by the general hospital. 3. It was shown that the knowledge of hypertension was highnest at the welfare center whereas the management of hypertension was highest at the public health clinic. Based on above results and considering the chronic nature. it is believed that family awareness of the illness was one of the most important aspects for effective management of the hypertension for the elderly patients. In addition. the health care clinics at every level should come forward to execition of the educational programs and home nursing schomes for the effective management of the hypertension patients.

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연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査) (A Basie Health Survey of the Yonsei Community Health Service Area, Seoul)

  • 양재모;김명호
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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