• Journal of Home Health Care Nursing
• /
• v.27 no.3
• /
• pp.250-258
• /
• 2020

Purpose: This study aimed to investigate the relationship between nursing work environment, patient safety culture, and patient safety nursing activities in hemodialysis units at primary care centers. Methods: In this cross-sectional descriptive study, 116 nurses working in hemodialysis units at 22 primary care centers were enrolled as participants. They were selected them by the convenience sampling method. Data were collected using structured questionnaires that included questions on general characteristics, nursing work environment, patient safety culture, and patient safety nursing activities. Results: The nursing work environment was relatively good; however, the patient safety culture and patient safety nursing activities were poor. A positive correlation was found between nursing work environment, patient safety culture, and patient safety nursing activities. Factors that affect patient safety culture were rated high in the order of nursing work environment and patient safety nursing activities, and factors affecting patient safety nursing activities were rated high in the order of patient safety culture and age. Conclusion: This study showed that the development of tailored patient safety training for nurses in hemodialysis units working in primary care and administrative support from those institutions are needed. In particular, strategies accounting for nurses' characteristics such as age are required to strengthen patient safety nursing activities.

• Journal of Hospice and Palliative Care
• /
• v.26 no.2
• /
• pp.42-50
• /
• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• Journal of agricultural medicine and community health
• /
• v.19 no.1
• /
• pp.31-39
• /
• 1994

We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

• Health Policy and Management
• /
• v.8 no.1
• /
• pp.232-265
• /
• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• Research in Community and Public Health Nursing
• /
• v.8 no.1
• /
• pp.144-154
• /
• 1997

This study is planned to gather necessary data for setting up a system on students' health care in the university. In order to obtain statistical data on the students' health care problems especially in 'depression' among the mental health problems of the students, 'The Beck Depression Inventory' by A. T. Beck and 'Zung's Self-Rating Depression Scale' by W. W. K. Zung were used for gathering numerical data of scale of depression. It is evident that we have to prepare for further medical examination and health care educations for several students. For these students, it is clear that they have problems not only in mental health but also in physical health. I have screened out the high scored students for comparison and analysis. And it disclosed that we have to build up a periodical and continuous 'Health Screening System' utilizing Health Questionnaire for both physical and mental aspects, which will bring up us the very exact result to pick out any person who has healthy problem among the enormous number of the students with handy, convenient and effective procedures but with the least expense and effort. Also it is my firm confidence that this system will be applicable for primary health care control of mass population in local community or any organization.

• Journal of Preventive Medicine and Public Health
• /
• v.48 no.6
• /
• pp.271-273
• /
• 2015

Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.13
• /
• pp.5499-5505
• /
• 2015

Background: Providing care for hematologic cancer patients may lead to many negative complications in different aspects of life in their family caregivers. Based on a wide review of relevant literature, there are limited data about the burden of giving care for hematologic cancer patients on their primary family caregivers in Iran or other Middle Eastern countries. Therefore, the aim of this study was to investigate the cancer care burden on primary family caregivers of hematologic cancer patients, in terms of physical, psychological, social, spiritual, and financial aspects. Materials and Methods: In this descriptive study, 151 primary family caregivers of hematologic cancer patients referred to two cancer care centers in East Azerbaijan Province in northwest of Iran participated. The Financial Distress/Financial Well-being Scale, Hospital Anxiety and Depression Scale, Vaux Social Support Questionnaire, Spiritual Well-being Scale, and SF-36 were used for data collection. Data analysis was performed with SPSS software. Results: The findings of this study indicated that the primary family caregivers experience a high level of financial distress and a significant percentage of them suffered from anxiety and depression. In addition, the physical quality of life in these caregivers was moderate. On the other hand, spiritual health and social support of participants was at an acceptable level. Conclusions: Iranian primary family caregivers of hematologic cancer patients experience many problems in physical, psychological, and financial aspects of their life. Therefore, developing care plans for reducing these problems appears necessary.

• Korean Journal of Child Studies
• /
• v.38 no.1
• /
• pp.185-203
• /
• 2017

Objective: The present study examined the perspectives of grandparents raising their grandchildren in an attempt to better understand grandparents' child-rearing experience while providing kinship foster care to their primary-grade grandchildren. Methods: Data were collected through individual in-depth interviews with eight grandparents who have raised one or two primary-grade (ages 8-10) grandchildren using a qualitative approach. Results: First, the participants viewed the reason for their kinship foster care as a failure for caring for their own children and accepted the present grandparent-care provision as their responsibility. Second, the participants communicated constant struggles with their own health and grandchild-care as well as positive/negative emotions associated with the care provision. Third, most of the participants did not fully understand the developmental needs of their primary-grade grandchildren. Fourth, the participants articulated concerns for their primary-grade grandchildren's learning, peer interactions, school adjustment, and extra-curricular activities. Lastly, the participants all agreed on hoping to raise grandchildren with good personality traits as members of a society and to have them fill the gap from the loss of their parents. Conclusion: Although most participants accepted the current circumstances as their obligation, they still noted difficulties in child-care provision. Given the developmental needs of grandchildren and the resource needs of grandparents, proper and continuous intervention approaches should be developed/provided.

• Journal of Korean Academy of Rural Health Nursing
• /
• v.2 no.2
• /
• pp.91-101
• /
• 2007

Purpose: The purpose of this study was to identify health promotion services in rural areas and factors influencing this service. Method: From March to April, 2007, a structured questionnaire on services in 2006 was used to collect data from community health practitioners in all of the Primary Health Care Posts (PHCP) in North Chungchong Province. Collected data were analyzed using SPSS 12.0 Win program. Results: The most frequently offered programs were health gymnastics, walking exercise, bathing and vaccination service, and hypertension management. The main obstacles to these health services were lack of adequate space, insufficient budget, and overwork. The most frequently offered health education programs were education on hypertension, exercise, diabetes, volunteer work, and smoking cessation. The main obstacles to health education were lack of adequate space, insufficient education materials and equipment, and lack of cooperation from the citizens. Improvement and reinforcement of health promotion programs should include support of specialist, development of appropriate methods of service delivery, and education materials, and increase ease in using community resources. Conclusions: The research results show that a new model of health promotion must be developed for efficient health promotion programs in rural PHCP.

• Journal of Korean Academy of Rural Health Nursing
• /
• v.11 no.1
• /
• pp.15-22
• /
• 2016

Purpose: The purpose of this study was to analyze changes in body weight (kg) and body mass index (BMI) in middle-aged women following a 12 week exercise program. Methods: The obesity management program for primary health care posts, which consists of exercise therapy and dietary counseling, was provided for obese women aged 40 to 64 (N=15). General characteristics of the women and differences in body weight and BMI before and after the program were analyzed using SPSS 22.0. Results: The major findings of this study are as follows; Average body weight before the program was 65.7 kg, and it was significantly reduced to 63.9 kg after the program (z = -3.41, p = .001). The average level of BMI decreased considerably from 27.9 kg/m2 to 27.2 kg/m2 (z = -3.41, p = .001). Conclusion: The findings from this study show a significant decrease in body weight and BMI after the program. Continuous study is needed to develop a variety of obesity management programs for middle-aged obese women. When developing programs regional characteristics need to be considered and there is a need to confirm the effectiveness of the programs.