Purpose: The purpose of this study was to identify community health nursing activities that community health practitioners perceive and their achievements in community by reviewing the community health nursing activities that community health practitioners have done for the last 30 years. Methods: This study was a qualitative study. Thirty one community health practitioners were interviewed using the focus group interview method and data were analyzed using content analysis. Data were collected from April to June in 2011. Results: Community health practitioners perceived themselves as "Community Vitalizers" and 9 categories were identified. They were 'ground to explore new nursing areas', 'assimilation to community', 'ground to establish community diagnosis', 'everyday life health management in the community', 'increased accessibility to medical services for the residents', 'enforced health practices for the residents', 'reinforced self-reliance of community', 'commitment to making a happy village' and 'mental fence of the community.' Conclusion: This study was meaningful in that it explained the unique identity of the community health practitioners and could be used as important basic materials in the process of re-establishment of the roles of Health Offices. Hereafter in-depth study on community competence reinforcement should be made to identify the roles of community health nurses.
The World Health Organization and its member states, in 1978, declared that primary health care is a key to attain the goal of Health for All by the goal of Health for All by the yeas 2000. As a member state of WHO, the Republic of Korea has participated in the declaration of ALMA-ATA and committed to put national efforts for devedoping and implementing primary health care approach with the spirit and content of this Declaration. Since 1978, to translate the spirit of the Declaration into realization, Korean goverment has developed a new category of health manpower such as Community Health Practitioners serving people living in remote rural areas and Village Health Workers serving voluntarily their own village, strengthened the function of Health Centers and Health Subcenters through their reorientation and improved the infrastructure by their new construction or renovation. While primary health care is viewed as an essential health care in Korea, there are some circles who follow a narrow definition in referring to the health care at the periphey of a health system, which is erroneous. Considering the PHC is accepted as the best alternative approach to health care to solve problems that modern health systems are facing, we propose the followings as desirable health policy directions that modern health systems are facing, we propose the followings as desirable health policy directions which might translate the persopective into action at the national level after reviewing past and current PHC approach in Korea : 1. To improve the equity through the reduction of gaps between those who have access to health care and those who have not. 2. To reinforce multisectoral approach and intersectoral coordination through the re- establishment of the National Health Council or establishment of equivalent organization at the central level. 3. To stengthen community participation through lacal people's empowerment by leadership training, changing planning process from the top-down approach to bottom-up and giving the priority to human resources rater than technology, 4. To reinforce the Ministries of Health and Social Affairs through upgrading its role and function to Coordinate Ministries which involve human welfare policies, and creating a Division which is in charge of PHC in the Ministry.
Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.
Purpose: This study was done to identify Community Health Practitioner's (CHP's) perception of barriers to research utilization Method: Participants were 153 CHPs working in Chungbuk Province. Modified Barriers Scale was utilized in the research, and 4 sub-scales were nurse factor, organization factor, research factor and communication factor. Data was analyzed by using SPSS/WIN12.0. Results: Research factor showed the highest barrier score among four sub-scales, and nurse factor was the lowest. CHPs with membership in any nursing academic society showed lower scores on the four sub-scales. Those who had taken a course related to research were less likely to see the research factor or communication as barriers. Barriers to research utilization were not associated with work experience years or to demographics. Conclusion: It is highly recommended that CHPs be trained in research methods and evidence-based practice and that research articles be written more clearly.
Purpose: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. Methods: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. Results: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. Conclusion: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.
In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.
Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.
Purpose: The purpose of this study was to analyze differences in the needs of primary health care posts before 2008 and after 2009. Methods: For the final analysis data on 1,905 public health centers and 1,521 public health practitioners were analyzed. The chi-test was used to examine differences between the employees before and after 2008 in general, and T-test for differences in core competencies and job training needs. The test was carried out during June and July, 2017. Results: There were statistically significant differences in general characteristics, future health clinic function, necessity for core competency education, and for job education. Conclusion: Information on the need for new job training should include information the use of public health center information systems, drug mechanisms, medication guidance, discrimination of major symptoms, treatment for common diseases, patient referral and follow-up, health management for elders, dementia management, and chronic disease management. In future job training, it is necessary to elaborate intensively details and evaluate effectiveness.
Purpose: This study describes a case report of wound care performed by a community health practitioner for a rural older adult with diabetic ulcers. Methods: Data were collected from a rural older adult who had a diabetic lower extremity ulcer, and wound dressing was applied over 20 weeks after the skin graft operation. Results: The patient visited a primary healthcare post for regular ulcer care, and a community health practitioner applied appropriate wound dressings and managed the patient's diabetic condition. Conclusion: In rural areas, where healthcare resources are scarce compared with urban areas, rural nurses, such as community health practitioners, are primarily required to manage rural residents' health problems. Advanced nursing practices such as complicated wound care should also be appropriately provided to patients by enhancing rural nurses' competencies in the changing health care environment.
Background: Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. Aim: The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. Materials and Methods: An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Results: Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. Conclusions: The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.
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