• 제목/요약/키워드: Quality of primary care

검색결과 249건 처리시간 0.023초

Beyond Limitations: Practical Strategies for Improving Cancer Care in Nigeria

  • Eguzo, Kelechi;Camazine, Brian
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권5호
    • /
    • pp.3363-3368
    • /
    • 2013
  • Background: The burden due to cancers is an emerging public health concern especially in resource-limited countries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS and malaria combined. As people in Nigeria and other developing countries are beginning to survive infectious diseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of 1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks an organized and comprehensive strategy to deal with cancers. Materials and Methods: This article reviewed 30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care in Nigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequate manpower (in terms of quality and quantity) as well as limited treatment options. Results: This review led to the formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies used in Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis on tobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primary cancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDS will improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals, hub-and-spoke implementation of screening services, as well as investment in effective treatment options and increased research in cancer care are essential. International 'twinning collaborations' between institutions in richer countries and Nigeria will enhance effective knowledge translation and improve the quality of patient care. Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcome the present limitations which help contribute to the observed increases in cancer morbidity and mortality rates. Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategies proposed here.

외과계 중환자실 수술 후 환자의 섬망 예방 중재가 섬망 발생에 미치는 효과 (The Effects of Delirium Prevention Intervention on the Delirium Incidence among Postoperative Patients in a Surgical Intensive Care Unit)

  • 심미영;송숙희;이미미;박민아;양은진;김민수;김유진;김두나
    • 임상간호연구
    • /
    • 제21권1호
    • /
    • pp.43-52
    • /
    • 2015
  • Purpose: This study was aimed to develop the multicomponent intervention for preventing delirium among postoperative patients in a surgical intensive care unit (SICU). Methods: Using a quasi-experimental pre & post-test design with a non-equivalent control group, a total of 88 hospitalized patients in a SICU participated in this study. The 44 patients were allocated in each experimental and control group. The experimental group received the multicomponent intervention for delirium prevention including a delirium assessment and nursing intervention using a checklist, whereas the control group was provided with a standard care. The primary outcome of this study was the delirium incidence during the course of hospitalization. Results: There were no significant differences in the demographic and clinical characteristics between the two groups. The delirium occurred in 19.2% in the experimental group, whereas 38.6% in the control group ($x^2=4.526$, p<.05). Conclusion: The findings of the study demonstrated an effect of the multicomponent delirium prevention intervention in decreasing the delirium incidence rate over the standard care among the patients in SICU.

국내 질 향상부서 중심의 질 지표 측정 현황, 장애요인과 평가 (The Current State of and Barriers to Quality Measurement, and Quality Managers' Reported Evaluation on Quality Indicators in Korea)

  • 황지인
    • 보건행정학회지
    • /
    • 제15권4호
    • /
    • pp.26-45
    • /
    • 2005
  • The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

의료서비스의 내부고객만족, 외부고객만족 및 고객애호도의 인과관계 (The Causality among the Internal Customer Satisfaction, the External Customer Satisfaction and the Customer Loyalty of Medical Service)

  • 백수경
    • Journal of Preventive Medicine and Public Health
    • /
    • 제35권3호
    • /
    • pp.236-244
    • /
    • 2002
  • Objective : To empirically investigate the relationship of internal and external customer satisfactions, service quality, and customer loyalty in medical services. Methods : This essay proposes an integrated model to explain the causality of internal and external customer satisfactions, service quality, and customer loyalty. To this end, a structural model was developed, consisting of the following factors: internal and external customer satisfactions, service quality, and customer loyalty. The study included 214 sets of data, with 107 sets being collected for both out-patients and in-patients. The data were analyzed using AMOS 4.0. Results : We found the greater the internal customer satisfaction, the greater the out-patient quality of service quality. Secondly, the greater the service quality, the greater the external customer satisfaction of both in- and out-patients. The service quality of doctors, compared to that of the nurses, had a greater effect on external customer satisfaction. Thirdly, the service quality of doctors and nurses affected both internal and external customer satisfactions, which ultimately affected the customer loyalty. Finally the greater the external customer satisfaction, the greater the customer loyalty. Conclusion : This Study confirms the positive relationship among the internal and external customer satisfactions, service quality, and customer loyalty, which proves the doctors quality of service is the primary factor for external satisfaction, and customer loyalty relating to medical services.

대만 의료보장개혁과 교훈 (Tawian's Health Care Reform and Its Lessons)

  • 이규식
    • 보건행정학회지
    • /
    • 제8권1호
    • /
    • 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.

  • PDF

입원 말기암 환자가 지각한 가족지지와 삶의 질의 관계 (Relationship between Perceived Family Support and Quality of Life in Hospitalized Patients with Terminal Cancer)

  • 주명진;손수경
    • 종양간호연구
    • /
    • 제8권1호
    • /
    • pp.32-39
    • /
    • 2008
  • Purpose: This study was to identify the relationship between perceived family support and quality of life in hospitalized patient with terminal cancer. Method: Study subjects were 104 patients with terminal cancer who were hospitalized and treated at K university hospital, in Busan. Perceived family support and quality of life were measured using the Kang's Revised Family Support Scale and Youn's Quality of Life scale for terminal patients. Results: 1) The mean score of perceived family support was $4.23{\pm}0.61$. The mean score of quality of life was $5.83{\pm}1.37$. 2) The perceived family support was significantly different with primary care giver, food type, medical period after diagnosis. 3) The levels of quality of life was significantly different by number of children, effect of religion on the one' life, perceived state of disease and pain. 4) There was moderate positive correlation between perceived family support and quality of life. Conclusions: Increase in perceived family support was associated with increase in quality of life in hospitalized patients with terminal cancer. It is necessary that the development of nursing education program for family which help to support the patient with terminal cancer for increasing the quality of life of patient with terminal cancer.

  • PDF

보건진료소의 관할 지역 건강조사 사례 (Case Report on a Community Health Practitioner's Health Survey)

  • 최영미;진영란
    • 한국농촌간호학회지
    • /
    • 제14권2호
    • /
    • pp.47-53
    • /
    • 2019
  • Purpose: This case study was done to describe the health survey conducted by a community health practitioner. Methods: The community health survey was carried out from April 16 to May 31, 2018 with face to face interviews done by 48 trained senior nursing students. Results: Compared with other regions, rates for chronic disease prevalence, chewing discomfort, falls, and depression were higher than those of the relevant district/the relevant city, and the whole country. It is encouraging that the treatment rate for hypertension, diabetes, and hyperlipidemia, and walking practice rate were higher than those other regions. Those who participated in village events had low stress, and those who participated in health promotion programs had a higher quality of life. Conclusion: The community health practitioner in the public health center post needs to operate health promotion programs continuously. Programs including chronic disease management, fall prevention, depression control, and oral health management should be emphasized, and ways to increase social participation, including participation in village events should be developed.

노인환자의 특성을 고려한 노인요양병원 치유환경 평가지표 (A Study on the Development of the Healing Environment Evaluation Criteria for Elderly Care Hospital focusing on the Elderly Inpatient Characteristics)

  • 전수경;남경숙
    • 한국실내디자인학회논문집
    • /
    • 제26권4호
    • /
    • pp.22-29
    • /
    • 2017
  • This paper investigates the evaluation criteria in order to manage healing environment of long-term care elderly hospital. Elderly hospital evaluation tool developed by Korean Government is used to assess elderly hospital facilities to check the hospital facility and maintain its quality. However, the evaluation indicators and questions mainly focusing on safety indicators. Some questions are too vague for precise evaluation. In this paper, we discuss the advantages and disadvantages of the present evaluation criteria to establish new assessment tool for precise evaluation. The literature research was conducted tp set up the new evaluation criteria. From this research, we developed an elderly focusing on healing environment checklist for elderly care hospital which contains 7 factors as the primary hierarchy structure (Safety, Accessibility, Amenity, Sensibility, Friendly to nature, Territory, Interaction) and 23 factors as the secondary hierarchy structure. This evaluation criteria will help healthcare facility designers and healthcare organizations to build the healthcare facilities.

융합적 요소를 고려한 의료서비스 질 인식도와 의료이용의 관련성: 서울시 보건소를 이용하는 노인을 대상으로 (Patients' Perception of Quality of Health Service and Utilization considering convergence factors: A Survey of Elderly Patients of Public Health Centers, Seoul, Republic of Korea)

  • 손민성;김미선;김준식;문상식;최만규
    • 디지털융복합연구
    • /
    • 제13권8호
    • /
    • pp.345-356
    • /
    • 2015
  • 오늘날 의료가 단지 치료라는 개념을 넘어 서비스라는 인식이 확대되면서 의료서비스 소비 주체인 이용자들이 인식하는 의료서비스 질의 중요성은 날로 강조되고 있으며, 일차의료라고 해서 예외는 아니다. 이 연구는 65세이상 노인들이 보건소에서 제공하는 의료서비스의 질을 어떻게 인식하고 있는지 파악하고, 어떠한 요인들이 의료서비스 이용량과 관련성이 있는지를 탐색하고자 하였다. 이 연구는 서울시 보건소를 이용하는 노인들을 대상으로 연구원이 면접조사를 통하여 자료를 수집하였고, 총 307명의 설문자료를 분석하였다. 의료서비스 질은 융합적 요소를 고려하여 접근하였으며, 분석 결과, 이들의 구성항목 중에서 이용시설 및 환경, 환자중심진료, 의사의 전문적 지식 및 기술수준, 그리고 직원 및 간호사의 정서적 지지에 대하여 노인들이 긍정적으로 인식할수록 보건소의 의료이용이 증가하였다. 따라서 보건소가 쾌적하고 편리한 시설환경을 갖추고, 직원 및 간호사들은 이용자들과 원활한 의사소통을 위해 노력하며, 동시에 의사가 환자중심의 전문적인 의료서비스를 제공한다면 보건소의 의료서비스 질과 가치 향상에 도움이 될 것이다.

여성의 요실금에 대한 연구 (A Study on Urinary Incontinence of Adult Women)

  • 김성학
    • The Journal of Korean Physical Therapy
    • /
    • 제13권2호
    • /
    • pp.305-312
    • /
    • 2001
  • The purpose of this study were to identify the characteristics of incontinence in adult women and to identify it's relating factors, physiology, evaluation and treatment related urinary incontinence. Urinary incontinence is a common health problem for adult women. And the symptoms of urinary incontinence are causes of discomfort, shame, loss of self-confidence and result in sufferers to withdraw from social life. But many do not report this problem until they have had the symptoms for a long time. So physical therapy protocol for assessment, treatments, educational programs should be implemented in primary care setting. In conclusion, this study revealed that self·care agency may be a important that it would be necessary to promote quality of life in urinary incontinence women.

  • PDF