• Title/Summary/Keyword: Relationships between medical care providers

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An Organization Theory Perspective on the Structural Reform of the Health Care Delivery System (의료공급체계 구조의 개혁방향에 대한 조직이론적 시각)

  • Han, Dal Sun
    • Health Policy and Management
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    • v.28 no.3
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    • pp.197-201
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    • 2018
  • There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

Self-care, Social Support, and Biological Markers in Liver Transplant Recipients (간이식 수혜자의 자가간호이행, 사회적 지지, 생리학적 지표)

  • Kim, Hyunkyung;Choi, Mona;Kim, So Sun;Kim, Soon-Il
    • Korean Journal of Adult Nursing
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    • v.27 no.2
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    • pp.170-179
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    • 2015
  • Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.

Evaluation of Quality of Life of Breast Cancer Patient Next-of-kin in Turkey

  • Ogce, Filiz;Ozkan, Sevgi;Okcin, Figen;Yaren, Arzu;Demiray, Gokcen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2771-2776
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    • 2013
  • Introduction: Quality of life (QoL) issues are of importance in relatives of women with breast cancer (BC)as caregivers in neglecting their own needs due to care of a patient and also as women regarding the potential risk of themselves developing BC. The objectives in the present study were to compare the QoL of female relatives of women in treatment for breast cancer. To date, no study had examined multi-dimensional QoL in accompanying people as compared them into two groups of female relatives whose first degree and second degree. Methods: QoL of female relatives was assessed using the Quality of Life-Family Version (QOL-FV) scale. Relationships between socio-demographic characteristics and QoL scores were analyzed using the Mann-Whitney U, Kruskal Wallis and Crosstabs tests. Results: The mean age of the female relatives was 37.6 years, and nearly 48% had a university education. It was found that first degree relatives had worse QoL in all domains except physical wellbeing than second degree relatives. Conclusion: This study showed that being female relatives of BC, especially first-degree, affect QoL negatively. Health care providers are of an important role in the stage of information related to genetic influence of BC.

Personal and Socio-Cultural Barriers to Cervical Cancer Screening in Iran, Patient and Provider Perceptions: a Qualitative Study

  • Bayrami, Roghieh;Taghipour, Ali;Ebrahimipour, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3729-3734
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    • 2015
  • Background: Although cervical cancer is preventable and early screening might decrease the associated mortality, challenges faced by the women and health care providers can postpone early detection. This qualitative study aimed to establish patient and provider perceptions about personal and socio-cultural barriers for cervical cancer screening in Mashhad, Iran. Materials and Methods: In the present study, which was conducted in 2012, eighteen participants, who were selected purposefully, participated in individual in-depth, semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using conventional content analysis and Atlas-Ti software. Results: One theme and two categories were derived from data including: cognitive/behavioral factors (lack of a community-based approach to cervical cancer, lack of awareness, wrong attitude and lack of health seeking behaviors) and socio/cultural issues (socio-cultural invasion, mismatch between tradition, modernity and religious, extra marital relationships and cultural taboos). Conclusions: Providing community based approach education programs and employing social policy are needed for preventing of cervical cancer in Iran.

Relationships between compliance and health-related quality of life in patients with hemodialysis (혈액투석환자의 이행과 건강관련 삶의 질 간의 관계)

  • Cha, Jieun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.10
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    • pp.6495-6503
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    • 2015
  • The purpose of the study was to evaluate patients' compliance with the hemodialysis and to investigate relationships between compliance, physiological parameters, and health-related quality of life. Data were collected from 220 patients at 27 local hemodialysis clinics. Compliance was measured with Sick-role Behavioral Compliance including interdialytic weight gain, serum potassium, and phosphorus. Health-related quality of life was assessed using Medical Outcomes Study Short Form-12. Data were analyzed using descriptive statistics, t-tests, ANOVA, and Pearson correlation. Total compliance scored 2.92 out of 4 points on average. Among fifteen items, 'I keep on my dialysis schedule(time and date)' was the highest score. There were differences in the scores for compliance according to age, marital status, and dialysis period. Statistically significant correlations were found between four compliance items(medication, infection control, sleep, eating vegetable and fruit) and health-related quality of life. The results of the study indicate that a patient-centered approach would be helpful to improve quality of life in patients with hemodialysis. Healthcare providers need to understand the patients' perspectives by identifying what is important to patients and taking patient values and priorities into account.

Older Adults' Self-reported Difficulty in Understanding and Utilizing Health Information (노인의 자가 보고에 따른 의료정보 이해 및 활용수준)

  • Kim, Su Hyun
    • 한국노년학
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    • v.30 no.4
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    • pp.1281-1292
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    • 2010
  • This study was performed to identify older adults' self-reported difficulties in understanding and utilizing health information and their relationships with health status and to investigate the differences between age groups and among education levels. Data were collected from July 1 to August 31 in 2007 from older adults in senior centers located in Daegu, Kyungpook, and Busan area. A total of 103 subjects participated in the study. The level of understanding health information in older adults was 50 on average (possible score 15-75). The most difficult items to understand were patient educational materials, written information provided by health care providers, and medical forms. The lower level of difficulty in utilizing health information was associated with better physical and mental health status. There were differences in their self-reported difficulties between the young-old and the old-old as well as among different education levels. Health care providers may need to tailor educational materials and medical forms to the cognitive ability of older adults under the consideration of their age and education levels.

An Exploration of Adult Women Health-Behaviors (성인여성의 건강행위에 관한 연구)

  • Kim Myoung Hee;Chon Mi Young
    • Journal of Korean Public Health Nursing
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    • v.16 no.2
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    • pp.239-253
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    • 2002
  • Health care for women regularly focuses on the reproductive system to the exclusion of other health needs. The lack of research focusing on women's common health issues is a major problem to the enhanced optimal level of women's health. Health care providers have to recognize biological and social differences between men and women. This study was conducted to identify the baseline data and their correlation of health perception, health behavior, and health status of adult women for developing nursing intervention. The study was a descriptive correlational design. A convenient sampling method was used for collecting data from 103 adult women, over 18 years of age, during the period from Sep 1 to Nov 30, 2001. The study's subjects were interviewed using a structured questionnaire. The instruments for this study were the health perception scale modified by Lee(1985) based on the tool developed by Ware(1977) and Jenkins (1966), and the health behavior scale by Ko, Kumja(1987). Health status was measured by the short form Cornell Medical Index(CMI) modified by Nam, Hochang(1965). The data were analyzed SPSS PC+, by frequency, mean, t-test, ANOVA, and Pearson correlation coefficients. Also, the Duncan test was utilized for a post hoc test of ANOVA. The results of this study are as follows: 1. The mean score for health perception was 3.02(S.D=0.39) on a 5 point scale. 2. The mean score for health behavior was 3.08(S.D=0.43) on a 5 point scale. 3. The mean score for health status was 18.54 on 58 items. The mean score for physical symptoms of a subscale of health status was 11.30 on 36 items and the mean score for psychological symptoms was 7.37 on 22 items. 4. The relationship of sociodemographic variables to health perception. health behavior, and health status of women.: 1) There were significant differences in the scores of health perception by disease experience(t=-3.37, p=0.00). 2) There were significant differences in the scores of health behavior by age(F=10.52, p=0.00), height(F=4.73, p=0.01), marital status(t=-5.56, p=0.00), educational background(t=2.90, p=0.00), and drinking or non-drinking(t=2.17, p=0.03). 3) There were significant differences in the scores of health status by educational background(t=2.28, p=0.02) and disease experience(t=2.61, p=0.01). 5. Health perception showed significant positive correlation with health behavior(r=0.39, p=0.00). Health perception showed significant negative correlation with health status(r=-0.44, p=0.00), that is, the more women perceived health, the less she complained about unhealthy symptoms. Health behavior had no significant correlation with health status but showed a positive correlation with psychological symptoms of a subscale of health status(r=-0.19, p=0.05). Many of the leading causes of disease are preventable through changes in health perception and behavior. The need to increase individual awareness of relationships among health perception, health behavior, and health status and to enhance knowledge regarding the long-term effects of positive health behaviors, is an important nursing strategy for women's health promotion.

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