Objective : The incidence of head injury has been increasing in the rural area. The author investigated the clinical features and difficulties in care of the acute head-injured patients in this area. Method and Material : The authors performed a retrospective review of radiological data and clinical records in patients with mild to moderate head injury. Cause, type of craniocerebral injury, delayed intracranial lesions, complications, its relation to alcohol abuse, and outcome were analyzed. Results : In total of 68 cases, 20(29.4%) victims were associated with acute alcohol intoxication. Motor vehicle accident was the leading cause of head injury and the most common craniocerebral lesion was basilar skull fracture. Eight(11.8%) patients showed delayed radiological and clinical deterioration and 40(58.8%) were followed-up regularly after discharge. The subdural hygroma was commonly noted in the elderly and alcoholics. Causes of thirty events that resulted in an atypical and difficult neurosurgical practice were as follows : delayed admission, premature discharge against doctor's request, refusal of radiological studies and admission, misunderstanding of disease entity, and unreasonable desire of transfer to tertiary hospitals. Inaccurate initial diagnoses were made by emergency doctors in twenty patients. During the course of treatment, there were a few complications such as alcohol withdrawal, acute otitis media, cerebrospinal fistula, facial weakness, and posttraumatic seizure. Outcome was good in 60(88.2%) patients. Conclusion : Most of minor head trauma patients in this series have shown good results, but we have to consider some possible complications and delayed intracranial lesions in these patients that should be managed with special cautions with various kinds of treatment difficulties.
Purpose: This study was conducted to develop an education program for safe drug use in the rural elderly and to measure the effect of the program. Method: This study utilized a nonequivalent control group pretest-posttest design. The subjects of this study consisted of 40 older persons who were more than 65 years old and lived in G and C moon, Y gun, Gyeongsang-bukdo and visited the public health subcenter. Twenty were assigned to the experimental group and 20 to the control group. The education was provided for one and a half hours, once a week for 3 weeks. Data was collected before, right after, and one month after the program. Result: The first hypothesis was supported(F=79.24, p=0.000) showing that the knowledge scores of the drug use of the experimental group were significantly higher than those of the control group at post education and one month after education. The second hypothesis was supported(F=23.84, p=0.000) showing that the drug misuse and abuse prevention behavior scores in the experimental group were significantly higher than those of the control group at post education and one month after the education. Conclusion: This study suggests that the education for safe drug use is effective in promoting knowledge and behavior for safe drug use of the rural elderly.
Recently, the small-scale local governments of japan are enlarging and enriching the service of health, medical and welfare facilities for the elderly . Intensive arrangement of the three types of facilities is one of the effective ways especially for the small-scale local governments. The service network between facilities benefits by the intensive arrangement. Benefits include the network of the medical service, the share of care information, the share of space and equipment. It can be a notable feature in the intensive arrangement that the elderly were taken from welfare facilities (especially dayscare center) to hospital of high movement frequency quickly. Instead of EV path as possible, It is desirable to stand close between facilities of high movement frequency. For large area, the heavy snow made low daycare ratio. Therefore, it is desirable to construct a branch office at a long distance.
Purpose: This study covered the effect of shoulder stabilization exercise on muscle activity, postural alignment and self-efficacy of the elderly people with round shoulders by visiting village hall in rural area. Methods: 40 elderly people with round shoulders were recruited for this study (experimental group: 20 subjects and control group: 20 subjects). The experimental group was asked to perform shoulder stabilization exercise 60 minutes per one time for 8 weeks and three times in a week and the control group was asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects' muscle activity of upper trapezius, serratus anterior, infraspinatus, pectoralis major and the lower trapezius, then postural alignment of craniovertebral angle and round shoulder posture. In addition, self-efficacy is measured through the questionnaire. Results: Compared to the control group, the experimental group showed significant differences in the muscle activity of all muscles, posture alignment of the craniovertebral angle. round shoulder posture, and improvement of self-efficacy. Conclusion: We found that shoulder stabilization exercise is effective in muscle activity, postural alignment and self-efficacy of the elderly people through visit-rehabilitation service. This study can be used for improving the physical and mental abilities through active visit-rehabilitation service for areas where have poor medical benefits. It is considered that systematic visit rehabilitation service should have institutional framework ultimately.
Objective: This study covered the effect of stabilization exercise on muscle activity, shoulder painanddisability index(SPADI) oftheelderly people with chronic shoulder pain by tele-rehabilitation village hall in rural area. Design: A randomized controlled trial. Methods: The study subjects are 29 elders with chronic shoulder pain aged over 65-year-old who reside in the rural area (experimental group: 14 elders and control group: 15). The elderly people in the experimental group were asked to perform shoulder stabilization exercise 60 minutes per one time for 4 weeks and three times in a week and the others in the control group were asked to receive education related to pain management for the initial one time. Before and after the experiment, we measured the subjects' muscle activity of upper trapezius, serratus anterior and the lower trapezius. In addition, SPADI is measured through the questionnaire. Results: Compared to the control group, the experimental group showed significant differences in the muscle activity of the three muscles (upper trapezius, serratus anterior, lower trapezius), and SPADI. Conclusions: It is found that shoulder stabilization exercise is effective in muscleactivity, pain and ability of the elderly people through tele-rehabilitation service. This study should be used for improving the quality of the elderly people's lives through active tele-rehabilitation service for areas where have poor medical benefits.
Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.
This study attempts to analyze the relationship between various job-related factors and the intent to turnover of employees working at different types of hospitals/clinics in urban and rural areas. The data was compiled from 1,506 employees in 21 hospitals and 10 clinics located in Kyung-gi Do. Korea, using a self-administered questionnaire. Major findings are as follows: 1) The intent to turnover was higher for the employees of small hospitals located in rural areas. It was also higher when the employees were less than 30 in age, female, single, had not received college education, and had worked for 2-5 years in their hospitals. 2) An important factor affecting the intent to turnover was job satisfaction, which in turn had a strong correlation with the job itself(opportunity of utilizing abilities and skills, subjective value attached to the current job, sense of accomplishment) and had a rather weak correlation with salary, supervision, promotion and co-worker relationship. 3) In the analysis by job category, it was found that, besides job satisfaction, the intent to turnover was significantly affected by the job itself in case of administrative personnel and by the level of salary in case of nurses. 4) For a successful management of turnover, hospitals need to develop (a) programs for improving adaptive abilities of 'new' employees(who have worked for less than 2 years), and (b) for the other employees(who have worked for more than 2 years), strategies for enhancing job satisfaction by providing the environment where they can show their maximum abilities.
Purpose: This study is a mixed methods research that was conducted to verify factors affecting the working experience of community-based long-term care hospital workers during the COVID-19 pandemic. Methods: The study was carried out from July 19 to November 3, 2021 for 340 nurses who worked at 10 long-term care hospitals located in G city. Results: As the study results, factors that affected job stress of the workers working at community-based long-term care hospitals included job satisfaction (β=-.27, p<.001), work demand (β=-.25, p<.001), fatigue (β=.19, p=.001), and cooperation and leadership (β=-.12, p=.049). It was found that the participants were struggling with physical and mental stress caused by the increased workload due to the preventative measures taken to stop the infection and spread of COVID-19. Despite this, they accepted their situation as necessary to overcome the pandemic and shared the quarantine guidelines of the government and community health centers while actively responding to prevent the spread of COVID-19 under the leadership of their supervisors. However, they were experiencing psychological and emotional burnout in the prolonged pandemic situation. Conclusion: It is considered necessary to help relieve their stress and provide psychological and mental support by adopting a policy to develop and apply comprehensive programs.
Purpose: This study aims to provide primary data for policy alternatives by identifying the problem of the nursing workforce shortage. Methods: For quantitative data, 446 questionnaires were analyzed. The mean and standard deviation were used for content description. ANOVA analysis and Scheffe? test were used to compare the differences according to the hospital level. For qualitative data, 1:1 in-depth and group interviews were conducted for six participants. Results: The factors nurses prioritized when choosing a workplace were salary, commuting distance, and work-life balance. Clinical nurses cited low wages, heavy workloads, and burnout as the most considerable difficulties in performing their duties. Factors influencing nurse's turnover intention were low wages, unmanageable workload, and rotation to unwanted departments in that order. New nurses tend not to apply to small-medium-sized hospitals, experienced nurses in their 30s-40s leave hospitals due to childcare and shift work difficulties, and nurses in their 50s and older tend to move to nursing homes rather than acute hospital settings. Conclusion: In this study, wage and workload were mentioned as the most critical factors in nurses' workplace selection, job performance difficulties, and turnover intention, so it is necessary to pay attention to this aspect when improving treatment for nurses.
Background: This cross-sectional observational study was undertaken to identify the epidemiological characteristics of patients with gynecological malignancies in India, in relation to gynecological cancer risk. Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: More than two-thirds of the cases (69.0%) occurred in the age range of 35-64 years and the same proportion of patients was from rural areas. Almost all the patients were "ever-married" (96.5%). More than half (54.9%) were illiterate/just literate. Nearly two-thirds (64.6%) were parity 3 or higher. Among the 18 patients with history of multiple sexual partners of the husband, 94.4% (17) were suffering from cervical malignancy, along with all the 3 patients with history of STD syndromes (sexually transmitted diseases) of their husbands. No one had given a history of condom use by her husband. Most of the patients (91.1%) used old / reused cloth pieces during menstruation. Conclusions: There is a need to increase awareness among women and the broader community about different epidemiological factors that may be responsible for increased risk of gynecological malignancies.
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