Purpose: A survey was conducted to investigate the role, priority, and awareness of physical therapists in the community care system for the elderly. Methods: Nine hundred ninety-three physical therapists were invited to an online survey from 1st to 30th June 2020. Results: While the awareness of physical therapists for the community care system for the elderly was found to be low, the role priority and performance ability were found to be high. Fall training scored the highest for the job duties of physical therapists, and functional training scored the highest for the performance ability of physical therapists. For the role priority by the education status regarding the community care system, the participants who received the education program showed higher scores in the performance ability than those who did not. For the role priority and performance ability according to the education levels, higher education levels resulted in higher scores in both outcomes. Regarding the clinical experience, low scores were found in the participants with less than five years of experience. Conclusion: Physical therapy establishes itself as an essential area of expertise in the community care system for the elderly. Therefore, these results can be utilized in developing a model for Korean community care for the elderly.
The purpose of the current study was to select vulnerable regions with insufficient child care services based on an in-depth investigation of diverse regional characteristics and to establish a practical goal for the expansion of public child care centers through identifying priority regions in foremost need of public child care centers out of the vulnerable regions. The vulnerable regions were selected from both urban and rural areas with particular criterions to determine their critical situation. First of all, the number of children aged zero to five, private and public child care centers, and capacity and enrolment of the regional child care center were selected from towns (Eup) and townships (Myeon) within rural areas and neighborhoods (Dong) within urban areas to calculate the capacity fulfillment. Specifically, a dense population of low-income families inhabited within urban areas defined the region's vulnerable status for the analysis, whereas poor accessibility of a child care center within rural areas correspond to the lack of child care services. The analytical result displayed that a total of 456 towns and townships did not acquire child care centers. Out of 456 towns and townships, 162 were selected as priority regions. On the other hand, 546 neighborhoods corresponding to upper 30 percentiles of urban area where children receive basic subsidy for low income families were selected as vulnerable regions. Out of 546 neighborhoods, 243 were selected as priority regions according to the analytical result.
Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.
Purpose: This study was attempted to identify the importance and performance of person-centered care in nurses in intensive care units (ICU) at general hospitals and to derive the priority of practical person-centered care needs and intervention by analysing their needs. Methods: A total of 156 ICU nurses who wrote a written consent participated in a survey questionnaire on person-centered critical care nursing (PCCN). The collected data were analyzed using paired t-test, Borich's needs assessment, and the Locus for Focus Model. Results: All 15 items of person-centered care in ICU nurses were found to be significantly higher in perception of importance than performance level (t=17.98, p<.001). According to the analysis of Borich's needs and the Locus of Focus Model, person-centered care items with highest priority in ICU were therapeutic contact, comfort words and actions, and efforts to empathize with patients in the compassion category. Conclusion: As a strategy to improve the person-centered nursing performance of ICU nurses in the 'individuality', it is necessary for ICU nurses to recognize the ICU patients as an individualized person, not as a disease or machine-dependent entity. Also, it is necessary to develop programs to improve the ICU nurses' compassion competence because 'compassion' was a top priority according to Borich's needs assessment model and the Locus for Focus Model.
Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.
Purpose: The purpose of this study was to determine core nursing intervention in nursing records and to compare perceived nursing intervention priority and nursing intervention frequency of general surgery department. Methods: Subjects were 70 nurses who work in the general surgery department. Data was collected using a nursing intervention classification and analyzed by frequency and mean. Results: The most frequent nursing interventions of nursing records were orderly risk management, coping assistance, tissue perfusion management, skin/wound management and nutrition support. Important nursing interventions were tissue perfusion management, respiratory management, electrolyte acid-base management, elimination, peri-operative care. The most frequent nursing interventions were drug management, peri-operative care, risk management, tissue perfusion management, patient education. Conclusion: This study found that nursing records were different from intervention priority and nursing frequency. So further study is needed for finding focused intervention of specific subjects and differences with priority of nursing and frequency of nursing.
Purposes: Rapid aging and increase of high chronic diseases of the elderly are increasing the needs for expanding elderly care beyond the concept of treatment in medical institutions. This study is to discuss the core values, functions, and roles of municipal hospitals and suggest a suitable community care model. Methodology: The survey was collected twice derived from the domestic expert groups. This study analyzed experts' responses using Delphi method and Analytic Hierarchy Process, using Microsoft Excel 2016. Findings: Among the core values of the municipal hospitals, it was shown that community linkage had the highest priority. The publicity had the highest priority among the functions and roles of the municipal hospitals. In the community care models presented in this study, the model focused on 'Community Care Integration Center' showed highest relevance, suitability and applicability. Practical Implications: This study suggested three different community care models and derived the most suitable model for community care, which is focused on the municipal hospitals. It suggested effective application of the community care model to promote community care in each community.
In health care, the process of resource allocation becomes a controversial process of rationing, as scarce resources are allocated between the numerous health care interventions. Especially for the last few years, decisions to define and expand the benefit package of National Health Insurance have always become the object of fierce criticism. It is partly because we have not reached a collective agreement as to what the most important criteria for spending priorities are. This paper considers the procedures and the principles which could be used to determine rationing in health care, and emphasizes the need to have explicit principles which determine patient access to care and to have an evidence base to inform rationing decisions. Also, the need to set up a public committee is suggested to take rationing decisions on behalf of government and NHS and to present them as evidence-based decisions.
This study was conducted during the time period of September 1997 to February 1999. in order to provide data concerning important facets of horne care nursing and the degree to which practicing hospital and public health nurses believe themselves to be competent in each area. The study subjects consisted of 610 hospital nurses, 158 public health nurses and 21 other nurses from Seoul and the province of Kyunggi. Korea. Data was collected through self-reporting questionnaires which was used by Kim et al.(1999) to evaluate the status of home health nursing and the varying ideas of self-competence that practicing nurses have. The results of the study were as follows: 1) The mean scores of perceived important components and competencies on home health nursing measured on the Likert 4 point scale were $3.15{\pm}0.36$ for importance. and $2.56{\pm}0.36$ for competency. Of the four categories regarding nursing services, the 'Nursing skill' factor had the highest importance and competency. 2) There were significantly higher scores for hospital nurses' importance components and competencies of home care nursing as compared to those scores for public health nurses. 3) The significant factors of the importance component of home care nursing listed in order of priority were 'general infection control', 'bed sore care skill', 'rehabilitation care', 'keeping maintenance of the client's confidentiality', 'malpractice', 'diabetes patient care', 'ability for problem solving' respectively. In contrast, of low priority in the importance components of home care nursing were 'referring nursing as a job to others'. 'record keeping', 'family dynamics', 'medical equipment', 'economic problems', 'environmental assessment', 'suture removal', 'multidisciplinary coordination' respectively. 4) The high priority of the degree to which practicing nurses believe themselves to be competent in home health nursing were the 'blood sugar test', 'enema skill', 'injection skill', 'skin care', 'bed sore care skill', etc. In contrast, lower competence for home care nursing as perceived by nurses were 'AIDS care', 'family violence care', 'substance abuse care', 'mental health care' respectively.
Akjiratikarl, Chananes;Yenradee, Pisal;Drake, Paul R.
Industrial Engineering and Management Systems
/
v.7
no.2
/
pp.171-181
/
2008
Home care, known also as domiciliary care, is part of the community care service that is a responsibility of the local government authorities in the UK as well as many other countries around the world. The aim is to provide the care and support needed to assist people, particularly older people, people with physical or learning disabilities and people who need assistance due to illness to live as independently as possible in their own homes. It is performed primarily by care workers visiting clients' homes where they provide help with daily activities. This paper is concerned with the dispatching of care workers to clients in an efficient manner. The optimized routine for each care worker determines a schedule to achieve the minimum total cost (in terms of distance traveled) without violating the capacity and time window constraints. A collaborative population-based meta-heuristic called Particle Swarm Optimization (PSO) is applied to solve the problem. A particle is defined as a multi-dimensional point in space which represents the corresponding schedule for care workers and their clients. Each dimension of a particle represents a care activity and the corresponding, allocated care worker. The continuous position value of each dimension determines the care worker to be assigned and also the assignment priority. A heuristic assignment scheme is specially designed to transform the continuous position value to the discrete job schedule. This job schedule represents the potential feasible solution to the problem. The Earliest Start Time Priority with Minimum Distance Assignment (ESTPMDA) technique is developed for generating an initial solution which guides the search direction of the particle. Local improvement procedures (LIP), insertion and swap, are embedded in the PSO algorithm in order to further improve the quality of the solution. The proposed methodology is implemented, tested, and compared with existing solutions for some 'real' problem instances.
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