• Title/Summary/Keyword: Continuum of care

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A Consideration on the Instituting Home Health Care in Korea (우리나라 가정간호제도화 방안에 관한 고찰)

  • Yun, Soon-Nyoung;Hwang, Na-Mi;Hyun, Hye-Jin;Choi, Joung-Myoung;Kwon, Mi-Kyung
    • Journal of Home Health Care Nursing
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    • v.2
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    • pp.5-18
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    • 1995
  • While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

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Development and Evaluation of a Navigation Program for Newly Diagnosed Cancer Patients (암을 처음 진단받은 환자를 위한 신환 네비게이션 프로그램 개발 및 효과 평가)

  • Kwon, In Gak;Hong, Jin Young;Baek, Hye Jin;Kim, Sung;Nam, Seok Jin;Kim, Im Ryung;Kim, Hye Jung;Kim, Ae Ran
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.111-125
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    • 2012
  • Purpose: The purposes of this study were to develop a navigation program for newly diagnosed cancer patients and to evaluate its effects. Methods: The navigation program was based upon Professional Navigation Framework. Patients were asked to complete self-administered questionnaires on satisfaction, distress, anxiety and depression for evaluating the program. Results: The navigation program consisted of facilitating two concepts: continuity of care and empowerment of patients. Information-education package, telephone counseling and navigator's phone number were provided to the newly diagnosed cancer patients for care continuity. Self-care diary and emotional support by telephone counseling were provided to the patients for empowerment of patients. A total of 163 patients - 78 control and 85 experimental participants - were included in the study. The mean scores of satisfaction, distress, anxiety and depression had no statistical differences between the two groups after program implementation. In patients with longer waiting days, the experimental group with the navigation program showed higher relational continuity than the control group after program implementation(p=.023). In patients with longer waiting days or with higher distress, satisfaction of relational continuity was improved after program implementation in the experimental group. Conclusion: The navigation program in this study has applied the concept of patient navigation into oncology clinical setting in Korea. Navigation program can play a significant role in assisting patients navigating across the care continuum.

Multiple Stakeholder Perspectives on Cancer Stigma in North India

  • Gupta, Adyya;Dhillon, Preet K;Govil, Jyotsna;Bumb, Dipika;Dey, Subhojit;Krishnan, Suneeta
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6141-6147
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    • 2015
  • Background: Cancer is a leading cause of death worldwide. A large proportion of cancer deaths are preventable through early detection but there are a range of social, emotional, cultural and financial dimensions that hinder the effectiveness of cancer prevention and treatment efforts. Cancer stigma is one such barrier and is increasingly recognized as an important factor influencing health awareness and promotion, and hence, disease prevention and control. The impact and extent of stigma on the cancer early detection and care continuum is poorly understood in India. Objectives: To evaluate cancer awareness and stigma from multiple stakeholder perspectives in North India, including men and women from the general population, health care professionals and educators, and cancer survivors. Materials and Methods: A qualitative study was conducted with in-depth interviews (IDIs) and focus group discussions (FGDs) among 39 individuals over a period of 3 months in 2014. Three groups of participants were chosen purposively - 1) men and women who attended cancer screening camps held by the Indian Cancer Society, Delhi; 2) health care providers and 3) cancer survivors. Results: Most participants were unaware of what cancers are in general, their causes and ways of prevention. Attitudes of families towards cancer patients were observed to be positive and caring. Nevertheless, stigma and its impact emerged as a cross cutting theme across all groups. Cost of treatment, lack of awarenes and beliefs in alternate medicines were identified as some of the major barriers to seeking care. Conclusions: This study suggests a need for spreading awareness, knowledge about cancers and assessing associated impact among the people. Also Future research is recommended to help eradicate stigma from the society and reduce cancer-related stigma in the Indian context.

Appling Nursing Theory to Clinical Practice of Home Health Care (가정간호실무에 적용가능한 이론적틀)

  • Woo, Seon-Hye
    • Journal of Home Health Care Nursing
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    • v.11 no.1
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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Critical Success Factors for the Adoption of Health Management Information Systems in Public Hospitals in Zimbabwe

  • Caleb Manjeese;Indira Padayachee
    • Journal of Information Science Theory and Practice
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    • v.11 no.2
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    • pp.82-103
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    • 2023
  • The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

Development and Clinical Application of Critical Pathways for Vaginal Delivery and Cesarean Section (정상산모의 질식분만 및 제왕절개술에 대한 표준진료지침서의 개발과 임상 적용)

  • Park, Yong Won;Bai, Sang Wook;Jung, Young Nae;Lee, Hae Woo;Kim, Young Ran;Hong, Sun Bok;Park, Heun Ju;Tark, Kwan Chul
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.32-45
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    • 2000
  • Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

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Embarrassment; a concept analysis (당혹감(embarrassment); 개념분석)

  • Cho, Eun-Jung;Chung, Bok-Yae
    • Korean Journal of Adult Nursing
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    • v.14 no.2
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    • pp.276-286
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    • 2002
  • Purpose: The concept of embarrassment as an unpleasant emotion is important in caring for those who are in the continuum of illness and health requiring body care and facing sexual problems. In spite of its nursing implication, embarrassment has not been focused in nursing research. Therefore, the purpose of this paper is to develope a conceptual analysis of embarrassment. This analysis would help to understand comprehensively an embarrassing situation in which an intimate relationship between nurse and patient regarding body care of the patient could develope. Futhermore, it would be a basis for developing strategies for prevention of embarrassment which could lead for both patient and nurse to emotionally vulnerable situation because of their failure of self-presentation (impression management). Method: The concept analysis model suggested by Walker and Avant (1988) is used to clarify what is meant by the term 'embarrassment'. Result: This analysis defines the attributes of embarrassment such as follows. First, embarrassment is often attributed to situational factors interrupting a smooth interaction such as intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience. Second, embarrassment is closely related with cognitive factor such as fear of losing face resulted from a behaviour being out of line. Third, embarrassment is closely associated with dispositional factor such as embarrassability. Fourth, embarrassment is an unpleasant and unwanted emotion arising reactively after an interaction had occurred. Fifth, embarrassment encloses physical, physiological and behavioral aspects such as a variety of unique and easily noticeable reactions and a pattern of verbal and non-verbal behaviour for coping in an embarrassing situation. The antecedents were normally socialized adolescents with normal cognitive ability, concern of losing face, embarrassability, embarrassing events related with situational intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience, physical, behavioral blunders resulting in a failure of impression management. The consequences were an emotional coping behaviour, audience's embarrassment responses, and verbal and non-verbal coping strategies of interactional participants. Conclusion: It is hoped that this analysis will stimulate further exploration of this concept and study for developing systematic assessment and nursing practice that diminishes embarrassment of interactional participants.

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Life Transition of Mothers of Children with Autism (자폐성장애 아동 어머니의 삶의 전환 과정)

  • Lee, Ae-Ran;Hong, Sun-Woo;Kim, Ji-Soo;Ju, Se-Jin
    • Journal of Korean Academy of Nursing
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    • v.40 no.6
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    • pp.808-819
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    • 2010
  • Purpose: While there are a number of studies on children with disabilities, there have been few studies on mothers of children with autism. The purpose of this study was to explore the process of life transition of mothers who have children with autism. Methods: From June 2007 to May 2009, the researcher interviewed 15 mothers of children with autism living in Seoul City, Gyeonggi or Chonbuk Provinces, and then analyzed the data gathered using the constant comparative method of grounded theory. Results: "Living together holding a string of fate" was a core category showing along the continuum of life. The basic social process of life transition encompassed 5 stages: stages of denying, wandering, devoting, mind controlling, and finally accepting. These five stages proceeded in phases, though returned back to the wandering stage occasionally. Conclusion: This study has opened the door to understanding how mothers of children with autism experienced life transition. The findings suggest that differentiated support and care at each stage should be given and there is the need to develop transition assessment tools for mothers of children with autism.

A Theoretical Examination on Appraisal System of Public Records in Korea : Comparative Study on Archival Selection and Concepts of Values (공공기록물의 평가체제에 대한 이론적 검토 -선별 방식 및 가치 범주를 중심으로-)

  • Kim, Myoung-hun
    • The Korean Journal of Archival Studies
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    • no.6
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    • pp.3-40
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    • 2002
  • Appraisal is a basic archival function that analyzes values of records and determines the eventual disposal of records based upon their archival values. In Korea, this appraisal concept introduces in earnest through Public Records and Archives Act(PRA, 공공기관의 기록물관리에관한법률) with which Korean record management systems settle inflexibly. In theoreical and methodological area, therefore, it is necessary to analyze appraisal system in this Act with it in archival science. In PRA Act, appraisal system is founded on the Tables of Transaction for Records Scheduling(TRS, 기록물분류기준표) through which disposal activities of all records are definited in a concrete form. In this system, selection of archival materials which has been recognized as a important function of record center is carried out by record creators and archival institutions; Primary value between semi-currenty and non-currenty are reflected at the same time. In view of values, this appraisal system intends to separate reasonably consideration for continuing utility of achives from current use of records throughout agencies duration. Ultimately, appraisal based upon TRS makes up not separated management course but organic courses reflecting the Continuum of Care. Of course, this appraisal system makes up the deficiency partially. TRS regarded as 'mainboard' of current appraisal system will have to be enacted elaborately. And appraisal strategies of electronic records must set up in detail in PRA Act and TRS. Lastly, arrangement and description concepts immanent in TRS will have to supplement in archival institutions.

Predictors of Complementary and Alternative Medicine Use by Breast Cancer Patients in Bandung, Indonesia

  • Azhar, Yohana;Achmad, Dimyati;Lukman, Kiki;Hilmanto, Dany;Aryandono, Teguh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2115-2118
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    • 2016
  • Background: The study aimed to assess complementary and alternative medicine (CAM) use and their associated factors with breast cancer patients in Bandung, Indonesia. Materials and Methods: In total, 330 breast cancer patients were administered questionnaires on their CAM use and CAM predictive factors including socio-demographic parameters, clinical data and quality of life, trust in physicians, trust in hospitals, satisfaction and informational needs. Data were analyzed using univariate analysis and multivariate log regreesion analysis. Results: Overall 33.3% of patients reported use of CAM. Lower income, lower education, presence of metastasis, prolonged diagnosis, less trust in physician were found to be highly associated with CAM use. Conclusions: CAM use by breast cancer patients can be interpreted as an attempt to explore all possible options, an expression of an active coping style, or expression of unmet needs in the cancer care continuum. Physicians need to openly discuss the use of CAM with their patients and identify whether they have other unmet supportive needs.