• Title/Summary/Keyword: Elderly in the Community

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Factors Associated with Unmet Needs for Medical Care among Island Inhabitants in Korea (일개 섬 지역 주민의 미충족 의료와 관련 요인)

  • Cho, Seong-Sik;Lee, Tae-Kyung;Bang, Ye-Won;Kim, Chul-Ju;Im, Hyoung-June;Kwon, Young-Jun;Cho, Yong;Paek, Do-Myung;Ju, Young-Su
    • Journal of agricultural medicine and community health
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    • v.35 no.2
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    • pp.151-164
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    • 2010
  • Objective:Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. Methods: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. Results: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. Conclusion:In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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A Survey on the Status of Health Examination among Farmers in a Rural Area (일부 농촌지역 농업종사자들의 건강진단 수검 실태)

  • Park, Soon-Woo
    • Journal of agricultural medicine and community health
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    • v.22 no.1
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    • pp.1-18
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    • 1997
  • This study was carried out to reveal the status of health examination among farmers and to attract more attention to the health care system for farmers. Ten pre-trained medical students interviewed the rural residents 18 years of age and older in eight villages which were randomly selected from a county near Taegu city in Korea, in August 1996. Finally 751 persons were interviewed of whom the percentages of male and female were 41.8%, 58.2% respectively. Among the subjects, 361(48.3%) were fully engaged in farming, 184(24.4%) were partly engaged, and the remaining 206(27.3%) were not engaged in farming at all. The overall prevalence of farmer's disease was 23.0% and there was no significant difference between the group of fully engaged in farming(23.3%) and the group of not-fully engaged(22.9%). But the prevalence of farmer's disease in female subjects(27.8%) was significantly higher than that in male(16.2%)(p<0.01). Among the 288 farmer engaged in spraying pesticide, 113(39.2%) had experienced one or more pesticide related symptoms during last one year, but only 18(15.9%) of them had visited medical facilities due to their symptoms. The experience of receiving education about pesticide was significantly correlated with the degree of wearing protectors during pesticide spraying(p<0.001). Among the 736 persons excluding non-respondents, 281(38.2%) received health examination during last one year ; 176(62.6%) of them received free health examination, and 105(37.4%) received charged one. Among the 533 persons 40 years age and older, only 124(23.3%) had received the 'health examination for the elderly' during last one year, which is provided for the 40 years age and older by Korea medical insurance corporation and medical insurance societies. Most of all beneficiaries of self-employed medical insurance thought the imposed contributions as very expensive(77.4%) or moderately expensive(13.2%). The great majority of farmers are exposed to various health risk factors including pesticide, high temperature, overwork etc. comparable to industrial workers. But farmers are excluded from the regular yearly worker's health examination because of not belonging to a company despite they pay relatively more medical insurance contributions compared with the industrial workers and the urban self-employed medical insureds. It is necessary to develop special health management program for farmers such as the special health examination for the industrial workers exposed harmful agents.

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Nursing research issues and trends : views from Korea (우리나라 간호연구의 현황과 문제)

  • Oh, Kasil;Sin, Hee-Sun;Kim, Hee-Soon
    • The Korean Nurse
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    • v.31 no.3
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    • pp.76-87
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    • 1992
  • The purposes of study was: 1. To identify the direction and scope of research activities in Korean Nursing. 2. To discuss the unique problems present in Korea that warrant nursing research. 3. To delineate the factors that facilitate and/or hinder nursing research in Korea. This study was conducted at six colleges of nursing in Korea. The schools which were selected had doctoral programs at the time, the data were collected in 1990. Four of the schools were located in the metropolitan area of the capital city, Seoul, and two were in two other cities similar in size. The total population of the study was 283 nurses. The instrument for the research was the English version of Research Profile Questionnaire which was translated into Korean by the researchers and was validated in its translation by two professors. A pretest procedure was done before the data collection process. Of the population of 283, 210 subjects received the questionnaire and 150 subjects responded(71.4%). Excluding incomplete questionnaires, 141 questionnaires were utilized for data analysis. Data were analyzed using descriptive statistics. Responses to open-ended questions were content analyzed for themes and categories. Results of the study were as follows : Respondents currently , involved in nursing research numbered 108(76.6%), but 33(23.4%) did not have any research experience. The inexperienced respondenLs tended to be younger than the experienced subjects and most( 60.6%) were employed in hospitals, while 82.4 percent of the experienced nurses were employed in nursing schools. Among the respondents with research experience, 68.5 percent were involved in one to three projects and 31.5 percent were engaged in four or more projects. The experienced nurses indicated that nursing research in Korea is active. On the other hand, the responses of the inexperienced were that nursing research is not active. The most frequently selected research subjects were patients(76.9%, 83 respondents) followed by nurses, healthy persons and nursing students. The relatively high percentage of healthy persons as study subjects, could be explained as a concern of nurses for healthy persons as well as for ill patients. The aforememioned literature review showed a dramatic change in the kinds of study subjects; approximately 33 percent were patients but 25 percent were healthy subjects of various ages. The hospital was the prevailing research setting(67.6%) but at the same time various community settings were used. This is a changing phenomena in nursing research of Korea. Current research designed to build on previous studies amounted to 75 percent; about 39.8 percem were theory and hypothesis generated. Over 65 recommended additional research focusing on hypothesis-testing 0:' theory building. The previously quoted literature review found that only 4.0 percent of the study quescions were developed from a theoretical framework. The most frequently listed current major focus of nursmg research was stress and adaptation. Patients with cancer, pain, social support and care of the elderly were the next most frequently reported. These concerns may reflect problems associated with a technological and industrializing societyl. The most frequently identified problem was lack of clinical research. The need for replication research and research that contributes to the accumulation of nursing knowledge were found to be rare in Korean research. A need for theory testing and theory construction research was also identified. Although advanced statistical methods were often utilized in nursing research, the results were frequently considered by the interviewers not to be applicable in practice, and readers had difficulty in comprehending the findings. Even though the number of clinical nurses involved in research is increasing, it is still considered inadequate. Among 108 respondents, 83(76.9%) gave lack of time as a barrier to conducting nursing research. Over fifty percent of the respondents reported lack of funding or, personally, low confidence in research skills as barriers. The respondents offered 183 suggestions for future emphasis in nursing research. Among the 51 areas of emphasis, clinical research received the highest number and nursing intervention was next. The findings suggested that nursing research should be based on theory, be related to practice and relevant to the situation of a unique Korean culture.

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Meta-Analysis about Effect of Aromatherapy on Stress (향기요법이 스트레스에 미치는 효과에 대한 메타 분석)

  • Kim, Gyung-Duck;Suh, Soon-Rim
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.188-195
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    • 2008
  • Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.

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Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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Effects of Health Education with Printed Media for Smoking Cessation, Pap Smear and Breast Self-examination (금연, 자궁암 검진 및 유방암 자가검진에 대한 인쇄매체를 이용한 보건교육의 효과)

  • 김인숙;김석범;강복수
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.163-183
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    • 1998
  • To evaluate the impacts of the health education programs including smoking cessation, pap smear and breast self-examination(BSE), a community trial was conducted during one year from December 1996 to December 1997 in Kyongju City. Before health education, a base-line survey was implemented and the target population was allocated randomly to case and control groups. The case and control groups were divided into three categories which were smoking cessation, pap smear and BSE. The series of health education leaflets about anti-smoking, pap smear and BSE were mailed to case group and the evaluation survey was conducted at the end of this trial to compare the change of health related behaviours of case and control groups. Smoking prevalence of case group did not decline significantly after anti-smoking education but the cessation rates of the elderly and low educated were higher than others. The knowledge level of case group on the health risk associated with smoking was higher than that of control group and the willingness of case group to quit smoking was higher than the control group. The case group's compliance with pap smear for cervical cancer was more increased compared to control group after health education. Of the case group, the younger and lower educated women were screened at a higher rate than others. The knowledge level of case group on the risk factors of cervical cancer and how to prevent it was higher than that of control group. Nearly 60 percent of case group reported that the health education leaflet influenced them to have the pap smear. The unscreened cases were highly motivated to get the pap smear test in the future.

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