Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.
Caring for patients with cancer is highly stimulating and rewarding, attracting health professionals to the field who enjoy the challenge of managing a complex illness. Health professionals often form close bonds with their patients as they confront ongoing disease or treatment impacts, which may be associated with multiple losses involving function and/or eventual loss of life. Ongoing exposure to patient loss, along with a challenging work setting, may pose significant stress and impact health professionals' well-being. The prevalence rates of burnout and compassion fatigue (CF) are significant, yet health professionals have little knowledge on these topics. A 6-week continuing education program consisting of weekly small-group video-conferencing sessions, case-based learning, and an online community of practice was delivered to health care providers providing oncology care. Program content included personal, organization and team-related risk and protective factors associated with CF, grief models, and strategies to mitigate against CF. Content analysis was completed as part of the program evaluation. In total, 189 participants (93% nurses) completed the program, which was associated with significant improvements in confidence and knowledge of CF and strategies to support self and team resilience. Qualitative themes and vignettes from experiences with the program are presented. Key themes included knowledge gaps, a lack of support related to CF and strategies to support resilience, organization-and team-based factors that can inhibit expression about the impacts of clinical work, the health professional as a "person" in caregiving, and the role of personal variables, self-skill practices, and recommendations for education and support for self and teams.
Purpose: The purpose of this study was to analyze the necessity of home visit rehabilitation therapy by rehabilitation professionals working at social welfare facilities. Methods: The subjects of this study were 227 rehabilitation professionals (social worker, nurse, physical therapist, occupational therapist, speech-language therapist, special education teacher, and staff of institutions for the disabled who were working at community rehabilitation centers. The data were collected over 65 days (2008. 09. 10~11. 14). The results were analysed statistically by the Chi-square test. Results: The results are as follows: Long-term care service was established in Korea by the Ministry of Health in July, 2008. But there are limits to their being able to provide various rehabilitation services for chronic patients and old people. According to a recent survey, almost all rehabilitation professionals (N=227) stated that home visit rehabilitation therapy is necessary. Conclusion: In Korea, the long-term care service has a nursing service and a service supporting physical activities of daily living, but not physical therapy. So, home visit rehabilitation services should include physical therapy, rehabilitation exercise, and pain management.
The purpose of this study is to reinterpretate the history of nursing and health care from the view-point of post-structuralism. It has been emphasized that the development of modern health care has been due to the progressive efforts of medicine and to medical discoveries. Medicine has dominated the history of health care rather than nursing or other health professions. The present study adopts the post-structural method by Foucault, which tries to unite language and knowledge. Foucault examines "the institutionalization of knowledge and the power exerted thereby, with special reference to the devices of social regulation and their function over the madness, the disease, the crime, and the sexuality. " The concept of power in Foucault's writing is that it is exerted spontaneously in verbal behaviors of individuals through knowledge of everyday life such as definition of body or mind, sexuality and relationship of family. Therefore as to the problem of power, this study tries to understand the meaning of the health care history through an analysis of the formation of medical discourse. In order to have authority in a power relation, the medical professional asserts that medical discourse is the most scientific knowledge. The authority of medical professionals can be reinforced by the fact that male medical professionals outnumber female. Devaluation of nursing care is reinforced by the medicine which has the legitimate authority through use of the political skills.
Purpose: This study aimed to explore frontline nurses' experience of patient-centered care and understand the factors affecting its implementation in hospitals. Methods: Four focus group interviews were conducted with 30 nurses in two university hospitals. The following theoretical framework of patient-centered care was used: 1) Respect for patients' values, preferences, and expressed needs, 2) Care coordination and integration, 3) Information, communication, and education, 4) Physical comfort, 5) Emotional support and alleviation of fear and anxiety, 6) Involvement of family and friends, 7) Care transition and continuity, and 8) System issues. We performed a directed content analysis. Results: The most frequent patient-centered nursing practices of the hospital nurses were "promoting physical comfort" in inpatient settings and "providing information and communicating" in outpatient settings. The factors influencing patient-centered nursing included the health professionals' mindfulness, work overload and staff shortage, and unreasonable social demands and regulations. Conclusion: A more comprehensive patient-centered nursing practice should be implemented by improving "care transition and continuity," "family/caregiver involvement," and "system building." Health professionals' mindfulness is significant, and organizational supports addressing work overload and staff shortage are needed alongside change in social awareness.
A 15-minute questionnaire on breast-feeding was administered to the obstetric and pediatric residents and nurses in metropolitan academic training programs in Korea to assess their attitudes to and knowledge about breast-feeding and their confidence in managing breast-feeding problems. The questionnaires were self-administered and confidential and the participants was 279. Overall, the study participants indicated a supportive attitude toward breast-feeding. Nurses had a highest supportive attitude than obstetric and pediatric residents. Their self-confidence in this area was inappropriately high with 48% of total, 49% of obstetric, 42% of pediatric and 58% of nurses describing themselves as "confident" or "very confident" to manage common breast-feeding problems to compare their knowledge level answering only 46% of the questions correctly. However, nurses who did have continuing education about breast-feeding had significantly high in knowledge level. These health care professionals have extremely limited knowledge of breast-feeding management compared to their reported confidence. To be truly supportive of breast-feeding, health care professionals should receive didactic and clinical training to breast-feeding management.
Journal of the Korea Academia-Industrial cooperation Society
/
v.14
no.1
/
pp.275-284
/
2013
With the propofol-induced accident such as adverse effects, abuse, death is becoming to the fore as a social issue, there is an increasingly loud call for self-examination about excessive propofol use. The purpose of this study was to identify the knowledge, attitudes and practices in health care professionals and awareness in the public toward propofol. Participants in this study were 359 health care professionals, and 682 publics who is going to undergo endoscopy. The collected data was analyzed using t-test, ANOVA, Scheffe for knowledge, attitude, and practice toward propofol in health care professionals, Pearson Correlation for its correlation. and frequencies, %, mean for others. Scores of knowledge, attitudes, and practices were 7.16 (11), 3.26 (5), 3.95 (5) respectively. Nurses' attitudes toward propofol was much more higher than doctors', doctors' practice toward propofol was higher than nurses'. There was a correlation among knowledge, attitudes, and practices toward propofol. 53.4% of the publics answered that never heard what is propofol. Considering these results, regular customized and standardized-education strategies for both groups need to be developed for the purpose of proper use and management of propofol.
When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.
The purpose of this study was to identify patients' perceptions of health professionals' unkind behavior and the effects of this unkind behavior using a Phenomenological research methodology. Understanding of this phenomena should enlighten nurses to interaction and relationship problems between patient and health professionals and thus lead to further research toward enhancing these interaction and relationships. The subjects were 40 adult patients hospitalized in a university hospital in Seoul. They were from 20 to 65 yews old and hospitalized at IM, GS, OS, NS, OB /GY ward. Their hospital days were from 4 to 72. Data were collected from July 29 to August 9, 1991 and from January 6 to 17, 1992. The research questions were “What behavior on the part of health professionals you perceive as unkind and what effect does such behavior have in you\ulcorner”. Responses to the non-structured open-ended questions were audio-recorded during the interviews done by two nurses researchers. Data were analyzed using the phenomenological method of Colazzi. The validity was enhanced by confirmation of the analysis by two nursing clinical researchers, and professor of psychology, and philosophy, all knowledgable of phenomenological research. From the protocols, 146 significant statements about unkind behavior were organized into 38 formulating meanings which were then grouped into six clusters of themes. Patients' Perceived health professional' unkind behavior as being cold, insincere, unconcerned, disregardful, lacking in technical skill, and failing to provide a therapeutic environment. From the protocols, 65 significant statements about the influence of such behavior on patient care were organized into 18 formulating meanings which were then grouped into four clusters of themes. Patients perceived these unkind behavior influencing then emotionally, physically and having negative effects on their compliance with medical and nursing care. The study points to the need for health professionals to understand how their behavior may be perceived by their patients as unkind behavior. Patients perceptions of health professionals' unkind behavior may suggest the opposite desire, that professionals have exellent medical knowledge and skill and that they be sincere, concerned, respectful and warm emotionally toward their patients.
Purpose: This study was performed to develop the case management program that can provide the qualitative health care service to satisfy the increasing needs for health care elderly and prevent the increase in medical cost cased by prolonged and repetitive hospitalization. Method: The survey was completed as follows. First, 290 elderly patients who would be soon discharged in 4 hospitals are participated in the survey on needs of nursing care and case management programs. Second, 70 professionals working at 5 hospitals including doctors, nurses, social workers and so on are participated in the survey on the case management team operation. Result: Level of needs to Nursing care and case management programs showed so high. Professionals suggested on the case management team operation. Finally, based on the survey and literature review, the case management program was developed. Conclusion: In this study, the specific models for the five case management services were suggested. It is thought that the service provision by the case management team based on the multi-disciplinary case management program model suggested in this study would be suggested as a constituent of the effective health care delivery system for the hospitalized elderly patients.
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