• Journal of Hospice and Palliative Care
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• 제27권3호
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• pp.87-98
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• 2024

Purpose: This study aimed to investigate advance care planning needs expressed online. Methods: This study collected data from online community posts and healthcare news sites. The search keywords included "death," "euthanasia," "life-sustaining medical care," "life-sustaining treatment," "advance directives," "advance medical directives," and "advance care planning." Data collection spanned from February 2018 to February 14, 2020. Out of 2,288 posts, 1,190 were included in the final analysis. Data analysis was conducted using NVivo 12, a qualitative data analysis software program. Results: Content analysis categorized patients' advance care planning needs into eight themes, 11 theme clusters, and 33 meaningful statements. Similarly, care providers' advance care planning needs were categorized into eight themes, 14 theme clusters, and 42 meaningful statements. The identified themes of care needs included life-sustaining medical care, decision-making related to life-sustaining medical care, physical care, environmental care, supportive and spiritual care, respect, preparing for death, and family. Conclusion: This study identified care needs from the perspectives of patients and their families. The findings may serve as preliminary data for future research and clinical applications.

• 가정∙방문간호학회지
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• 제25권2호
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• pp.219-229
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• 2018

Purpose: This study explored the sexual harassment-related experience, awareness, coping, and institutional prevention schemes for health personnel in industrial settings. Methods: Data were collected using self - report questionnaires from 300 health personnels. Data were collected between September 1 and December 31, 2017. The collected data were analyzed using descriptive statistics. Results: Health personnels experienced 29% of sexual harassment, in order of verbal, visual, physical. The frequency of sexual harassment was higher when women were younger, particularly younger than men. Although the average health personnel's awareness of sexual harassment was high, the common coping style was passive such as distancing form the perpetrator. Institutional efforts to prevent sexual harassment included separating employees and staff, but perpetrators tended to account for a high proportion of the supervisors and staff. Conclusion: Health care managers should develop an effective and effective sexual harassment prevention education program by raising gender equality awareness in relation to the awareness of sexual harassment and identifying the influencing factors that can bring about appropriate sexual harassment coping behavior.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

• 한국보건간호학회지
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• 제13권2호
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• pp.215-226
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• 1999

The purpose of this study was to investigate the factors influencing self care in ostomates, to provide the basic data for self care promoting intervention, The subject of this study were 110 ostomates living in Deagu and Deajon, during the period from March to April. 1998. The instruments for this study were the self care scale developed by Lee Ji Sook(1990), the family support scale by Lee Ji Sook(1990), the self esteem scale by Rosenberg(1965) and the hope scale by Nowotny(1989). The instruments for this study were pretested on the ostomates for reliability and validity. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression. The results are as follows : 1. The average score on the self care was 2.90. 2. There were significant positive correlations between self care and other factors self esteem(r=.652 P<.05), family support (r=.632 P<.05) and hope(r= .604 P<.05). 3. The variables that affected the self care of the subjects were self esteem, hope, family support, economical status, fecal control type and monthly participation in ostomate meetings in that order. These variance of self care was R2=62 percent by calculating the sum of those variables. The results of this study might help nurses and other health providers to develop interventions for the self care reinforcement of ostomates.

• 여성건강간호학회지
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• 제22권1호
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• pp.48-60
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• 2016

Purpose: This study was to explore the postnatal care experiences among first time Chinese immigrant mothers living in Korea. Methods: Data were collected by focus group interviews with 12 first time Chinese immigrant mothers utilizing 3 focus groups. After obtaining written informed consent from all participants, each session of the focus group was audio-recorded and transcribed verbatim. Data were analyzed by content analysis to identify major themes. Results: Four major themes for postnatal care experiences were extracted from the data as follows. 1) Range over traditional, modern, Korean or Chinese postnatal care, 2) Struggle with newborn care, 3) Another struggle with breastfeeding, and 4) Difficulties in becoming a mother as an immigrant. Conclusion: Based on their postpartum care experiences, it is concluded that participants requested more professional practical and individualized education/training for successful breastfeeding and newborn care. Health care providers need to develop and implement integrated support and mentoring programs that include information and peer support system for the first time Chinese immigrant mothers living in Korea. This would decrease the difficulties of becoming a mother.

• 기본간호학회지
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• 제22권1호
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• pp.79-86
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• 2015

Purpose: The purpose of this study was to examine levels of self-care behavior according to levels of depression among patients with heart failure (HF). Methods: Participants in this descriptive research were 169 outpatients with HF who being seen in three university hospitals and one general hospital located in B, Y, and D cities. Data were collected using the Korean version of the Center for Epidemiologic Depression Scale and European Heart Failure Self-care Behavior Scale. Data collection period was from April 25, 2012 to September 26, 2013. Data were analyzed using Chi-square tests and ANOVAs with SPSS WIN 21.0. Results: A higher proportion of patients who were female, without a spouse, with lower household income, not employed, and having lower functional status with serious symptoms of HF tended to be clinically depressed. HF patients with depression tended not to report symptom changes to their health care providers. Conclusion: The findings of this study indicate the need to screen for depression in patients with HF and to develop strategies to improve self-care behaviors in these patients in order to promote reporting of symptom changes to health care providers.

• 보건행정학회지
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• 제12권1호
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• 보건행정학회지
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• 제13권1호
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• pp.98-115
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• 2003

Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4％ of KDRGs had a CV of charges from tertiary care hospitals less than 100％ and 95.43％ of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80％ for non-outlier claims from tertiary care hospitals, 51.98％ for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

• Nutrition Research and Practice
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• 제8권1호
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• pp.66-73
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• 2014

The purpose of this study was to determine if Theory of Planned Behavior (TPB) variables predict soy milk intake in a sample of WIC participants in 2 Illinois counties (n = 380). A cross-sectional survey was used, which examined soy foods intake, behavioral beliefs, subjective norms, motivation, and intention. Soy product intake was low at both sites, and many participants (40%) did not know that soy milk was WIC approved. Most (> 70%) wanted to comply with their health care providers, but didn't know their opinions about soy milk (50-66%). Intention was significantly correlated with intake (0.507, P ${\leq}$ 0.01; 0.308, P ${\leq}$ 0.05). Environmental beliefs (0.282 and 0.410, P ${\leq}$ 0.01) and expectancy beliefs (0.490 and 0.636, P ${\leq}$ 0.01) were correlated with intention. At site 1, 30% of the variance in intention to consume soy milk was explained by expectancy beliefs and subjective norm beliefs (P < 0.0001); at site 2, 40% of the variance in intention was explained by expectancy beliefs. The TPB variables of expectancy beliefs predicted intention to consume soy milk in WIC participants. Therefore, knowing more about the health benefits of soy and how to cook with soy milk would increase WIC participants' intention to consume soy milk. Positive messages about soy milk from health care providers could influence intake.

• Journal of Preventive Medicine and Public Health
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• 제40권1호
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• pp.51-58
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• 2007

Objectives : The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. Methods : We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. Results : The average continuity of care in the entire population of 1,498,327 patients was $0.89{\pm}0.17$ as calculated by MFPC and $0.92{\pm}0.16$ by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. Conclusions : The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.