• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.42-50
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• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• Health Policy and Management
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• v.19 no.3
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

• Journal of Preventive Medicine and Public Health
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• v.40 no.1
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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.

• Korean Journal of Occupational Health Nursing
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• v.18 no.2
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• pp.252-261
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• 2009

Purpose: The purpose of this study was to determine factors affecting the burden on employment of occupational health care providers as well as to develop strategies to reduce burden on employment of them in the middle size manufacturing enterprises. Methods: The target population of this study was 123 managers working in the middle size manufacturing enterprises. The study questionnaires were selected, as theories and literature suggested, for explaining employment burden, general characteristics of participants and occupational health providers, general characteristics of companies, evaluation of occupational health provider's role and burden score. Results: The mean of employment burden score of manager was 2.2. There was a significant difference in the employment burden scores, manager's age and education, and occupational health provider's age, type of work, certification, and employment status. Also there was a negative relationship between employment burden scores and occupational health provider's role scores (need, role, satisfaction, and benefit). In the results of the standard multiple regression analysis, manager's need scores on occupational health providers were significant predictors of the employment burden scores. Conclusion: It is necessary to change the manager's perception to promote employment of occupational health providers.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.182-195
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• 2017

Purpose: This study explores school nurses' emergency care experiences and their needs for systemic institutional support. Methods: Data were collected in 2016 from the interviews with five focus groups comprising thirty school nurses. Qualitative content analysis was then performed using the collected data. Results: The study found that school nurses were vulnerable to over-reaction in uncertain situations as the school's sole health service provider. The study's findings are divided into ten categories. 1) Major obstacles to overcome as the sole health service provider, 2) Assessing an uncertain situation and making appropriate decisions, 3) Providing limited first aid while maintaining control over the situation, 4) Referring or transferring a student to a hospital that creates tensions and raises cost, 5) Becoming an advocate for information disclosure and treatment, 6) Ensuring follow-up actions and proper transfer of responsibility, 7) Making preparations for future emergency, 8) Responding to conflicts arising from over-reaction as a safeguard and professional expertise, 9) Need for the development of standardized manual for school emergency care, 10) Need for practical case-based training. Conclusion: The findings of this study should contribute to the development of the programs aimed at improving school emergency care and the professional competence of school nurse.

• International journal of advanced smart convergence
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• v.7 no.3
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• pp.140-145
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• 2018

This study is based on the National Pension Research Institute's 2013 Korean Retirement and Income Study(KReIS) 5 Data for Parents and Children Care over 50 years old and analyzed the satisfaction level of life according to the characteristics of 226 people in society. The results showed that women were more satisfied with their lives than men, and when the age was lower, when they had spouses, and when they had independent economic power. As for the grandchildren caring provider, the higher the education levels, the higher the satisfaction with life. And across all areas, the grandchildren care provider showed greater satisfaction with life than the parents care provider. These results show that the burden of the parents' carers is as great as that. Suggestions based on these results are as follows. First, It is necessary to develop a health care program that can be easily accessed by family carers. Second, Direct economic support is needed, with the primary focus being on family carers. Third, services targeting parents care providers are needed. It is also necessary to form a network that can share the difficulties of parental care.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.78-86
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• 2018

Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

• Journal of East-West Nursing Research
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• v.22 no.1
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• pp.51-59
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• 2016

Purpose: This phenomenological study aimed to identify breast cancer patients' experience of unkindness of healthcare providers. Methods: Ten participants who were diagnosed with breast cancer were recruited to participate in the study and asked to share their experience related to healthcare providers. Data were analyzed using the phenomenological method of Colaizzi. In-depth interviews were conducted from November, 2014 to March, 2015. Results: Seven consistent categories and fourteen theme clusters emerged from collected data. The seven themes were 'being treated thoughtlessly', 'not giving special services for breast cancer patients', 'cold and authoritative manner', 'incomplete explanation', 'not accepting an appeal', 'being sorry for having short consultation hours', and 'unskilled and careless treatment'. Conclusions: It is needed to develop health care services in the view of beneficiaries. This may reduce the patients' experience of unkindness of the healthcare providers and improve the satisfaction of health care service.

• Health Policy and Management
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• v.18 no.4
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• pp.125-147
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• 2008

The purpose of this study is to propose the factors affecting collaboration between community nurses and social workers in Korea. Data that is used in this study, were collected from 295 provider respondents by questionnaire, additionally from telephone survey and secondary data review. This study focuses on the working relationship between professionals in the field of health and social care. Based on the literature review, this study proposes a conceptual framework for collaboration between nurses and social workers in community health and social care. The dependent variable in this study is collaboration. It reveals whether or not the inter-professional works and shows the level of collaboration. The independent variables are categorized in: the client characteristics (frailty of client, client-provider relationship); the provider characteristics (specialization, perception of interdependence, perception of the other professional); the organization characteristics (closeness of the other professional, autonomy, on-the-job training, evaluation-reward); and the community characteristics (urbanization, capacity of resources). Major findings are as follows: First, the factors that appear to have the strongest impact on whether or not inter-professional working of respondent sampled are: the perception of other professional; the perception of interdependence; closeness of, the, other professional; and the frailty of client. Secondly, the factors that found to have the most significant effect on level of cooperation are: the perception of, the other professional; on-the-job training; evaluation-reward; and the closeness of the other professional.

• Child Health Nursing Research
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• v.24 no.4
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• pp.465-474
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• 2018

Purpose: The purpose of this study was to identify and describe health care providers' perceptions of family-centered care in pediatrics. Methods: A qualitative descriptive study was designed. Data were collected from individual interviews using open-ended questions. Fifty-six pediatric health care providers participated in the study from January to April 2015. Data were analyzed using qualitative content analysis to identify the major perceptions of pediatric health care providers. Results: The providers perceived that the concept of family-centered care has been incompletely implemented. Five themes (respecting a child's family, taking care of a child with the child's family, sharing information about children, supporting a child's family, a child's family participating in child care) with 11 sub-themes were identified in the providers' experiences with families. To achieve the goal of family-centered care in pediatrics, medical and nursing conditions must be improved, education about family-centered care must be provided, and improvements should be made in the mindset of health care providers regarding patients and in families' willingness to participate in care. Conclusion: The findings from this study provide insight into pediatric health care providers' perceptions of family-centered care. It will contribute to the establishment of a foundation for implementing family-centered care in pediatric nursing.