The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.
Park, Jeong-Yun;Park, Gong-Ju;Yoon, Soon-Duck;Chae, Hye-Seon;Han, Eun-Joo
The Korean Journal of Community Living Science
/
v.18
no.1
/
pp.3-20
/
2007
The purpose of this study was diagnosed to grasp the needs for the elderly-elderly care activity in rural areas. The research was conducted in questions and case studies in 7 farming villages. The major findings of this study as follows: First, the senior citizens in rural areas were not in good health, and the illnesses were revealed to be arthritis, high blood pressure, and diabetes. At the occurrence of an illness, they complained about the discomfort in doing daily life routines and expected eir spouses or offsprings to te care of them. Elders in the rural community responded that they had difficulty and financial problems in family maintenance. Leisure activities included watching TV, playing card/board games, or spending time without any specific activities. Second, recipients of elderly-elderly care expected to receive services from a woman in her 50s $1{\sim}2$ hours, once to twice a week. Third, the service providers wanted to be elderly-elderly care takers, hoping to work once a week for $2{\sim}3$ hours. They wanted the education for the elderly-elderly care to be once a week for 3 hours, with understanding the elderly, consultation, preventing senile dementia, and health as the contents.
Objectives : The aim of the study is to propose the fundamental data for further developments of the school dental clinic program through evaluating comprehensive improvements of the indices and the oral health status. Methods : This studied was carried out from December 2010 to September 2012. Subjects were 239 elementary school 4th, 5th, 6th grade students having no school dental clinic and 195 elementary school 4th, 5th, 6th grade students having school dental clinic in Busan. They completed self-reported questionnaires after accepting informed consent. The questionnaire included knowledges, attitudes and practices for oral health recognition and supports of the school dental clinic program. Results : Permanent tooth caries prevention rate revealed 59.0%, 53.3%, and 62.0%. in 4th, 5th, and 6th respectively. Rate of Care Group with fissure sealant permanent teeth showed 80.3%, 88.0%, and 88.9% respectively. Index of Care Group with fissure sealant permanent teeth revealed 2.68, 2.90, and 3.97, respectively. DMFT index of Care Group was 1.11, 1.35, and 1.51, respectively. Active D rate of Care Group resulted in 16.7%, 24.1%, and 16.7%, respectively. Dental health education group showed high awareness level of fluoride and sealant effect for caries prevention. Tooth brushing of three times per day was more effective when using rolling tooth brushing. On the other hand, oral health recognition and oral status in the control group was low. Conclusions : Oral health recognition was closely related to good oral care. Expansion of oral health care business is important to prevent dental caries. Systematic approach for oral health education programs and human resources development is very important to improve oral health care.
We use data from the Indonesian Family Life Survey (IFLS) to examine the relationship between child health and household economic resources, and find that economic resources as measured by equivalized expenditure have a statistically significant positive effect on child health and protect children from acute health conditions. We make additional use of the data (where extensive data on children's nutrition, household sanitation, the utilization of medical care, and family health status are available) to assess the mechanisms through which economic resources may affect child health. We find evidence that economic resources have a sizable and significant effect on these potential intermediary factors, and that they, particularly household sanitation, partly explain the protective role of economic resources in child health.
This study was purposed to find health promotion and care needs of the elderly in rural area of Korea. As the rural elderly are limited in accessibility to health care resources and could not immediately solve their health care needs when they need. health promotion and care services are expected to bring better and more practical solutions of their health care needs. Thus, the type of health care services to be developed in Korea rural area is discussed to have emphasis on health care service component in addition to health promoting components. Methods of this study was based on survey data analysis : total 322 persons aged older than 55 living at one 'Kun' in Korea administrative unit were interviewed by health workers working at the region and also get trained for this study data collection. The data collection interview was continued from February till May in 1996. The interview questions were modified with adjustment to Korea situation. with basis of the WHO's health promotion program components. The collected data were analyzed using SAS program for frequency, correlation, regressions. The major findings were as follows : (1) $74.8\%$ of the surveyed were sick at the survey time point. and $95.9\%$ known the diagnosis name of the disease. The most frequently complained diseases were Muscular-Skeletal diseases $(43.7\%)$. $34\%$ of those sick had never treated or discontinued therapeutic procedures. so that shown the necessity of systematic and usual health care services with health promotion program development for the elderly. (2) The percent of those who make social participation was $95.3\%$. and the activities were visiting neighbors $(70.4\%)$ and lack of qualified social activity programs. (3) $78.1\%$ of the surveyed had health counseling and education from professional health workers. Those ceased smoking and drinking were $59.6\%,\; 60.3\%$. respectively. Those had no application of therapeutic drugs or nutrion supplements was $40.7\%\;and\;94.1\%$ had regular meals. Those practiced exercises was low remarking $17.7\%$. (4) Positive health behaviors were better carried out by sick groups than by the healthier. except smoking. regular meals. and exercise. $17.5\%$ of sick group smoke more than one case of cigarettes. in contrast to $9.5\%$ of the healthier. (5) Mental health status was heathier among positive health behavior earners. Health counseling and education shown better score of mental health than those never counseled. (6) Positive health behavior practice frequency did not show significant differences when crossed by social activity participation status. (7) Health behaviors of the rural elderly people were carried out better when they had positive 'continuency in therapeutic procedure' 'health status'. 'familial relationship'. 'Health Status' of the rural olderly were explained by 'exercise'. 'drinking'. 'familial relationship'. 'activities of daily living'. Thus, health behaviors practice mutually interact with health status. In conclusion. the health promotion and care program component are recommended to include ation on the necessity of positive health promotion active social acitivities. pleasant life style, adaption into changes on the elderly, safety in residential area. community acitivity and resource utilization. etc .. in addition to the elderly's disability and sickness caring services.
Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.
Purpose: The study aim was to provide basic data needed for formulating systematic visiting nursing strategies by comprehending the characteristics and self-care ability of the object families of public health centers in Korea. Method: The research examined 252 families and 339 family members of the vulnerable class that were registered in a visiting nursing program of an urban public health center. The data of 220 families were analyzed using descriptive analysis, t-test, and ANOVA, after excluding any incomplete data. Result: 1. The most frequent characteristics of families were solitary families (52.8%) and financially vulnerable families (87.3%). The most frequent way of family detection was request of the community office. 2. The most frequent type of family problems were vulnerable families (93.2%), followed by patient families (91.0%). 3. The mean score was 11.67 for family self-care ability. 4. The variables of the number of family members, disease type of the patient family members, and the type of vulnerable family showed a significant difference of family self-care ability. Conclusion: This study suggests that vulnerable families demand specific nursing interventions focused on their own problems and that visiting nurses need to obtain and use supportive resources.
The Purpose of this study was to review the necessity of home care service for the handicapped. The Present momentum for home care for the handicapped become when the circulating rehabilitation service center for the handicapped was designated by the government in Korea. That was 1992. Home care service is a burgeoning segment of Korea health Service, driven by factors which include an expanding elderly population and increasing the disabled persons. To ensure quality of life for the disabled persons with diminishing financial resources allocated to health me, it is essential that community based rehabilitation and home care service be extended.
Purpose: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. Method: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a. 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). Result: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (Cl) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (Fl) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Conclusion: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
The Journal of Korean Academic Society of Nursing Education
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v.5
no.1
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pp.97-105
/
1999
Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.
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