• Title/Summary/Keyword: Health planning

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Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study

  • Hyosin Kim;Signe Peterson Flieger
    • 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.

An Analytic Study on factors Affecting the School Nurse's Activities in Daegu City and Kyungpook Province (대구.경북지역 일부 양호교사의 업무수행에 미치는 요인분석)

  • Gwak, Oh-Gae
    • Research in Community and Public Health Nursing
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    • v.1 no.1
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    • pp.503-517
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    • 1989
  • This study is to analyze factors affecting the school nurse's activities. The survey was undertaken during Sept. 1-Nov. 30, 1986. The subjects were 137 school nurses from elementary, junior-high, and senior-high schools in Daegu City and Kyungppk Province. The results are as follows: 1. Correlational findings between school nurse's self-confidence and their general characteristics 1) Program Planning & Evaluation: Health Experinece(r=-0.1803, p<0.05) Salary Step(r=-0.1741, p<0.05) 2) Clinic Management: Salary STep(r=-0.2580, p<0.01) 3) Health Education: Salary Step(r=-0.1929, p<0.05) 4) Management of School Environment: Salary Step(r=-0.2501, p<.05) 5) Health Care Services: Health Experience(r=0.1901, p<0.05) Salary Step(r=-0.2424, p<0.05) 2. The degrees of school nurse's self-confidence(high: 4 point, low: 1 point) 1) Clinic Management: 2.92 2) Health Education: 2.86. 3) Program Planning & Evaluation: 2.74 4) Health Care Services: 2.73 5) Management of School Environment: 2.67 6) Operating of School Health Organization: 2.42 3. Significances to self-confidence on school nurse's activities 1) Program Planning as Evaluation: Expending Times for Health Care Services (r=-0.2262, p<0.05) Expending Times for Health Education (r=0.2943, p<0.05) Size of Clinic(r=0.2163, p<0.05) Location of Clinic(t=2.43, gH0.047) Use of Clinic(t=2.06, p<0.007) 2) Clinic Management: Location of Clinic (t=3.36, p<0.010) 3) Health Education: Purchase of Medicine(r=-0.1736, p<0.05) No, of Classes (r=-0.1794, p<0.05) (4) Management of School Environment: School Health Budget(r=0.1731, p<0.05) Home Message(r=0.1805, p<0.05) Location of Clinic(t=4.46, p<0.0001) 5) Operating of School Health Organization: School Health Budget(r=0.1878, p<0.05) Use of Clinic(t:1.90, p<0.018) 6) Health Care Services: School Health Budget(r=1.90, p<0.018) Expending Times for Health Education(r=0.2577, p<0.05) Size of Clinic(r=0.4336, p<0.001) Location of Clinic(t:5.10, p<0.001)

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A Study on the Factors which influenced the Performance of Community Health Practitioners' Function -Around the CHPs in Kyonggi-province Area- (보건진료원 직무수행에 영향을 미치는 요인에 관한 연구 - 경기도 관내 보건진료원을 중심으로 -)

  • Lee Myoung-sook
    • Journal of Korean Public Health Nursing
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    • v.3 no.1
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    • pp.18-37
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    • 1989
  • This study was done in order to analyze the factors which influenced the performance level of community health practitioners' task. Interview survey was done during the period from August to October, 1986. Interviewee were 166 CHPs among total of 217 CHPs in Kyonggi province area. Multiple stepwise regression and canonical correlation analysis were used to identify major factors influenced to perform community health practitioners' task. The results of this study were summarized as follows: 1. General characteristics of CHPs 1) Personal characteristics The average age of CHPs was 37.8 years and their marital status was $77.6\%$ of married, educational back-ground was $65.3\%$ of junior college graduation. Their job career was $38.6\%$ of between 1-3 years, $33.3\%$ of between 3-5 years, $22.2\%$ of less than 1 years. Most of CHPs$(62.8\%)$ were fully satisfied with their job, $33.3\%$ were moderately, and $3.8\%$ were not satisfied. 2) Working environmental condition Only $31.7%$ of CHPs were satisfied with their working condition of primary health post, $26.6\%$ were not satisfied. Half of CHPs$(52.5\%)$ replied having good cooperation with health center, $10.1\%$ replied bad. Cooperation with health subcenter was good in $32.9\%$, and bad in $21.9%$. Cooperation with private health institutions was good in $34.2\%$, bad in $21.6%$. 2. Performance level of community health practitioners' task Among a total of 52 contents of their functions medical history taking. physical examination, referral of diagnostic laboratory work-up($(86.4\%)$, health assessment of pregnant women$(82.1\%)$, development of health information system$(79.4\%)$, supervision of health workers $(78.4\%)$, follow-up of family planning acceptors$(77.3\%)$, and follow-up of family planning acceptors' side effects$(77.3\%)$ were actively performed. Diagnosis of pregnancy$(62.1\%)$, sampling of drinking water for quality test$(52.5\%)$, making list of equipment' & supplies $(51.5\%)$, evaluation of primary health post activities $(37.6\%)$, organization of village health workers$(32.4\%)$ and management of village health workers $(30.1\%)$ were poorly performed. 3. Stepwise multiple regression analysis of job function The factors which influenced the performance level of community health practitioners' function were age, marital status, educational level, job career, job satisfaction, satisfaction of working environment of primary health post, cooperation of health center, cooperation of health center, cooperation of private health instiutions in orders. These 9 variables were able to explain job function from $25.7\%$ of program planning to $6.7\%$ of management of common disease. 4. Canonical correlation analysis between the performance of function and general characteristics of CHPs. Cooperation of private health institutions was found to be the factor influencing task performance of community organization, management of primary health post, technical supervision of health personnels. Job satisfaction of CHPs was also found to be the factor influencing task performance of family planning, management of common disease and maintenance of health information system.

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Human Cases of Fascioliasis in Fujian Province, China

  • Ai, Lin;Cai, Yu-Chun;Lu, Yan;Chen, Jia-Xu;Chen, Shao-Hong
    • Parasites, Hosts and Diseases
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    • v.55 no.1
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    • pp.55-60
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    • 2017
  • Fascioliasis is a foodborne zoonotic parasitic disease. We report 4 cases occurring in the same family, in whom diagnosis of acute fascioliasis was established after series of tests. One case was hospitalized with fever, eosinophilia, and hepatic lesions. MRI showed hypodense changes in both liver lobes. The remaining 3 cases presented with the symptom of stomachache only. Stool analysis was positive for Fasciola eggs in 2 adult patients. The immunological test and molecular identification of eggs were confirmed at the National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China. The results of serological detection were positive in all the 4 patients. DNA sequencing of PCR products of the eggs demonstrated 100% homology with ITS and cox1 of Fasciola hepatica. The conditions of the patients were not improved by broad-spectrum anti-parasitic drugs until administration of triclabendazole.

Coverage of Entry-Level CHES Responsibilities and Competencies Developed in the United States by Health Education-related Professional Preparation Programs in Japan

  • Sakagami, Keiko
    • Korean Journal of Health Education and Promotion
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    • v.23 no.5
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    • pp.75-97
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    • 2006
  • This study assessed 1) the coverage of the entry-level responsibilities and competencies for certified health education specialists (CHES) developed in the United States (U.S.) by 140 current health education-related professional preparation programs in Japan, and 2) barriers and concerns related to the development of Japanese health educators. A cross-sectional survey study was conducted to Japanese professors teaching health education-related courses at 4-year universities/colleges in Japan. All entry-level CHES responsibilities and competencies were generally covered to different degrees by the study respondents. The top 3 responsibilities most emphasized by the respondents were Responsibilities I, related to need assessment skills, Responsibility II, related to planning health education programs, and Responsibility III, related to implement health education programs. The 3 competencies most frequently covered by the respondents were related to needs assessment skills (Competencies 1-3). The competencies least covered by the respondents were those related to Responsibilities V (Competencies 1619). Other competencies related to role modeling, cultural competencies, and planning youth health education programs, were recommended. In addition, the major concerns and opinions that the respondents reported for this topic pertained to 1) Professional training, 2) The need for well-defined professional roles, and 3) The importance of licensing. The results suggested that Japanese health education-related programs cover all CHES responsibilities and competencies developed in the U.S. to different degrees. However, they tend to focus more on needs assessment, planning and implementing health education programs. Although possible responsibilities for future Japanese health educators were recommended, further research to identify the most appropriate responsibilities and competencies for this profession is needed. Major barriers, concerns and opinions reported by the respondents should be discussed at future meetings for this profession.

The Effects of Discharge Planning for the Elderly with Pulmonary Disease in the Emergency Room (퇴원계획중재가 응급실 내원 호흡기 질환 노인의 퇴원준비도, 간호서비스 만족도, 재입원율에 미치는 효과)

  • Kim, Hyeon-Ju;Park, Yeon-Hwan
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.24-32
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    • 2014
  • Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

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An Analysis of School Health Education Patterns and Related Factors in Korea (학교보건교육 수행실태 및 영향요인분석)

  • Kim, Young-Im;Ahn, Ji-Young
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.85-95
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    • 1999
  • The objectives of this study are to explain the performance patterns of health education and related factors in elementary middle, and high schools in Korea. The survey data were collected by questionnaires from June to September in 1998. the number of subjects were 294 school nurses. The SAS-pc program was used for statistical analyses such as percent distribution, a $x^2-test$, a Spearman correlation est., and logistic regression analysis. The major results were as follows: 1. The performance rates of health education by elementary, middle and high schools was higher than before. But the education time was not as sufficient as desired. 2. Planning and practice for health education in elementary and middle schools were high. The preparation of the instruction for health education in elementary school was especially strong. 3. The need survey for health education was low '-' 32~46%. The performance rates of health education increased yearly in elementary school. 4. The reference data were insufficient for health education; In other words, it was difficult for a systematic education. 5. Usually lecture and other methods were used. 10-15% used only the lecture method. 6. The content of heath education was life style in the lower levels of elementary school, Drinking, smoking, drug use etc. were concentrated on in middle and high school. 7. The education evaluation and application was activated in elementary school, otherwise, was low in high school. 8. School nurses and school performance in health education were influenced significatly by planning of health education and the instruction of heath education in elementary school. In the case of planning, the budget was a significant variable; in the case of instruction, the number of school classs was significant. In conclusion, these findings suggest that a developed health education curriculum be performed gearly in order to create a systematic school health education. Also, it is necessary to activate an evaluation to system measure behavioral changes. It is expected that the improvement of school health education be accomplished through the systematic support of schools by government in the physical, economi, and psychological areas.

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Survey on the Sodium Contents of Nursery School Meals in Gyeonggi-Do (경기도지역 어린이집의 단체급식 중 나트륨 함량 실태조사 연구)

  • Jung, Hong-Rae;Lee, Myung-Jin;Kim, Ki-Cheol;Kim, Jung-Boem;Kim, Dae-Hwan;Kang, Suk-Ho;Park, Jong-Suk;Kwon, Kwang-Il;Kim, Mee-Hye;Park, Yong-Bae
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.526-534
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    • 2010
  • The prevalence rate for chronic diseases such as obesity, diabetes, hypertension etc. caused by the increment of national income and the change of food life according to the globalization in Korea have been increased. Especially excess sodium intake may contribute to the development of hypertension, increasing cardiovascular disease risk. The objective of this study was to investigate sodium intake of nursery school meals in Gyeonggi-Do, and to construct database for lesser sodium intake policy. Survey consisted of 601 sample intakes of sodium in summer and in winter. A food weighed record method was used for measuring food intakes. Average intakes of ten children per nursery school were measured. The sodium contents of meals were analyzed by ICP-OES (inductively coupled plasma-optical emission spectrometer) after acid digestion by microwave. The sodium contents on food groups showed that sources (693 mg/100 g), grilled foods (689 mg/100 g) and kimchies (643 mg/100 g) had respectively higher sodium contents and the average sodium intake per meal was $582\pm204$ mg. The sodium contents of soups & hot soups and kimchies had 37.5% and 15.8% of total sodium intakes per meal, respectively. Sodium intakes per meal in summer and winter showed 572.3 mg and 592.3 mg, respectively. Regional ranking of sodium intakes showed the ascending order of apartment (514.3 mg/meal), rural region (540.5 mg/meal), multiplex house (635.9 mg/meal) and industrial complex (696.4 mg/ meal). A habit of excessive sodium intakes in childhood will threaten their health when they grow up to be adults; thus lesser intake of sodium per meal is needed for children in nursery school.

A Basie Health Survey of the Yonsei Community Health Service Area, Seoul (연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査))

  • Yang, Jae-Mo;Kim, Myung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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