• 한국농촌간호학회지
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• 제12권2호
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• pp.29-44
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• 2017

Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

• 지역사회간호학회지
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• 제23권2호
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• pp.179-188
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• 2012

Purpose: This study aimed to describe the cultural competence among community health practitioners (CHPs). Methods: A cross-sectional descriptive study design was used with a convenience sample of 257 CHPs. Data collection was conducted with a structured questionnaire, including Cultural Competence Assessment. Data were analyzed by t-test and ANOVA with the SPSS/WIN 17.0 program. Results: Most participants reported a moderate level of cultural competence (M=3.0,SD=0.41). Scores for culturally competent behaviors were high (M=3.4, SD=0.48) and cultural knowledge scores were low (M=2.6, SD=0.54). Those CHPs who were living with their family, were working in rural area, and had more opportunities to contact with multicultural patients and experience abroad showed significantly higher cultural competence. Conclusion: The findings support the need for future education and training to enhance CHPs' cultural competence.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(역학)
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• pp.7-11
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• 1994

Twenty years ago, the American Journal of Epidemiology published David Sackett's brief description of. clinical epidemiology and its practitioners [1]. This commentary was a useful focal point for an emerging discipline. By 1983, with clinical epidemiology already thriving in many academic medical centres, Walter Holland called into question both the term, 'clinical epidemiology', and the nature of the discipline [2]. More recently, clinical epidemiology has drawn strong criticism from John Last, a noted academician whose contributions include the editorship of the Maxcy-Rosenau Textbook of Public Health. Writing in the Journal of Public Health Policy in 1988 [3], Last referred to the 'uncritical enthusiasm' for clinical epidemiology in medical schools as 'a danger to health', and staked. a claim to the term 'epidemiology' as appropriate only to the description of what classical or population epidemiologists do. Faced with such views, practitioners and proponents of clinical epidemiology can respond in three ways. They can ignore the criticism, and go on about their business. They can reaffirm their differences and resort to defensive rhetoric. Or, the critique can become an opportunity for reflection about the nature of clinical epidemiology and its relations with sister disciplines in modem medical schools. The latter course is followed here by four physicians who-despite diverse backgrounds and interests-all consider their work to be in the field of clinical epidemiology.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권2호
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• pp.284-310
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• 2024

Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.

• 셀메드
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• 제5권4호
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• pp.23.1-23.6
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• 2015

Complementary and alternative medicine (CAM) practice is still popular among the Malaysian population nowadays although western or allopathic medicine is the first line of treatment. Dissatisfaction with health services and therapeutic effects of western medicine or preference for holistic, integrative approach in treatment are common reasons favouring the increasing popularity of CAM practices. The efforts toward integration of CAM and western medicine in Malaysia were rather slow and in a piece-meal fashion. Strategic efforts in strengthening government and self-regulation among practitioners, formalizing education, promoting research, and cultivating national and international networks are necessary to achieve an integrative system. Regulations to restrict the practice and sale of CAM products to licensed practitioners, strict and mandatory registration of the practitioners, inclusion of CAM in essential medicines list, and pricing regulations must be comprehensively discussed. Development of curriculum, offers of scholarship and incentives, promotion of courses and seminars for professionals is necessary to increase the numbers of CAM experts. Malaysia should follow the efforts of other countries on the production and documentation of local CAM data, allocation of funding, and establishment of research centres to assess the efficacy of potentially useful local products. Local and international collaboration in research and continuous education is important for exchange of knowledge and skills. In conclusion more coordinated efforts in regulation of CAM practice and products, formalizing CAM training and education would significantly move the process forward and allow the public to enjoy more health benefits from CAM practice in Malaysia.

• 한국보건간호학회지
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• 제16권2호
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• pp.378-387
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• 2002

This study was conducted to investigate the degree of PSI (self-evaluative awareness of problem solving ability) in PMHNP (psychiatric mental health nurse practitioners) and to identified the factors predicting problem solving ability of them, in order to provide basic data for the development of the specific education programs to improve problem solving ability. Data was collected from 355 subjects who have the certificates of PMHNP working in hospitals and public centers. Chun Seok Kyun's instruments (1993) based on the Heppner and Petersen's Problem Solving Inventory (1982) was used to determine PMHNPs' PSI. The results were as follows; 1. The average score of PSI of PMHNP was $2.81\pm0.23$. Of the three factors. there marked the lowest score in the factor 3. personal control $(2.56\pm0.43)$, and the highest score was in the factor 1. problem-solving confidence $(2.95\pm0.34)$. 2. The differences in PSI were significant for degree of education and career in psychiatric settings (p=0.000l, p=0.0187). 3. Job satisfaction was the highest factor predicting PSI of PMHNP$(17.9\%)$. When degree of education, career in psychiatric setting and marital status were added, the total predictors explained $24.3\%$. As a result, it is necessary to conduct further research in relation to the problem-solving process, the development of education program. skill acquisition and measurement of problem solving in nursing practice.

• 한국간호교육학회지
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• 제21권1호
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• pp.141-149
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• 2015

Purpose: This study was carried out to describe the process and evaluation of a critical thinking class for new community health practitioners. Methods: The case study design was used to develop and evaluate a critical thinking class for 46 participants in the community health practitioners training program. The class was held two hours a week for 8 weeks. Critical thinking disposition was tested before and after the class and critical skill was graded according to the final test score. Data analysis was performed using descriptive statistics and paired t-tests using SPSS WIN 20.0. Results: Clinical critical thinking competences were identified through the literature review. The case situations with questions guiding the problem-solving process were developed and used for group discussion. Critical thinking disposition of participants was determined to have increased slightly after having taken the class. 17.4% of the participants had a competency level high enough to solve a problem and half of them stayed at the level of understanding of critical thinking. Compared with the class's satisfaction with the relevance to their jobs, the satisfaction with the learning method and instructor was high. Conclusion: The findings of this research will serve as the basis for developing critical thinking classes for community health nurses in order to improve their critical thinking competence.

• 한국농촌간호학회지
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• 제3권1호
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• pp.24-33
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• 2008

Purpose: To analyze health programs of the PHCP (Primary Health Care Posts) Method: From August 2006 to July 2007, data on the general quality and health program of the PHCP was requested by official letter and replies were received via E-mail. From December 8 to December 30, 2007, data from 1,268 (66.8%) PHCP out of 1,897 PHCP were analyzed using SPSS 12.0 Win program. Results: The average population covered by each PHCP is 878.3 people. For the health and special programs, Community Health Practitioners report high motivation for programs on health promotion, management of chronic illness, social welfare (40-50%). Demand by the residents was reported at 10% and increases in the health of the residents were attributed to high interest and demand. Volunteer work was 83.3% for bathing, 54.5% for equipment support and 46% for exercise programs. As elders make up 30% of the population in rural areas, there is an increasing demand for volunteer work in bathing programs. Conclusions: As the number of elders in the population increases and there is an increased need for more medical treatment for older people who are sick, the role of PHCP must be strengthened to include visits to homes of community residents. Where financial support for the PHCP is difficult, it is necessary to develop sound data on demographic characteristics of the population in order to develop efficient and effective health promotion programs. The finding that 54.7% of the population need management of chronic illness has difficulty in seeing a physician indicates a need to enhance the health care delivery system by strengthening the role of the Community Health Practitioners and including them in the civil service system to ensure stability of the PHCP.

• 한국보건교육건강증진학회:학술대회논문집
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• 한국보건교육건강증진학회 2001년도 제4회 국제학술 심포지움
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• pp.91-111
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• 2001

Background: Alcohol and tobacco use are two major behavioral risk factors implicated in increased morbidity and mortality. Since both substances are widely used in Korea, a concerted effort is currently underway to reduce the use of tobacco and alcohol in Korea. Objectives: Efforts directed toward educating health promotion planners and health educators from local health departments to organize and implement health education programs to reduce the proportion of people smoking and excessive drinking in the community. Methods: A training guide on prevention of smoking and excessive drinking has been developed. Comprehensive multi-media health promotion materials were developed based on health behavior theories and strategies for effective health behavioral interventions. To better control of behavioral risk and promote health enhancement, the materials were developed to introduce a user-oriented developmental approach by making messages more persuasive and organizing content in a user-friendly manner. Sections of the report explain theoretical background of the intervention, choosing goals and a target population, specific program activities to include in an intervention, development, organization, methods of making program content vivid and persuasive, and evaluation,. Implications for Practitioners: The process followed in developing the health intervention materials is described in detail to assist practitioners who need to develop effective programs to reduce the use of tobacco and excessive alcohol. Health educators from all local health departments in the country were trained in the use of the materials, to enable them to develop community interventions to reduce smoking and excessive drinking.