• Journal of Hospice and Palliative Care
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• 제26권2호
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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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권5호
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• pp.263-269
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• 2020

Fibromyalgia is a syndrome characterized by chronic pain in the skeletal system accompanied by stiffness, sleep disturbance, fatigue, and psychiatric problems, such as anxiety and depression. Fibromyalgia commonly affects orofacial health, presenting with a variety of oral manifestations, including temporomandibular disorder, xerostomia, glossodynia, and dysgeusia. Therefore, oral healthcare providers need to be aware of this clinical entity to effectively manage oral symptoms and provide proper oral self-care modification and education on the nature of fibromyalgia. This review focuses on the epidemiology, pathophysiology, clinical manifestation, diagnosis, orofacial concerns, and treatment of fibromyalgia.

• 보건행정학회지
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• 제27권1호
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• pp.30-38
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• 2017

Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

• 근관절건강학회지
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• 제19권2호
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• pp.142-151
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• 2012

Purpose: This study was to explore the relationships among emotional labor, social support, job satisfaction, organizational commitment, and turnover intention in healthcare providers. Methods: Participants were healthcare providers (54 male and 328 female) with a mean age of 30.28 years old. Data analysis were done with PASW 18.0 for descriptive statistics and AMOS 5.0 for path analysis. Results: The hypothetical path model showed a good fit to the empirical data (${\chi}^2$=4.178, df=2, p= .124, GFI= .997, NFI= .995, NNFI= .987, RMSEA= .053). Emotional labor, job satisfaction, and organizational commitment had significant direct effects on turnover intention. Social support had a significant direct effect on emotional labor, job satisfaction and organizational commitment, and indirect and total effect on turnover intention. Conclusion: These findings suggest that turnover prevention or education programs for healthcare providers should include maintaining good mood when interact with patients or visitors with various negative moods in healthcare setting. Further strategies may need to resolve emotional labor, enhance job satisfaction and organizational commitment, and provide social support.

• 융합정보논문지
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• 제9권12호
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• pp.71-80
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• 2019

본 연구는 노인요양시설 간호제공자의 골다공증 관련 지식과 골다공증 예방활동을 파악하기 위한 서술적 조사연구이다. 연구대상자는 S시와 Y시의 노인요양시설 4곳에서 근무 중인 간호제공자 142명이며 자료 수집기간은 2019년 7월 1일부터 7월 20일까지이다. 연구 자료는 SPSS 24.0 Version을 이용하였으며 t-test, ANOVA, Pearson's correlation coefficient를 실시하였다. 연구결과, 간호제공자의 골다공증 관련 지식은 중간수준으로 간호제공자의 학력, 골다공증 관리 교육 경험, 입소자 수, 노인 뼈 건강 중요도 인식에 따라 차이를 보였으며, 골다공증의 예방활동은 골다공증 관리 교육 경험, 노인 뼈 건강 중요도 인식에 따라 차이를 보였다. 연구대상자의 골다공증 관련 지식과 골다공증 예방활동은 정적 상관이 있었다. 따라서 노인 요양시설 간호제공자의 노인 골다공증 관리와 노인 뼈 건강 중요도 인식을 향상시키기 위한 교육 프로그램의 개발과 그에 따른 교육이 필요하며, 향후 교육의 효과를 확인하는 추가연구가 필요하다.

• 보건행정학회지
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• 제12권2호
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• pp.92-114
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• 2002

While making a vigorous discussion about self-regulation for exponential growth of harmful health information on the Internet, many countries lave made various efforts to select and circulate high quality health information on the Internet. The purpose of this study Is to review the serf-regulation methods of health information on the Internet and to suggest quality control methods of health information on the Internet suitable for Korea. Self-regulation methods of the health information on the Internet include ‘content rating system(or content selection system)’, ‘codes of conduct or guideline’, ‘internet hot-line’, ‘education for information providers and consumers’. Any self-regulation method should be used with other methods. We can regulate health information on the Internet effectively by using both self-regulation methods and compulsive methods such as law. Also information providers, information consumers, specialists, consumer representatives, scholars, governments officers should take part in doing these efforts and make concern.

• 보건행정학회지
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• 제25권4호
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• pp.323-332
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• 2015

Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

• 대한간호학회지
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• 제47권5호
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• pp.663-675
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• 2017

Purpose: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. Methods: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. Results: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. Conclusion: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

• Child Health Nursing Research
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• 제22권2호
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• pp.126-136
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• 2016

Purpose: The purposes of this review were to address misconceptions of childhood fever and fever management practice among parents and health care providers, and to identify the scientific evidences against such misconceptions and practices. Methods: Journal databases and clinical guidelines from 2000 to 2015 were searched. The search terms were fever, fever management, misconception, myth, fiction, fact, fever phobia, child, antipyretics, tepid bath, alternating use/combined use of antipyretics, and physical cooling method. Results: There are significant gaps between current concepts and practices, and the scientific evidence. Misconceptions and unrealistic concerns about childhood fever still exist among parents and even health care providers, worldwide. The evidences suggest that antipyretics should be given carefully with the aim of relieving discomfort or pain rather than decreasing the temperature itself. Alternating use of antipyretics should be discouraged due to the risk of confusion and error. Antipyretics do not prevent febrile convulsions. Moreover, the scientific evidence does not support tepid sponge massage. Conclusion: Evidence-based childhood fever management interventions should be targeted toward parents and health care providers. By adopting an evidence-based approach to nursing interventions, pediatric nurses can ensure children receive appropriate and safe fever management.

• Journal of Preventive Medicine and Public Health
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• 제57권4호
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• pp.356-369
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• 2024

Objectives: The objective of this study was to explore healthcare providers' experiences in managing the coronavirus disease 2019 (COVID-19) pandemic and its impact on healthcare services. Methods: A qualitative study was conducted with 34 healthcare professionals across 15 districts in Bangladesh. Among the participants, 24 were health managers or administrators stationed at the district or upazila (sub-district) level, and 10 were clinicians providing care to patients with COVID-19. The telephone interviews were conducted in Bangla, audio-recorded, transcribed, and then translated into English. Data were analyzed thematically. Results: Most interviewees identified a range of issues within the health system. These included unpreparedness, challenges in segregating COVID-19 patients, maintaining isolation and home quarantine, a scarcity of intensive care unit beds, and ensuring continuity of service for non-COVID-19 patients. The limited availability of personal protective equipment, a shortage of human resources, and logistical challenges, such as obtaining COVID-19 tests, were frequently cited as barriers to managing the pandemic. Additionally, changes in the behavior of health service seekers, particularly increased aggression, were reported. The primary motivating factor for healthcare providers was the willingness to continue providing health services, rather than financial incentives. Conclusions: The COVID-19 pandemic presented a unique set of challenges for health systems, while also providing valuable lessons in managing a public health crisis. To effectively address future health crises, it is crucial to resolve a myriad of issues within the health system, including the inequitable distribution of human resources and logistical challenges.