Purpose: The purpose of this study was to analyze the effects of a case management program on range of motion, pain, depression and self efficacy in community-dwelling older women with knee arthritis. Methods: The research design was one-group pre and post-test design with 40 participants with knee arthritis who agreed to participate in the 12-week case management program. Data were collected four times, before and after 4, 8 and 12 weeks. Results: Repeated measures ANOVA revealed significant differences between before and after the service in range of motion, pain, depression and self efficacy. Significant improvements from the baseline to 4 weeks after the service were observed in the measurements of range of motion, pain, depression and self efficacy. There were no significant differences in range of motion, pain and depression between 4 and 12 weeks after the services. Conclusion: This study represents the first effort showing that a case management program can have positive outcomes on range of motion, pain, depression and self efficacy for older women with knee arthritis. More research using a control group pre-post test design considering time lapse is needed in order to examine more accurately the effects of case management programs for knee arthritis.
Purpose. This study compares and analyzes customer service on customer satisfaction and customer royalty on customer satisfaction targeting the customers visiting a hospital or a clinic which is franchised or not. And it aims at helping business rationalization for a medical institution. Methods. This paper conducts a survey and selects a sample of 670 customers except the missing value targeting the customers of 4 primary health care institutions and 4 bigger health care institutions in Seoul and Gyeonggi province. It conducts frequency analysis for the purpose of investigating the respondents' generic characteristic and factor of their medical institution selection, and factor analysis, reliability analysis and regression analysis for the hypothesis testing. Results. The first hypothesis testing result is significant in level of significance of 0.01. The second one is the same as the first one, but the dummy variable shows a negative regression coefficient(-0.479). The third one is significant in level of significance of 0.01, but the forth one is not significant. And the respondents prioritize website(Home page) and convenience in use of a hospital procedure for selecting a hospital or a clinic. Conclusions. The additional analysis finds that the franchised group has more satisfaction than none franchised group. But in case of their royalty, the average of franchised and none franchised groups are not significantly different. Therefore, the results of this paper reveal to support the results of the advanced researches.
The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.
The Journal of the Korean Institute of Forest Recreation
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v.22
no.4
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pp.23-33
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2018
The purpose of this research is to develop basic materials useful for the visiting management policies' establishment of national parks by analyzing the characteristics of and satisfaction with the visit to Hallyeohaesang National Park according to travel routes. For this, a total of 671 visitors to Hallyeohaesang National Park were recruited and field surveys were conducted three times in spring, summer, and fall from March to November 2017. The Hallyeohaesang national park's visitors were surveyed using a self-administered questionnaire about visitor characteristics (ex: motivation of visiting, travel routes, travel time, and participating activities, etc.) and satisfaction (ex: satisfaction with the visit, intention to revisit, and intention to recommend). SPSS 21.0 program was used for the statistical analysis: frequency analysis and independent-samples t-test analysis. As a result of analysis the motivation of visiting, those who visited only Hallyeohaesang National Park (a single destination) showed a mean value statistically significantly higher level in health improvement and vacation, relaxation, and healing compared to those who had visited or would visit other places along with Hallyeohaesang National Park (multi-destinations). Single destination visitors spent less time traveling from home to national park than multi-destinations visitors. Those who visited only Hallyeohaesang National Park (as a single destination) showed a mean value statistically higher satisfaction and intention to revisit and recommend. The results of this research have significance in providing basic materials to develop efficient park management policies by studying the characteristics of Hallyeohaesang National Park visitors.
The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.
Objectives: This study examined the nutritional status according to frailty status in the elderly at home. Methods: The participants were a total of 76 elderly at home living in Seo-gu, Gwangju, Korea. The nutritional status and frailty status were analyzed using the Nutrition Quotient for Elderly (NQ-E) and the Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight Scale (K-FRAIL), respectively. Results: The distribution of frailty status was robust (17.1%), pre-frailty (38.2%) and frailty (44.7%), and its distribution was significantly different in genders, age groups and the number of medications. The mean NQ-E score was 47.0 for total subjects, indicating a low grade. The scores of balance, diversity and dietary behavior factors were within the low grade, while the score of the moderation factor was within the medium-high grade. According to the frailty status, pre-frailty and frailty showed significantly higher scores for sugar-added beverages intake in the moderation constructs than robust. Robust showed significantly higher scores for the exercise hours and perception level for one's health than pre-frailty and frailty. Conclusions: These results suggest that nutrition status is associated with frailty status. Regular nutrition education and visiting nutrition service should be established to improve the balance and diversity of food intake and improve the dietary behavior of the elderly at home.
Kim, Chang-O;Lee, Heeyeon;Ho, Seung Hee;Park, Hyunsuk;Park, Chulwoo
한국노년학
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v.30
no.4
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pp.1293-1309
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2010
This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.34
no.1
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pp.112-135
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2021
Objectives : To report a case of drug-induced xerostomia treated with Integrative Korean Medicine Visiting Care Service of a Public Health Center. Methods : Home visit treatment and telemedicine were provided by public health doctor(Korean medicine doctor) for person with physical disability who were diagnosed with Behcet's Disease. Palmul-tang(PMT) soft extract was provided steadily 3 times a day for 6 months, and acupuncture, electro-acupuncture, and electro-moxibustion were provided irregularly 6 times for 6 months. Yin-deficiency questionnaire(YDQ), oral health impact profile-14(OHIP-14), oral pain visual analogue scale(VAS), and xerostomia inventory(XI) were used 3 times(baseline, intermediate and termination) to evaluate the changes. Results : YDQ decreased from 620 to 375, OHIP-14 decreased from 34 to 6, VAS decreased from 70 to 40, and XI decreased from 44 to 34. Four scales all gradually decreased. Conclusions : Integrative Korean Medicine Treatments in health insurance including PMT soft extract through home visit treatment can improve drug-induced xerostomia and Quality of life(QoL) of person with disabilities.
The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.
The purpose of this study was to investigate and compare health, medical and welfare service providers' and local residents' perception on community care. The participants were 68 service providers and 95 local residents. The data were analyzed using independent t-test and chi-square test. The results showed that the degree of agreement of service providers on the need for policy, and visiting services were higher. Service providers' ability to link local residents with a need for care to community resources was higher, but in the activation of self-help group in community, local residents agreed more. In add budget of policy to health insurance, local residents agreed less. In perception on priority for community care policy, high priorities were preparation of financial resources and care culture. To effectively operate community care policy, it is necessary to establish a care culture through active exchanges for reducing differences in policy and opinions of recipients.
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