I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.
Objectives: The purpose of this study was to develop a community-based nursing center model that can provide health promotion for infants and toddlers as well as a research and practice site for nursing faculty and students. Methods: Review of current health care system and health promotion programs, and workshops with brain-storming were carried out to identify needy areas of services to be provided by the nursing center. Finally, the community nursing center model was developed through expert consultation and filed visits. Results: The services and programs were developed for infants and toddlers residing in Seoul area. These services and programs include growth and developmental screening, environment and health problem assessment, infant stimulation and parent education, and self-help group. Full-time and part-time staff nurses and nurse practitioners will provide those services and offer home visiting if needed. Database system, health information system, and trainers' training programs were developed as well. Conclusion: The nursing center model developed in this study will ensure clients direct access to nursing care and increase of autonomy and accountability of nursing practices. The nursing center model focused on disease prevention and health promotion will enhance the quality of life of the infants, toddlers and their families as well as to decrease national health care expenditure.
Journal of Agricultural Extension & Community Development
/
v.15
no.3
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pp.499-531
/
2008
Rural Traditional Theme Villages are one of the village-based businesses, which obtains excellent results. However, it also has brought negative results such as splits in locals due to income disparity, and ill-advised development which does not consider surrounding potential resources, etc. So, this study analyzes several problems of Rural Traditional Theme Villages, and proposes how Rural Traditional Theme Villages can be revitalized by benchmarking other successful cases. First, it is important to pursue differentiation of operating programs for Rural Traditional Theme Villages. Second, it is possible to give weight to elements which show efficiently rural atmosphere to enhance images of Rural Traditional Theme Villages. Third, expanding budget support and securing a new route for budget are definitely needed to cultivate self-growth capability of villages. Fourth, it is necessary to apply experts and facilities of local-based universities, cooperate with relevant organizations, and nurture local leaders by various means such as study in/visits to advanced regions at home and abroad and experts training. Localgovernment should be in charge of nurturing talented people. Fifth, it is necessary to reinvigorate rural economy by networking each Rural Traditional Theme Village, providing a wide range of information on diversified villages to people in cities, and promoting consumption. Moreover, securing immovable customers is important through networking city-rural exchange with city consumers and other organizations, and sisterhood relationship, membership businesses and events. As mentioned above, it is expected that Rural Traditional Theme Villages will be able to be developed continuously as a model for rural revitalization, which is stagnant, by expanding city-rural interchange.
Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.
Kim, Cho-Il;Lee, Yoon-Na;Kim, Bok-Hee;Lee, Haeng-Shin;Jang, Young-Ai
Nutrition Research and Practice
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v.3
no.3
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pp.171-179
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2009
Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in $NutriPlus^+$ aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the $NutriPlus^+$ in 2008.
In this paper, we propose an efficient seamless handoff scheme to minimize packet loss and unnecessary packets on the Internet using the peculiar mobility characteristics of public vehicles such as trains. MR (Mobile Router) in a train visits each AR (Access Router) in the fixed order. As the MR detects reachability to the NAR (Next Access Router) on the new link, the PAR (Previous Access Router) can directly deliver packets from MR's HA (Home Agent) to the NAR according to the HML (Handoff Mobile router List). Then. the NAR buffers them until the MR finishes L3 (Layer 3) handoff procedure with the NAR. Therefore, our scheme can support a seamless handoff without the packet loss and unnecessary packets on the Internet. The result of our performance evaluation has shown that the proposed scheme could provide excellent performance, compared with the NEMO basic support protocol and the Bi-casting protocol.
Abdullah, Matin Mellor;Mohamed, Ahmad Kamal;Foo, Yoke Ching;Lee, Catherine May Ling;Chua, Chin Teong;Wu, Chin Huei;Hoo, LP;Lim, Teck Onn;Yen, Sze Whey
Asian Pacific Journal of Cancer Prevention
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v.16
no.18
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pp.8513-8517
/
2016
Background: GLOBOCAN12 recently reported high cancer mortality in Malaysia suggesting its cancer health services are under-performing. Cancer survival is a key index of the overall effectiveness of health services in the management of patients. This report focuses on Subang Jaya Medical Centre (SJMC) care performance as measured by patient survival outcome for up to 5 years. Materials and Methods: All women with breast cancer treated at SJMC between 2008 and 2012 were enrolled for this observational cohort study. Mortality outcome was ascertained through record linkage with national death register, linkage with hospital registration system and finally through direct contact by phone or home visits. Results: A total of 675 patients treated between 2008 and 2012 were included in the present survival analysis, 65% with early breast cancer, 20% with locally advanced breast cancer (LABC) and 4% with metastatic breast cancer (MBC). The overall relative survival (RS) at 5 years was 88%. RS for stage I was 100% and for stage II, III and IV disease was 95%, 69% and 36% respectively. Conclusions: SJMC is among the first hospitals in Malaysia to embark on routine measurement of the performance of its cancer care services and its results are comparable to any leading centers in developed countries.
Objectives: Exposure to hazardous chemicals during pregnancy may result incritical reproductive health outcomes. Indoor residential levels are significant component of personal exposure. The collection of residential exposure data has been hampered by the cost and participant burden of health studies of indoor air pollution. This study utilized a participant-based approach to collect volatile organic compounds concentration from homes. Methods: Four hundred thirteen women were recruited from three major hospitals in Seoul and Gyeongi Provence and 411 agreed to participate. A passive sampler (OVM 3500, 3M, USA) with instructions were given to the participants, as well as a questionnaire. They were asked to deploy the sampler in their homes for three to five days and return them viapre-stamped envelope. Results: Three hundred forty six participants returned the sampler. Among the returned samplers, three hundred samplers satisfied our monitoring quality criteria. The success rate of the monitoring method was 73%. The geometric mean of TVOC level was 429(2) ${\mu}g/m^3$. The TVOC guideline of 500 ${\mu}g/m^3$ was exceeded in 38% of the houses. The residential VOC levels were significantly associated with remodeling of the house. Conclusions: The results suggested that a participant-based sampling approach may be a feasible and costeffective alternative to exposure assessment involving home visits by a field technician.
This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.
Kim, E.Y.;Kim, C.Y.;So, A.Y.;Shin, J.Y.;Lee, G.M.;June, K.J.;Choi, J.H.
Research in Community and Public Health Nursing
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v.15
no.1
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pp.18-28
/
2004
Purpose: The purpose of the study was to analyze the changes in functional status and caregiver burden after a community based case management program for stroke patients. Method: This study was designed as a one group pre and post test. A total of 61 stroke patients and their caregivers were sampled in three urban areas and two rural areas. Face to face interviews were conducted as a pre test one week before intervention, and a post test two weeks after intervention. The case management program consisted of four home visits and two telephone counseling sessions for assessment, education and providing information during the eight weeks. The collected data were analyzed with paired t test. Results: First, significant differences in functional status, and specifically mobility and cognition, were found between pre test and post test. Second, caregiver burden, in particular, objective burden was significantly decreased after 8 weeks. Third, the positive response for the services increased after 8 weeks. Conclusion: The community based case management program was effective to improve the functional status of stroke patients and to decrease the caregiver burden.
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