• Title/Summary/Keyword: Integrated Health Care

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A Concept Analysis of Therapeutic Intervention in Nursing (간호학에서 치료적 중재(therapeutic intervention)에 대한 개념분석)

  • Jin, Hye Kyung;Kim, Moon Ja;Lee, Eun Nam
    • Journal of muscle and joint health
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    • v.26 no.1
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    • pp.1-14
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    • 2019
  • Purpose: This concept analysis was done to clarify therapeutic intervention in nursing. Methods: For this study the process of Walker & Avant's concept analysis was used. Twenty-nine studies from electronic data bases met criteria for selection. Results: Therapeutic intervention can be defined by the following attributes: 1) goal-oriented, 2) forming a therapeutic relationship, 3) reinforcement of coping ability, 4) patient-centered, 5) a holistic integrated approach. The consequences of therapeutic intervention were improvement of quality of life, coping skills, self-care. Conclusion: Attributes of therapeutic intervention identified in this study can be applied to develop tools for measuring therapeutic nursing behaviors or to develop therapeutic nursing intervention programs for patient or family.

Suffering and Hospice Care (고통과 호스피스 케어)

  • Kim, Myung-Ja;Jung, In-Sook
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.21-28
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    • 2007
  • Although hospice care includes palliative care technology in terminally ill person for pain, it is much more holistic including emotional, spiritual and other life dimension. Human suffering that experiencing the hospice client must be reconsidered whether one starts with an objective side or a subjective side of suffering, the strategies about the expanded consciousness is important. In the hospice caring perspectives, the body, mind and spirit are integrated so the objectivity and subjectivity can merge; the extended awareness with inner resource or energy, and the positive thinking about the God is meaningful especially dying person, family member, and the hospice team.

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Approach Toward Integrated Curriculum for Dental Hygienist (치과위생사 통합교육과정을 위한 접근)

  • Hwang, Mi-Yeong
    • Journal of Korean society of Dental Hygiene
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    • v.3 no.1
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    • pp.59-72
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    • 2003
  • The purpose of this study was to examine what the role of denial hygienist was. The subjects were 751 dental hygienists from dental clinics, dental hospitals, general hospitals, public dental clinics and their branches throughout the nation. After a survey was conducted, the collected data were analyzed with SPSS WIN 10.0, and variance analysis and post-analysis were implemented. And Forgarty's 8th integrated model, out of 10 ones, was selected to delve into the practical role of dental hygienist in detail. The findings of this study were as follows: 1. The three age groups had a significantly different opinion on the significance of individual subjects. The dental hygienists of thirty six and over found the basic and preventive public dental care courses most important, and the 31~35 age group placed most stock in education and research. Overall, the post-analysis results showed that prevention and clinical courses were considered most vital, followed by education and fundamental courses. 2. There was a significant gap between four groups from the different work places in their view of the weight of the individual subjects. According to the post-analysis, the dental hygienists from the general hospitals, public dental clinics and their branches gave more weight to fundamental, education and research areas. Those who were with the dental clinics, dental hospitals and general hospitals put higher value on clinical course than the dental hygienists from the public dental clinics and their branches. 3. Two groups with a different career also had a different outlook on the importance of the individual subjects. The post-analysis results illustrated that the dental hygienists who had worked for three years or more put higher stress on the fundamental course than those with a less career, and the dental hygienists with a five-year or higher career attached more importance to the education and research field than those with a smaller career. 4. There was a significant difference between the three age groups in their clinical role. The post-analysis results indicated thai the younger dental hygienists were more of assistants than of professionals, as they chiefly took X-ray photograph, handled treatment materials or performed treatment-related works. Overall, handling treatment materials was most common. 5. The three groups from the different work places significantly varied in their clinical role. According to the post-analysis, those from the dental clinics and dental hospitals took more x-ray photographs, handled more treatment materials and performed more relevant works, compared to those from the general hospitals, public dental clinics and their branches. 6. The two groups with a different career differed significantly in their clinical role. The post-analysis results suggested that the dental hygienists with a less career played an assistant role more, which handled treatment materials or carried out other relevant works. 7. The fundamental courses (I) and (II), preventive class (I) and (II) and its practice course were regarded as integrated subjects that they should take 10 offer preventive treatment, which was one of the dental hygienist missions. What's needed to act as dental-care educators was the basic courses (I) and (II), dental hygiene education and its practice. Finally, integrated clinical courses (I) and (II) and clinical practice were viewed as necessary for their role performance as dental treatment collaborators.

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The Development Process and the Contents of the Self-management Education Program Integrated with Exercise Training (HAHA program) for Older Adults with Chronic Diseases (만성질환 노인을 위한 운동교실 통합 자기관리교육 프로그램(하하프로그램)의 개발과정과 내용)

  • Kim, Seon-Ho;Song, Mi-Soon;Park, Yeon-Hwan;Song, Wook;Cho, Be-Long;Lim, Jae-Young;So, Wi-Young
    • Journal of muscle and joint health
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    • v.18 no.2
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    • pp.169-181
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    • 2011
  • Purpose: This paper presents the development process and the final contents of the sellf- management education program integrated with exercise training (Healthy Aging Happy Aging, HAHA program) for community residing older adults with chronic diseases. Methods: The program evaluation methodology was applied which is an interactive program development process based on needs assessment, formative evaluation, process evaluation and outcome evaluation. The program was developed and revised while the program was implementing to 22 hypertension (HT) and 32 diabetic (DM) participants. Results: The final program has two sub-programs for HT and DM participants utilizing self-efficacy resources. They share four common components; 1) health screening of exercise risks, 2) weekly 1-hour group self-management education classes, 3) biweekly 1-hour group exercise training and 4) a mid-term individual counseling. Both sub-programs were 12-weeks long but have different education and exercise contents. Participants-rated mean satisfaction scores were 3.47/4 and 3.61/4 for HT and DM program respectively. Attendance rate were 83.1% ~ 92.3% for the classes. Conclusion: The HAHA program developed by multidisciplinary team which reflected participants needs was accepted well by participants evidenced by high attendance rate and perceived satisfaction level.

Rearranging Everyday Lives among People with Type 2 Diabetes in Korea

  • Yi, Myungsun;Koh, Moonhee;Son, Haeng-Mi
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.703-711
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    • 2014
  • Purpose: The purpose of the study was to understand what are the experiences and management of type 2 diabetes in everyday lives among Korean people. Methods: A grounded theory method was utilized to explore how people with type 2 diabetes to experience and manage their disease under the Korean socio-cultural context. The data were collected via narrative in-depth interviews with 21 people with type 2 diabetes during 2010-2011 and all interviews were transcribed for verbatim analysis. Results: The core category was 'Rearranging everyday lives by accepting diabetes as lifelong annoying companion.' Four stages were identified: ignoring; struggling compromising and conciliating. Each stage illustrates major problems and/or strategies that the participants face in dealing with diabetes. The process illustrates the transference from their ordinary life, in which diabetes or health was ignored, to the health-oriented life, within which diabetes is integrated into their lives. The most difficult barriers they faced in everyday lives include social stigma of diabetes and collectivistic culture in Korea. Within the culture, the group goals are concerned over individual ones, making it harder for the participants to take care of their own health. Conclusion: The findings of the study imply that health care professionals may consider the influence of social stigma in caring diabetic patients. Also, the intervention study is warranted to educate Korean people with diabetes to get aware of the sociocultural context and stigma as well as personal difficulties in self-caring diabetes.

An Analysis of Nursing Behavior and Unit of Treatment Cost of Non- Insurance Patients (종합병원의 비보험환자 처치행위 양상과 수가분석에 관한 연구)

  • 오세영
    • Journal of Korean Academy of Nursing
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    • v.10 no.1
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    • pp.41-55
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    • 1980
  • The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 %. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ₩22,650 while its daily average was ₩2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(₩10,880) and next in neurologic cases(₩ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (₩5,200) and integrated (₩5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

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Development of Clinical Pathway and Analysis of Clinical Patterns for Optimizing the Integrative Medical Service (양.한방 협진 의료서비스 최적화를 위한 Clinical Pathway 도입과 진료패턴 분석)

  • Oh, Ka-Eun;Bak, Won-Sook;Yang, Hyung-In;Han, Sang-Sook;Yoo, Myung-Chul;Park, Sang-Chan;Lee, Sang-Chul
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.16 no.2
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    • pp.23-32
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    • 2012
  • Objectives : The purpose of this research is to develop the clinical pathway for optimizing the integrative medical service (oriental-western integrated medical service) and to analyze the clinical pattern of the integrative patients who received the oriental-western integrated medical service. Methods : This research developed the clinical pathway by interviewing with doctors, nursing and experts at K Medical Center. To analyze the clinical patterns, this research used 860 integrative patients and 6345 non-integrative patients at K Medical Center since 2007. Results and Conclusions : 1. We developed the clinical pathway for optimizing the integrative medical service. 2. Comparing the clinical pattern of the integrative patients with the non-integrative patients, the results indicated that the interval and frequency of the integrative patients is shorter than that of the non-integrative patients. 3. Comparing the medical treatment type, the integrated patients take much more medical care and more frequently participate in medical treatment. 4. In conclusion, it is different that the clinical pathway of the integrative medical service from the non-integrative medical service and the integrative medical treatment is more effective than the non-integrative medical treatment.

Concept Analysis of Health Insensitivity using Hybrid Model (Hybrid model을 이용한 건강불감증의 개념분석)

  • 이동숙;이은옥
    • Korean Journal of Health Education and Promotion
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    • v.20 no.3
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    • pp.145-170
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    • 2003
  • The purpose of this study was to clarity the concept of health insensitivity using Hybrid model, which consists of three phases: theoretical, empirical, and analytic. In the theoretical phase, the definitions of health insensitivity were searched in korean dictionary and examples used in the websites because the concept of health insensitivity has never been studied before. Two dimensions of health insensitivity emerged out from this investigation were cognitive and behavioral. And then a working definition of health insensitivity was established. The sub-concepts and related factors of health insensitivity were identified through the extensive reviews of the literature focusing on two dimensions of cognitive and behavioral. In the empirical phase, in order to obtain description of health insensitivity, face-to-face in-depth interviews were conducted with nine persons who are not related to professional health care. Grounded theory approach was applied to analyze these qualitative data. In the final analytic phase, theoretical results and empirical results were analyzed in the integrated way and a theoretical framework of health insensitivity was established. A refined definition of health insensitivity was that decreased health risk perception in cognitive dimension and conduction of the unhealthy behaviors in behavioral dimension. Sub-concepts of decreased health risk perception were optimistic bias and decreased general fear. Sub-concepts of unhealthy behavior were doing health threatening behavior and not doing desirable health behavior. The contact of health information was a causal condition of health insensitivity. Optimistic disposition, health locus of control, and avoidance coping style were intervening conditions of health insensitivity. Three types of health insensitivity were identified: unconcern or ignorance type, optimistic bias type, and cognitive dissonance type. Finally, The implications of these findings for further research and nursing practice are discussed.

Effects of Role Conflict and Ambiguity, and Fatigue on Self-Resilience in Clinical Nurses: After the MERS outbreak (임상간호사의 역할갈등과 모호성 및 피로가 자아탄력성에 미치는 영향: 메르스 사태 이후)

  • Lee, Do-young;Oh, Seung Eun;Lee, Hye Jin
    • Korean Journal of Occupational Health Nursing
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    • v.27 no.2
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    • pp.77-88
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    • 2018
  • Purpose: This study aimed to investigate the degree of role conflict and its ambiguity, and fatigue in clinical nurses and to analyze the effect of these on their self-resilience in order to provide fundamental data for improving their working environment after the Middle East Respiratory Syndrome outbreak. Methods: After the collection of data from 258 clinical nurses in five general hospitals, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were performed using IBM SPSS Statistics 20.0. Results: A significant positive correlation was found between nurses' role conflict and ambiguity and fatigue; while a negative correlation was found between nurses' role conflict and ambiguity and self-resilience. A significant negative correlation was found between fatigue and self-resilience. According to the study results, the factor that affected clinical nurses' self-resilience the most was role conflict and its ambiguity, followed by marital status, fatigue, educational level, religion, and related tasks, which together accounted for 38% of self-resilience in clinical nurses. Conclusion: To improve weaknesses in nursing care after the Middle East Respiratory Syndrome outbreak, the scope of nursing care was changed upon the expansion of integrated nursing and care-giving services. Therefore, in the rapidly changing environment of nursing, policies to improve nursing performance, as well as successful reaction capability, are suggested.

Experience of Conflict in Three Shift Nurses Rearing more than Two Kids: Phenomenological Study (어린 두 자녀를 둔 3교대 간호사의 양육 갈등 경험: 현상학적 연구)

  • Kim, Jeung-Im;Yeom, Jeong Won;Park, Sun-Kyung;Jeong, Hyun-Hee;Min, Uhm-Joo;Park, Sun Hwa;Lee, Jung-Mi;Yeom, Young-Sun
    • Women's Health Nursing
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    • v.24 no.3
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    • pp.252-264
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    • 2018
  • Purpose: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. Methods: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. Results: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were 'Regret that I cannot satisfy even the slightest wish', 'Fail to care for kids', and 'Mutual feeling to care giver between appreciation and inconvenience'. Other themes were as follows: 'Body and mind are broken', 'The need for a three-shift system to support nurses who are rearing children', 'Doing my best for work and child rearing'. Conclusion: The nature of three-shift nurses working in advanced hospital and caring kids is explained as 'lives with conflict' between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.