• Title/Summary/Keyword: Managed care programs

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Evaluation of a Community Health Practitioner Self-care Program for Rural Korean Patients with Osteoarthritis

  • Lee, Chung Yul;Cho, Yoon Hee
    • Journal of Korean Academy of Nursing
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    • v.42 no.7
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    • pp.965-973
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    • 2012
  • Purpose: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. Methods: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. Results: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. Conclusion: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

A Study on the Need of Child-care Service and Child-care Programs for the Working Class Mothers (생산직 취업모의 탁아서어비스의 요구 및 그들을 위한 탁아제도에 관한 연구)

  • 정민자
    • Journal of the Korean Home Economics Association
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    • v.28 no.1
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    • pp.125-140
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    • 1990
  • The purpose of this study is to inverstigate the need of child care services and child care programs for the working class mothers. We surveyed four Industrial complex (in Seoul, Incheon, Pusan, Ulsan) to collect data. The samples were 282 mothers (Seoul: 95, Incheon: 54, Ulsan: 62, Pusan: 71). The mothers had children under six years of age and they worked at factory for 11 hours. They (65%) rented houses with 1-2 rooms. Their income was not enought to support their family. They were never supported by social network, so they had to work at factory and they need child care services. The mothers had many difficulties of child rearing and early childhood education. They wanted perfect day care programs. They expected it as followings: (1) Day care center placed at factory or near home. (2) The administrater is goverment or employer. (3) It is managed a full time system. (4) It is center-based day care or industrical day care. (5) They share day care expense with employer or goverment. (6) Day care expenses is 35,000 won in case of full time system, 25,000 won in case of half-time system. They desited highly qualifed day care programs, but they would not expense highly cost. So we suggest that goverment and factory employers support the working mothers.

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Primary Health Care Post Dementia Management Status Report for 2016 (<사례보고> 보건진료소 치매관리 실태 보고)

  • Han, Jong Suk;Cho, Soo Yeoun;Back, Hyun Hee;Kim, Yeomg Sug;Choi, Young Mi
    • Journal of Korean Academy of Rural Health Nursing
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    • v.12 no.2
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    • pp.45-54
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    • 2017
  • Purpose: The purpose of this study was to provide a survey of patients with dementia registered and managed by primary health care posts. Method: Computation of 2016 dementia data registered in Health Care Center programs of 14 municipalities in ChoongNam province was analyzed. Data collection was done based on a pretest for dementia prevention and general management of registered dementia patients. Results: Results showed; Screening tests for dementia, 40% of population 60 or over, average number of cases, 174, average number of dementia registrants, 3.1, programs for prevention, approximately 70% special policy measures and 28% cognitive rehabilitation programs, counseling and education operating well overall, average number of dementia registrants/clinic 11.8, with women accounting for 70%, elders with less than 3 years of education, 75%, residence type cohabitation by married couples, 41%, and elders with Alzheimer type dementia, 64%. Conclusion: During early detection of dementia and follow-up examinations, high-risk groups (women, elders) should receive a dementia examination. In management of dementia there is a need to develop various programs including physical, economic, and emotional support not only for patients, but also for families. Health care managers also need systematic education to give them expert knowledge of dementia and management of dementia.

A Case Study on Care Workers' Experiences of Coping with Falls among Community-Dwelling Elders (재가노인 방문요양보호사의 낙상관련 대처 경험에 관한 연구)

  • Lim, Sun-Young;Park, Hye-Sun;Ma, Ryewon
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.99-110
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    • 2021
  • Purpose: The purpose of this study was to understand the experience and meaning of falls among care workers caring for the elderly. Methods: The participants comprised 10 care workers in Seoul and Gyeonggi Province, South Korea. The data collection period was from September to November 2020, and the data were obtained through individual in-depth interviews. The collected data were analyzed using the content analysis method of qualitative research. The main interview questions were as follows: First, in the event of a fall, "can you tell us about your experience and how you dealt with the fall?; second, "can you tell us about your role and the role of family members or the center that manages falls that occur outside of nursing visits.", third, "can you tell us about the difficulties in managing falls based on your experience?", and fourth, "how are falls that occur during nursing visits managed?" Results: As a result of analyzing the experiences of nursing care workers of falls while caring for elders in their homes, five main themes were derived. These were understanding the characteristics of the elderly at home, understanding possible emergency situations, providing caring services, minimizing physical harm, and delivering clear information. Conclusion: A significant finding of this study was that care workers who visit and provide care to elders at home confirmed the need for standard guidelines on appropriate responses in the event of a fall at home and the importance of managing emergencies arising from falls among elders at home. These results highlight the need for the development of emergency response education programs, such as programs on fall care among nurses and care workers who provide care to the elderly, and for enhanced understanding of the fall risk of elders who live at home.

A Proposal of Health Promotion Program for Overweight Schoolchildren (비만학생을 위한 건강증진프로그램의 제안)

  • Choi, Sun-Ha
    • Research in Community and Public Health Nursing
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    • v.11 no.2
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    • pp.526-537
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    • 2000
  • This study was conducted to contribute to the expansion of activity areas for school nurses in the field of health promotion services whose importance are increasing daily. To achieve such goals the researcher proposed that health promotion programs for obesity management in overweight schoolchildren conducted by literature review to apply to school settings. In this program, the principal components developed a behavior modification program and an exercise program, which could be educated and managed by a nursing staff during for 9 weeks, three times per week, 60 minutes each. The program consisted of exercise, health education. health counseling, and a direct nursing care. This kind of approach may support the need of behavior modification programs and exercise programs on a regular base via the social organization, which may mean an intentional change of life style. A comprehensive approach to health promotion services proposed by this research would contribute greatly to the effectiveness of school health services and to promote health in overweight schoolchildren.

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A Study of the Children′s Afher-School Life and the Mothers′ needs on the After-School Care Program; The Comparison of Low-Income Families with Middle -income in Masan/Changwon Area (초등학교 아동의 방과후 생활실태 및 방과후 아동지도에 대한 어머니의 요구 조사;마산과 창원 지역 저소득층과 중류층을 중심으로)

  • 권민균
    • Journal of the Korean Home Economics Association
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    • v.39 no.7
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    • pp.1-19
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    • 2001
  • The purpose of this study are (1) to examine the types and the after-school child care for children from low-income(106) and middle-income(99) families and (2) to examine the needs and expectations for after-school child care program of low-income(107) and middle-income(100) mothers. The findings of this study are as follows ; (1) The percentage of self-care among children from low-income families are higher than the children from middle-income families. The after-school activities mainly consist of arts, music, physical and computer lessons. (2) The needs on the after-school care program with non-profit basis which is managed by public welfare systems are higher among the low-income mothers than the middle-income mothers. Many mothers want professional, non-profit, systematic and formal after-school care programs. Some suggestions are proposed for after-school care program which can meet needs of the children and the mothers from diverse economic and social backgrounds.

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A Review of the Operation Community Health Practitioner System as a Reorientation of Primary Health Care (보건 진료원 제도 운영 평가에 관한 연구 -우리나라 1차 보건의료 제도 방향 재설정을 위하여 -)

  • 홍여신;이인숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.568-583
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    • 1994
  • In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

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The control of the hypertension in rural primary health care settings in Korea (농촌지역 일차건강관리 기관의 고혈압환자 관리실태 -전남지역을 중심으로-)

  • Chung, Young-Hae;Kang, Hae-Young;Chung, Mi-Young
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.162-180
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    • 1994
  • The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.

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A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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Assessment of Foodservice Management Performance at Child Care Centers (보육시설 급식운영관리 실태 조사)

  • Lee Mee-Sook;Lee Jae-Yeon;Yoon Sun-Hwa
    • Korean Journal of Community Nutrition
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    • v.11 no.2
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    • pp.229-239
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    • 2006
  • This study was carried out to investigate foodservice management practices of 100 child care centers nationwide, and to provide background information for developing foodservice management policies at child care centers. Approximately 20% of the child care centers had a separate dining room; most of the centers were vulnerable to sanitation or safety problems. The percentage of the centers that planned menus was about 60% and 10% established standardized recipes. Fourteen percent of the centers kept records for distribution and menu evaluation and 33% kept sanitation management records. Since only 7% of the centers employed a dietitian, foodservice in most centers were not managed by professionals. The results of menu assessment revealed that 56.5% of the national/public child care centers received 19 points or higher out of 21 points, whereas 5.6% of the private child care centers received the same scores. Proper usage and storage of raw food, sanitary management of equipment and facilities, waste management/leftover food treatment, and basic facility of cooking zones were performed well by many centers. The overall scores of foodservice performance were only 31.2 out of 60 points, representing relatively poor safety management, food procurement management, and facilities and equipment management. These results indicate that the foodservice management of the child care centers are in a relatively poor state. Since nutrition management of the most centers was performed by non-professionals, it may not be possible to provide proper nutrition for health and normal growth of preschool children and to perform efficient nutrition education programs. The following suggestions are strongly recommended in order to improve foodservice performance at child care centers. First, foodservice administration should be performed by a dietitian, and second, efforts should be focused on strengthening nutrition and sanitation management.