Objectives: This study aims to determine fostering stress and mental health state that mothers of handicapped children perceive as primary care givers and to analyze their demand for information assistance in order to release their stress so that it can provide materials that contribute to establishment of assistance system for families with handicapped children. Methods: The research subjects were 340 mothers whose children went to a nursery for special children, 3 general nurseries and 6 special schools in Daegu, and the data were collected using structures questionnaires. The survey analyzed mothers' fostering stress, their demand for fostering information assistance, children's daily activity abilities. Component concepts of each scale was validated by adopting confirmatory factor analysis, and factors affecting demand for fostering information assistance were analyzed by adopting covariance structural analysis. Results: Younger mothers tend to have higher demand for information, and mothers with younger children or children with double handicaps also have higher demand. Mothers under 30 have the lowest demand for public health and medical care assistance and for home and community life assistance, while mothers with children with physical handicaps have the highest. The validity of component concepts was verified by categorizing as cognitive structure models fostering stress, information demand, children's daily activity abilities, and their appropriateness was evaluated through confirmatory factor analysis using structural equation modelling. And then, GFI (more than 0.9), CFI (more than 0.9), TLI (more than 0.9) and RMSAE (less than 0.08) were used to evaluate the appropriateness. It was found that all the component concepts are valid, as every item is within appropriate range. The result of analyzing information demand demonstrated that children's handicap levels significantly affect their mothers' mental health, while fostering stress significantly affect mothers' metal health, information demand. As well, it was confirmed that mothers' mental health has a significant effect on information demand. Conclusions: Therefore, to reduce special children's mothers' uncertainty, helplessness and fostering burden, it is necessary to provide them with information on children's challenges, development and fostering and to offer them quality public health, medical care and welfare assistance along with family and local community life assistance.
This study intended to examine the willingness to use as well as necessary functions for ICT-based care assistance devices in older adults living alone. A total of 241 older adults living alone from a city participated in the study. Study results show that many older adults living alone are willing to use ICT-based care assistance devices at their home and the functions of care assistance devices that they perceived as necessary were diverse. In addition, there were differences in perception of functional necessity by socio-demographics and medical and functional characteristics of older adults living alone. In particular, there were significant differences in the functions perceived as necessary according to the presence of osteoporosis, depression, insomnia, and limitations in daily activities. Our study findings suggest that the functions of ICT-based care devices should be developed in various ways in order to help healthy aging in place. Findings also imply that it is necessary to provide individualized services and customized care assistance devices according to individual's medical and functional characteristics and needs.
Ahn, Yang Heui;Ham, Ok Kyung;Kim, Soo Hyun;Park, Chang Gi
Journal of Korean Academy of Nursing
/
v.42
no.7
/
pp.928-935
/
2012
Purpose: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. Methods: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. Results: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. Conclusion: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.
As advance care planning is taking center stage in the field of end-of-life care, various tools have been developed to aid in the often emotional and difficult decision-making process. Video decision support tools are one of the most promising means of assistance, of which the modus operandi is to provide more comprehensive and precise information of medical procedures to patients and their families, allowing them to make better informed decisions. Despite such value, some are concerned about its potential negative impact. For example, video footages of some procedures may be shocking and unpalatable to non-medical professionals, and patients and families may refuse the procedures. One approach to soften the sometimes unpleasant visual of medical procedures is to show less aggressive or more relaxing scenes. Yet another potential issue is that the objectivity of video decision support tools might be vulnerable to the very stakeholders who were involved in the development. Some might argue that having multiple stakeholders may function as checks and balances and provide collective wisdom, but we should provide more systematic guarantee on the objectivity of the visual decision aids. Because the decision of the modality of an individual's death is the last and most significant choice in one's life, no party should exert their influence on such a delicate decision. With carefully designed video decision support tools, our patients will live the last moments of their lives with dignity, as they deserve.
The Journal of Korean Academic Society of Nursing Education
/
v.15
no.1
/
pp.53-61
/
2009
Purpose: This study was conducted to evaluate the need for education for emergency care in nursing homes. Method: 312 people who were engaged in caring for the elderly at nursing homes in D-metropolitan c! ity answered the questionnaires about the experiences, the need, and the ideal methods of education for basic emergency care, from Jul. 1. 2007 to Jul. 30. 2007. Result: 69.9% were female. Only 7.1% were nurses and the rest did not have majors in the medical field. 83.0% had experienced education for emergency care, and 89.2%, 78.4% and 44.8% of them had been educated about cardiopulmonary resuscitation, airway obstruction care, and fracture/sprain/dislocation care respectively. Fifty-three who had not experienced education answered 'no opportunity' as a cause of non-education. The need for emergency care education was 4.53/5.00, and the desire to receive education was 2.81/3.00. Mainly workers wanted to be educated abo! ut airway obstruction (88.1%), and breathing assistance & cardiac massage (72.4%). Workers preferred to be educated 1-2 times per year for 2-3 subjects, through programs including both lecture and practice. Conclusion: It is essential to create an adequate program and apply it to the people engaged in caring for the elderly.
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.
To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.
Nayssem Khessairi;Dhouha Bacha;Rania Aouadi;Rym Ennaifer;Ahlem Lahmar;Sana Ben Slama
Journal of Hospice and Palliative Care
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v.27
no.2
/
pp.64-76
/
2024
Purpose: End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care. Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections: knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index. Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers. Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.
Kim, Bong Joo;Kang, Hyung Won;Kim, Nam-Kwen;Seo, Eun-Sung
Journal of Oriental Neuropsychiatry
/
v.29
no.3
/
pp.135-144
/
2018
Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.
Bon-Kyeong KOO;Min Woo LEE;Sang Hee LEE;Byoung Ho CHOI
Korean Journal of Clinical Laboratory Science
/
v.55
no.3
/
pp.213-218
/
2023
When it comes to 'Team Medical Care' in Japan, clinical laboratory technologists have actively engaged in various kinds of teams, such as a diabetes team, a nutrition support team, an infection control team and a medical practice support team. Overall, with continual changes in the medical environment, clinical laboratory technologists are recently being required to not only conduct phlebotomy, specimen collection, laboratory testing, and electrocardiography, but also get actively involved in 'medical practice assistance or support' in collaboration with medical doctors and nurses. Therefore, it is anticipated that resident clinical laboratory technologists in wards or emergency rooms in Korea will be better able to contribute to improving medical quality and securing medical safety by functioning as a link to the clinical laboratory, while medical doctors and nurses will have a reduced burden of work and can dedicate themselves to better patient care.
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