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Predictors of the Utilization of Oral Health Services by Children of Low-income Families in the United States: Beliefs, Cost, or Provider?

  • Kim Young Ok Rhee;Telleen Sharon
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1460-1467
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    • 2004
  • Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

Effects of the Health Status and Health Behavior on Health-related Quality of Life of the Elderly Living Alone and Living with Their Families: Using Data from the 2014 Community Health Survey (독거노인과 가족동거노인의 건강상태와 건강행위 경험이 건강 관련 삶의 질에 미치는 영향: 2014 지역사회 건강조사 자료 활용)

  • Kim, Kyung-Sook
    • Research in Community and Public Health Nursing
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    • v.28 no.1
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    • pp.78-87
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    • 2017
  • Purpose: The purpose of this study is to identify factors influencing the quality of life of the elderly living alone and living with their families with regard to their health statuses and health behavior experiences. Methods: We used source data from the 2014 Community Health Survey. The subjects of this study included some elderly people aged 65 and over, and analyzed the data of 13,373 elders living alone and 13,322 elders living with family. Results: Factors influencing the quality of life of the elderly living alone and living with their families include gender, age, education, household income, current occupation, subjective stress level, depression, number of diagnosed diseases, walking exercise, the experience of health screening, and the experience of not having necessary medical services (p<.001). Region was a significant variable influencing the quality of life of the elderly living with their families (p<.001). Conclusion: In order to improve the quality of life of the elderly, it is necessary to provide sound conditions for working, emotional support, walking exercise and promotion of health screening, and to supplement the environment and institution for them to receive necessary medical services.

Continuous effect of advanced cardiovascular life support simulation education according to Felder-Silverman learning style (Felder-Silverman 학습유형에 따른 전문심장소생술 시뮬레이션 교육의 지속효과)

  • Kim, Yu-Jeong;Park, Mi-Jeong;Ham, Young-Lim
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.3
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    • pp.21-35
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    • 2016
  • Purpose: The purpose of the study was to investigate the continuous effect of advanced cardiovascular life support (ACLS) simulation education according to Felder-Silverman learning style. Methods: A self-reported questionnaire was completed by 94 students of emergency medical technology and nursing. There were 50 female students (53.2%) and 88 students (93.6%) had basic life support certification. The study instruments included knowledge, performance, and confidence. Data were analyzed using SPSS v. 20.0. Results: The learning style consisted of reflective type (51.1%), sensory type (76.6%), visual type (63.8%), and sequential type (64.9%). There was a significant difference in continuous effect on performance by learning type. Conclusion: It is necessary to identify the learning style of students before simulation education in order to maintain continuous effect of ACLS education.

A Concept Mapping Study of Good Service Experience among the Elderly Residents of Long-term Care Facilities (장기요양시설노인의 좋은 서비스 경험에 관한 개념도 연구)

  • Choi, Hyoungshim
    • Korean Journal of Adult Nursing
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    • v.28 no.6
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    • pp.669-679
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    • 2016
  • Purpose: The purpose of this study was to explore the reported good service experiences from the perspective of elderly residents of long-term care facilities. Methods: Of those residents who are 65 years old or older, 14 residents whose length of stay were one month or longer and scores of the K-Mini Mental State Examination were 15 or higher were interviewed. The interview data formed the basis for the empirical statements about the reported nature of patients' experiences as residents of long-term care facilities. These data were used in concept mapping. Results: Through multidimensional scaling analysis and hierarchical cluster analysis, 62 core statements, two dimensions, and six clusters of good service experiences were derived. The two dimensions were classified as 'care centered-participation centered services' and as 'physical-emotional services.' Six cluster themes emerged as good service experiences: 'safety of care and treatment', 'responsible and supportive staff', 'comfort of living environment', 'mental well-being', and 'respect and communication'. Conclusion: The result of the study provides information about what experiences are important to older adults with cognitive impairment. The concept map can be used to develop a patient experience index for the elderly residents of long-term care facilities.

Management Strategy by Evaluation on Comprehensive Health Problem in the Community-dwelling Elderly of Korea (재가노인의 포괄적 건강문제 평가와 관리방안)

  • Lee, Jae-Chang;Kim, Eun-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.3
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    • pp.464-472
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    • 2006
  • Purpose: The aim of this study was to define the health problem in the community-dwelling elderly of Korea and to compare differences of CAPs(Client Assessment Protocols) by characteristics. Method: Data was collected by visiting nurse from 556 elderly over 65 years in selected metropolitan areas. To evaluate the functional state of elderly in the community, I used "RAI-MDS HC; Residental Assessment Instrument Minimum Data Set-Home Care(2.0 version)" and established information exchange system among resources, by developing the data into a computer program. Results: The health problem of 'preventive health measures' was the largest(99.6%), and then 'health promotion(85.3%)', 'visual function(75.5%)', 'psychologic drug(68.9%)', 'pain(68.5%)', ‘social function(59.2%)', 'communication disorders(56.2%)', 'environmental assessment(53.2%)', 'depression & anxiety(46.9%)', 'oral health(43.4%)' followed. The number of health problems was average 10.16 in the community-dwelling elderly. Conclusion: The results suggest the need to emphasize the importance of assessment of the health problem of the elderly. We can apply it in the distribution of community resources and the development of service providing programs by figure out the health problem and resource in need for the elderly in the community.

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Experiences of Breast Cancer Women Undertaking Genetic Test (국내 고위험 유전성 유방암 환자의 유전자검사 경험)

  • Jun, Myung-Hee;Choi, Kyung-Sook;Ahn, Sei-Hyun;Gu, Bo-Kyung
    • Asian Oncology Nursing
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    • v.5 no.2
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    • pp.146-158
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    • 2005
  • Purpose: This study was to obtain a understanding of breast cancer women with high risk for hereditary cancer syndrome. Method: A micro-ethnography was used, including participation observation, open-ended in-depth interviews. Results: Two major arguments were derived. First, When Korean women at high risk to hereditary breast cancer make a decision about whether to take a genetic test, they are strongly motivated by a desire to preserve close kinship bonds and "family love" among their siblings, parents and children. Second, Even after genetic risk assessment and counseling services, Korean women at high-risk for developing a hereditary breast cancer who have been informed that they are mutation carriers, still hold onto previous beliefs about cancer causation. Their cancer prevention strategies are constructed according to their unchanged perceptions and beliefs about cancer causation. Conclusion: More sensitive genetic counseling program needs to be developed. Referral programs and clinical services must be attentive to cultural values and beliefs otherwise cultural attitudes and practices toward genetic counseling will not change.

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Improvement and Backsliding after Chronic-disease Self-management Education in Japan: One-year Cohort Study

  • Park, Min Jeong
    • The Korean Journal of Rehabilitation Nursing
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    • v.20 no.1
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    • pp.42-51
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    • 2017
  • Purpose: In people who have chronic diseases, disabilities, and rehabilitation needs, self-management education can improve health and health-related behavior, and it can reduce the utilization of healthcare services. The purpose of this research was to assess the long-term effects of chronic-disease self-management education in Japan. Methods: This study included 184 adults living with various chronic medical conditions who participated in the Chronic Disease Self-Management Program (CDSMP) in Japan. Data were collected before the program began, and then collected 3 more times over 1 year. Results: Healthcare-service utilization was low at baseline, and it did not change. Self-evaluated health status, health-related distress, coping with symptoms, communication with doctors, and self-efficacy to manage symptoms all improved after the program. However, there was backsliding in all of the outcomes that had improved. Conclusion: Some benefits of this program can last for at least 1 year, but interventions to prevent attenuation may be needed. For economic evaluations, research should focus on populations with higher baseline levels healthcare-service utilization, including use of rehabilitation services. Also, more attention should be focused on the longer-term decay or persistence of the program's benefits, particularly regarding on preventing and reducing disabilities and with regard to rehabilitation needs.

Levels of Health-related Quality of Life (EQ-5D) and Its Related Factors among Vulnerable Elders Receiving Home Visiting Health Care Services in Some Rural Areas (일부 농촌지역 맞춤형 방문건강관리 대상 취약계층 노인들의 건강 관련 삶의 질 (EQ-5D) 수준 및 관련요인)

  • Kim, Jong Im
    • Research in Community and Public Health Nursing
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    • v.24 no.1
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    • pp.99-109
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    • 2013
  • Purpose: The purpose of this study is to identify levels of quality of health-related life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. Methods: The subjects of this study were vulnerable elders aged 65 or higher receiving visiting health care benefits by a public health center in a county. Results: Levels of health-related EQ-5D were high when the subjects were males, their ADL and IADL were high. The EQ-5D of the vulnerable elders and social supports had a positive correlation, while their IADL and depression had a negative correlation with the EQ-5D. We can see that the EQ-5D related factors are variables that have significance influence on gender, subjective health status, BMI, IADL, depression levels, and social support. Conclusion: To improve the EQ-5D of the vulnerable elderly, it needs maintenance of independent IADL levels, social supporting systems using small meeting of the elderly in community. It is necessary to maintain independent IADL levels, enhance social supporting systems including small group gatherings for elders living alone by means of places like community halls, and develop specific intervention programs for the prevention and management of depressive elders.

Analysis of Health and Social Needs for the Establishment of Coordinated Health and Social Service (보건복지 통합사업을 위한 보건복지욕구 분석)

  • So, Ae-Young;Hong, Myung-Sun
    • Journal of Korean Public Health Nursing
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    • v.19 no.2
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    • pp.188-203
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    • 2005
  • The study was performed to provide basic data for developing a coordinated health and social service model. Method: The subjects consisted of 1000 residents in Wonju city. The sampling process was randomized stratified into 26 geographical areas. The data was collected from Apr. 16nd, to May. 15nd, 2002 by using a structured questionnaire that included general characteristics, the patterns of disease, the family function and the community support systems. The collected data was analyzed by the SPSS. windows program via descriptive statistics, correlation testing and t-tests. Result: 61.7% of the elderly perceived their health status as being poor. There were correlations among age, income and the way clients perceived their health status. The prevalence rate of chronic disease was 70.8% in the elderly. The prevalence rate for arthritis was the highest (33.6%). The average number of diseases in the target populations was 2.31; it was 2.65 in the deprived elderly group and 2.47 in the elderly group. 35.4% of residents did not have any family care giver. 61.2% of the clients needed support by the health and social services. Conclusions; Coordinated health and social services need to be allocated by priority to the elderly and to the socially and economic deprived clients.

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Health Issues and Management for Children with Disabilities attending Daycare Centers (보육시설을 이용하는 장애아동의 건강문제와 건강관리 현황)

  • Kim, Ji-Soo
    • Child Health Nursing Research
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    • v.18 no.3
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    • pp.127-134
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    • 2012
  • Purpose: This study was conducted to investigate health issues of children with disabilities attending daycare centers, and to identify the way of teachers' management on child health. Methods: A cross-sectional descriptive study design was performed with a convenience sampling of 127 teachers from 19 daycare centers for children with disabilities and 175 teachers from 17 general daycare centers. A survey questionnaire was used to collect data, and the data were analyzed using the SPSS 17.0 program. Results: For the last one month, about 90% of the teachers working in daycare centers for children with disabilities had to care for sick children. When a child is sick, 50% of the teachers tended to contact with the parents of the child. The majority of the teachers caring for sick children experienced difficulties with no one available to give expert health care advice. Conclusion: The results of the study indicate that there are many health issues in daycare centers for children with disabilities and therefore health professionals need to be available to the centers. Specifically, health management services and programs need to be developed and provided for children with disabilities.