• Title/Summary/Keyword: Nursing practice model

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Development of Village Health Worker Training Program in Tuguegarao, Phillipines (필리핀 뚜게가라오 지역에서의 마을보건원 훈련 프로그램 개발 사례)

  • Kim, Jung-Min;Lee, Hye-Yeon;Pakr, Dae-Jin;Oak, Chul-Ho;Jeon, Man-Joong;Yu, Byeng-Chul;Koh, Kwang-Wook;Lee, Yong-Hwan
    • Journal of agricultural medicine and community health
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    • v.33 no.3
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    • pp.324-334
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    • 2008
  • Objectives: The purpose of this study was to develop and execute the village heath worker(VHW) training program which based on short term overseas medical volunteer and medical mission. Methods: Through case studies of previous VHW program and review articles about the state of medical volunteer and medical mission, we developed the VHW training program. Pilot test of the program was carried out in Tugeugarao city, Phillipines on July, 2008. The subject were 32 persons from 15 villages around Tuguegarao city. After training we surveyed regarding the satisfaction of training and the degree of getting knowledge and skills. Results: Through article review, we got the common subjects of previous VHW training program and the limitations of overseas medical volunteer and medical mission. We developed VHW training program aiming to community health promotion through community participation and community change. The main text was "Where There Is No Doctor" of Hesperian Foundation. The program executed through 1 day intensive lecture and practice. The satisfaction of the program was 8.95±1.70 on 10 point rating scale. Conclusions: We strongly expect VHW training program can be available as new model of short overseas medical volunteer as well as medical mission if we could systemize it with the confirming subject before training , management after training and continuous support through connection with the field.

A Systematic Review on the Certified Geriatric Pharmacist Program of the U.S.: Certification, Education and Outcomes (미국의 노인전문약사 제도에 대한 체계적 고찰: 인증, 교육 및 성과)

  • Nam, Hye Yeon;Cho, Eun
    • YAKHAK HOEJI
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    • v.58 no.2
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    • pp.129-140
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    • 2014
  • Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

The Relationship with Internet Addiction, VDT Syndrome and Health Behavior of Elementary School Students (초등학생의 인터넷 중독과 VDT 증후군 및 건강행위 간의 관련성)

  • Lee, Gyeong-Ran;Hwang, Mi-Hye
    • The Journal of Korean Society for School & Community Health Education
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    • v.9 no.2
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    • pp.65-80
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    • 2008
  • Objectives: To identify the relationship between the internet addition of elementary school students, and their health behavior and VDT syndrome, and thereby to detect the impact of internet addiction on the health behavior of elementary school students, to get the basic information necessary to develop a prevention program for internet addiction and to plan for VDT syndrome prevention program. Methods: We conducted this study during the period from jun 27, 2007 through July 8, 2007. The subjects of this study were 416 children whose grades were in 4th through 6th grades of elementary schools located in the city A in Kyung Pook Providence. Data were obtained from self-rating questionnaires. The questionnaires were composed of Korean Internet Addiction Self-examination on Internet Use Patterns (K-scale), Health Behavior Profile, VDT Syndrome, and general characteristics. We used t-test, AVOVA with Ducan method for Post-hoc comparison in means comparison between groups, $X^2$-test for frequency analysis and Pearson's correlation coefficient. We used SPSS/PC(12.0 ver) program and the LISREL 8.53 Win program for covariance structural analysis. Results: Major results were as follows. 1. The internet addiction propensity distribution based on the distribution of scores were investigated according to the self diagnosis scale on internet addiction. 6.5% of them were high risk user group, 14.4% were potential risk users and 79.1% of them were common user groups. 2. Internet addictions by sex, internet use duration, frequency (days/week), time(hours/day), purpose, position, brightness of internet, attitude of parents and frequency of conversation of family members were statistically significant(p<0.01). 3. There was a statistically significant difference in VDT syndrome according to internet addiction groups(p<0.001) besides ocular symptoms, dry mouth and GI troubles. 4. The health behavior score was the lowest in high risk user group(p<0.001). There were significant differences between internet addiction groups in personal hygiene and habits of daily living(p<.002), the prevention of accidents(p<.002), the practice concerned with the prevention of infectious disease(p=.002), and mental health(p<.001). 5. There was also a significant negative correlation between internal addiction and health profile(r=-0.365, p<0.01) and a significant positive correlation between internal addiction and VDT syndrome(r=0.331, p<0.01). 6. As the result of structural model analysis, internet use time(/day), days of internet use(/1week), conversation frequency among family members, degree of brightness of internet use had significant direct effects on internet addiction. Conclusions: The results will help the development of an effective intervention program for the prevention and treatment of internal addiction by clarifying the effect of the internal addiction upon elementary school students' VDT syndrome and health behavior.

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The Effects of In-service Education of Newborn's Behavior Response on the Nurse-Newborn Play Interaction (신생아의 행동반응에 대한 실무교육이 간호사와 신생아와의 유희적 상호작용에 미치는 영향)

  • Yang, Young-Ok
    • Korean Parent-Child Health Journal
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    • v.5 no.1
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    • pp.1-23
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    • 2002
  • The purpose of this study was to find out the effect of in-service education on the nurse-newborn play interaction. The research design adopted the pre-experimental design applied only for one pretest-posttest group and Barnard's mother-infant interaction model was used as a conceptual framework. The subjects were 26 nurses who were selected from 2 nurseries in general hospital in Pusan, and 52 healthy newborns who were after 4 days from birth during data collection period at the same hospital. The data were collected from June 1st to October 5th in 2001, by video-taping for the interactive behaviors between the nurse and the newborn, played for 5 minutes in nurseries 2 weeks before and after in-service education. The in-service education consisted of the newborn's behavior responses focused on the newborn baby's states, behavior, cues and state modulation, 3 times per 1 week, 90 minutes per 1 time, lecture, demonstration and hand out project. The experimental tool used for this research was Ha Young-Soo's Korean translation of the Maternal-Infant Play Interaction Scale by Thompson, Jody Baird, Sara Gordman, Bryant(1982), some parts of which were adapted to be suitable for the purpose of this research. Mother and baby scale by Wolke & James-Roberts(1987) was also modified and used as the criterion of nurse's perception of a newborn baby. The results of this study were as follows: 1. This result supported the major hypothesis : After the intervention of in-service education, the nurse and newborn play interaction was promoted. 2. After intervention of in-service education, the nurse perception of newborn, especially the criteria of newborn's reaction was promoted., The results of this research confirm that in-service education on the newborn's behavior responses such as states, behavior, cues and state modulation is an effective way to improve the interaction between the nurse and the baby. It elevated the nurse's sensitivities to the baby's needs. Therefore, in-service education can change the conditions of current nursing practice mostly centered on physical care into a better one in which nurses consider the emotional, social, and intellectual development stages of babies. Accordingly, in-service education contributed to promoting the effective nurse-newborn play interaction so positively.

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Factors Influencing Health Promotion Behavior in Patients with Pulmonary Tuberculosis (폐결핵 환자의 건강증진행위와 관련요인)

  • Kim, Soon-Mi;Seo, Nam-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.129-136
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    • 2019
  • This study was conducted to identify the health promotion behavior of patients with pulmonary tuberculosis and examine the factors influencing this behavior. The subjects were 152 outpatients who were treated for pulmonary tuberculosis at the national tuberculosis hospital located in M City. Data were collected from July to September, 2016 and analyzed using the t-test, ANOVA, Duncan's test, Pearson's correlation coefficient, and multiple regression analysis. Health promotion behavior was negatively correlated with physical symptoms, perceived barriers, and depression, but positively correlated with self-efficacy. The most powerful variable influencing health promotion behavior was depression and the model showed an explanatory power of 63.5%. The results of this study suggest that it is necessary to employ a variety of strategies to practice and maintain the health promotion behavior of pulmonary tuberculosis patients to decrease their depression and provide psychological support.

Identification and Measurement of Hospital-Related Fears in Hospitalized School-Aged Children (학령기 입원아동의 병원관련 공포에 관한 탐색연구)

  • 문영임
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.61-79
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    • 1995
  • When children are admitted to hospital, they have to adapt to new and unfamiliar stimuli. Children may respond with fear to stimuli such as pain or unfamiliar experiences. One goal of nursing is to help hospitalized children to adapt effectively to their hospital experience. Accordingly, nurses need to assess childrens' fears of their hospital experience to contribute to the planning of care to alleviate these fears. The problem addressed by this study was to identify and measure hospital-related fears(hereafter called HRF) in hospitalized school-aged children. The study was conceptualized with Roy's model. A descriptive qualitative approach was used first, followed by a quantitative approach. This study was conducted from November 30, 1989 to January 12, 1991. The sample consisted of 395 hospitalized school-aged children selected through an allocated sampling technique in nine general hospitals. The HRF questionnaire (three point likert scale ) was developed by a delphi technique. The data were analyzed by an SAS program. Factor analysis was used for the examination of component factors. Differences in the HRF related to demographic variables were examined by t-test, analysis of variance and the Scheffe test. The crude scores of the HRF scale were transformed into T- scores to calculate the standard scores. The results included the following : 1. Forty-four items were derived from 188 statements identifying the childrens' hospital-re-lated fears. These items clustered into 14 factors, fear of injections, operations, bodily harm others' pain, medical rounds, physical examinations, medical staff, disease process, blood and X-rays, drugs and cockroaches, tests, harsh discipline from parents or staff, being absent from school, and separation from family. The 14 factors was classified into four categories,'pain','the unfamiliar','the un-known' and 'separation'. 2. The reliability of the HRF instruments was .92(Cronbach's alpha). In the factor analysis, Cronbach's alpha coefficients for the 14 factors ranged from .84 to .86 and Cronbach's alpha coefficients for the four categories ranged from .70 to .84. Pearson correlation coefficient scores for relationships among the 14 factors ranged from ,11 to .50, and among the four categories, from ,44 to ,63, indicating their relative independence. 3. The total group HRF score ranged from 45 to 130 in a possible range of H to 132, with a mean of 74.51. The fears identified by the children were, in order, injections, harsh discipline by parents or staff, bodily harm, operations, medical staff, disease process, and medical rounds ; the least feared was others' pain. The fear item with the highest mean score was surgery and the lowest was examination by a doctor. HRF scores were higher for girls than for boys, and for grade 1 students than for grade 6 students. HRF scores were lower for children whose fathers were over 40 than for those whose fathers were in the 30 to 39 age group, and whose mothers were over 35 than for those whose mothers were in the 20 to 34 age group. HRF scores were lower when the mother rather than any other person stayed with the child. The expressed fear of pain, the unfamiliar, the un-known and of separation directs nurses' concern to the threat felt by hospitalized children to their concept of self. This study contributes to the assessment of fears of hospitalized children and of stimuli impinging on those fears. Accordingly, nursing practice will be directed to the alleviation of pain, pre-admission orientation to the hospital setting and routines, initiation of information about procedures and experiences and arrangments for mothers to stay with their children. Recommendations were made for further research in different settings and for development and testing of the instrument.

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The interaction of Apolipoprotein A5 gene promoter region T-1131C polymorphism (rs12286037) and lifestyle modification on plasma triglyceride levels in Japanese

  • Yamasaki, Masayuki;Mutombo, Paulin Beya wa Bitadi;Iwamoto, Mamiko;Nogi, Akiko;Hashimoto, Michio;Nabika, Toru;Shiwaku, Kuninori
    • Nutrition Research and Practice
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    • v.9 no.4
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    • pp.379-384
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    • 2015
  • BACKGROUND/OBJECTIVE: Apolipoprotein A5 gene promoter region T-1131C polymorphism (APOA5 T-1131C) is known to be associated with elevated plasma TG levels, although little is known of the influence of the interaction between APOA5 T-1131C and lifestyle modification on TG levels. To investigate this matter, we studied APOA5 T-1131C and plasma TG levels of subjects participating in a three-month lifestyle modification program. SUBJECTS/METHODS: A three-month lifestyle modification program was conducted with 297 participants (Age: $57{\pm}8years$) in Izumo City, Japan, from 2001-2007. Changes in energy balance (the difference between energy intake and energy expenditure) and BMI were used to evaluate the participants' responses to the lifestyle modification. RESULTS: Even after adjusting for confounding factors, plasma TG levels were significantly different at baseline among three genotype subgroups: TT, $126{\pm}68mg/dl$; TC, $134{\pm}74mg/dl$; and CC, $172{\pm}101mg/dl$. Lifestyle modification resulted in significant reductions in plasma TG levels in the TT, TC, and CC genotype subgroups: $-21.9{\pm}61.0mg/dl$, $-20.9{\pm}51.0mg/dl$, and $-42.6{\pm}78.5mg/dl$, respectively, with no significant differences between them. In a stepwise regression analysis, age, APOA5 T-1131C, body mass index (BMI), homeostasis model assessment-insulin resistance (HOMA-IR), and the 18:1/18:0 ratio showed independent association with plasma TG levels at baseline. In a general linear model analysis, APOA5 T-1131C C-allele carriers showed significantly greater TG reduction with decreased energy balance than wild type carriers after adjustment for age, gender, and baseline plasma TG levels. CONCLUSIONS: The genetic effects of APOA5 T-1131C independently affected plasma TG levels. However, lifestyle modification was effective in significantly reducing plasma TG levels despite the APOA5 T-1131C genotype background.

Awareness of Doctors' Shared Decision-Making in Life-Sustaining Care Decisions

  • Kim, Dalyong;Lee, Hyun Jung;Yu, Soo-Young;Kwon, Jung Hye;Ahn, Hee Kyung;Kim, Jee Hyun;Seo, Seyoung;Maeng, Chi Hoon;Lim, Seungtaek;Kim, Do Yeun;Shin, Sung Joon
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.204-213
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    • 2021
  • Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

Stressful Life Events, Health Symptoms, Social Support and Coping/in Early Adolescents (스트레스생활사건, 건강문제, 대응, 사회적 지지의 관계 -청소년을 대상으로-)

  • 오가실;한정석
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.414-429
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    • 1990
  • Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social, support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean=16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76, respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using an SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie were selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events(Gamma=.35, p=.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma=.13, p=.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptability to biological social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize the diverse sources of social support that are readily available to adolescents.

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Job Analysis by DACUM Method in the Field of Well Dying Education Model Development : focusing on the Social Worker (DACUM 기법을 통한 죽음교육프로그램 개발 분야의 직무분석 : 사회복지사를 중심으로)

  • Hwang, Hye-Jeong;Kim, Kwang-Hwan;Kim, Yong-Ha;Lee, Moo-Sik;Shim, Moon-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5501-5507
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    • 2015
  • This study seeks to identify the duties and tasks of a social welfare worker when developing a combined death education program for welfare workers using DACUM method. The program would adopt both a medical and humanistic perspective that can be applied to real life. The study period was between March 2 to March 10, 2015. The study was conducted on eight DACUM committee members who are professors in the field of healthcare or humanities and social sciences. Their medical, humanistic and social viewpoints were investigated. The results show that the focus of the education needs to be on 'the acceptance and understanding of death' and 'healing the stress from loss and suicide prevention'as tasks under the duty of 'loss and mourning'. The tasks for the duty 'the need for death education'were identified as 'death in traditional society and death in contemporary society' as well as 'understanding of issues related to death'. The results show that there is a need to develop death education programs that emphasize healing for the acceptance and understanding of death from a humanistic perspective.