• Journal of Information Science Theory and Practice
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• 제11권2호
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• pp.82-103
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• 2023

The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

• 종양간호연구
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• 제2권1호
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• pp.5-16
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• 2002

Purpose: This study was to develop a stress-adaptation model for family caregivers of cancer patients that could provide the basis of planning nursing intervention. Method: A hypothetical model was developed using the family adaptation model proposed by Haley et al. (1987). In the literature, the stressor was identified as patient's characteristics, caregiver's characteristics, duration of illness, and family life events. It affected stress appraisal, family resources, family coping and finally caregiver's adaptation. In this model, 18 paths were constructed. Data were collected from 241 caregivers, whose family members were in treatment between June and August 2000, at 3 university hospitals and were analyzed by SPSS and LISREL programs. Results: 1) The overall fitness indices of the hypothetical model were x 2=267.78 (P= .0), GFI= .92, AGFI= .87, NFI= .93, NNFI= .93, PNFI= .64, PGFI= .55, and RMR= .43. Ten of the eighteen paths proved to be significant. 2) To improve the model fitness, the hypothetical model was modified considering modification indices and the paths proved not significant. Final model excluded 3 paths demonstrated to be improved by x2=161.96 (P= .00), GFI= .95, AGFI= .91, NFI= .96, NNFI= .96, and RMR= .23. Twelve of fifteen paths proved to be significant. 3) Stress appraisal was influenced by disease related characteristics and duration of illness and was explained 22% of the variance. Family resources were influenced by stress appraisal and was explained 57% of variance. Family coping was influenced by disease related characteristics, caregiver's characteristics, duration of illness, family life event, and stress appraisal and was explained 57% of variance. Family caregiver adaptation was influenced by disease related characteristics, caregiver's characteristics, stress appraisal, and family coping and was explained 31% of variance. Twelve of fifteen paths were significant. Conclusion: Based on this study, to help family caregivers to adapt, individual intervention is necessary with consideration of disease related and caregiver's characteristics and duration of illness. The intervention should include efforts to raise the family resources and to identify positively the stress they encounter, and there is a need to establish an adaptation model that considers emotional aspects of family caregivers. Since there is a difference in emotional status depending on the disease stage, a study needs to be done to analyze the differences among the disease stages (diagnosis, treatment, recurrence, and terminal stages).

• 보건의료산업학회지
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• 제1권1호
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• pp.59-74
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• 2007

Considering the characteristics of the Korean family which maintain a close connection with their patients from the moment of their falling sick to hospitalization to discharge, the family is the most important environmental factor of the social supporting system, and is the important object of the client as well as activity system. The medical social work intends to meet the practical needs of aged chronic patients, providing them and their family with a professional human service. The end of this study is to find out the hardships of both the aged chronic patients and their family as well as their needs for the social welfare service, and to search out the way of comprehensive social work service. The summary of the analysis of the survey is as follows: 1. The needs of aged chronic patients are divided into those of the solution of the problems of falling ill, social welfare program and discharge. Those needs arc affected by the various factors of the types of hospitals, the patients' age, the kinds of insurance, and the supporting systems, etc. Accordingly, the assessment of the needs of the patients are asked to be done comprehensively in accordance with the kinds of diseases and social environments. 2. The importance of the family to the aged chronic patients is evident. The family plays a decisive role in the patients' hospitalization and discharge, the family being an important supporting system and making it necessary to take an approach to client system. The family has difficulty in getting connection of community resources, in adapting to social life after the patient's discharge, and in paying the treatment. The family suffers the secondary hardships more than the burden of the treatment expenses. 3. For this reason various interventions are needed to reduce the stress caused by supporting and nursing patients. Thus the social welfare service for the aged chronic patients and their family needs the following prepositions: 1. It is the characteristics of the aged chronic patients that they need continuous care and that the strengths of the patients and their family cannot be too much emphasized, and that comprehensive assessment based on the connection 'with the community and the mutual interchange 'with the environment, is much emphasized. 2. The family of the aged chronic patient is a resources system as well as a client one. 3. Another characteristic of the aged chronic patients is that with the resources connection in mind, it needs an active intervention of social workers in the community. With these prepositions considered, the development of practical social work service for the aged chronic patients is thought urgently needed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1707-1713
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• 2013

Background: This study aimed to better understand the barriers to perinatal hepatitis B prevention and to identify the reasons for poor hepatitis B knowledge and delivery of education to hepatitis B surface-antigen-positive pregnant women among healthcare providers in Santa Clara County, California. Materials and Methods: Qualitative interviews were conducted with 16 obstetricians and 17 perinatal nurses in Santa Clara County, California, which has one of the largest populations in the United States at high risk for perinatal hepatitis B transmission. Results: Most providers displayed a lack of self-efficacy attributed to insufficient hepatitis B training and education. They felt discouraged from counseling and educating their patients because of a lack of resources and discouraging patient attitudes such as stigma and apathy. Providers called for institutional changes from the government, hospitals, and nonprofit organizations to improve care for patients with chronic hepatitis B. Conclusions: Early and continuing provider training, increased public awareness, and development of comprehensive resources and new programs may contribute to reducing the barriers for health care professionals to provide counseling and education to pregnant patients with chronic hepatitis B infection.

• 보건교육건강증진학회지
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• 제11권2호
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• pp.146-159
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• 1994

The conecpt of hospice care for the terminally ill is a development of relatively modern times, although it has its origins in antiquity. The hospice will be able to handle progressively more and more patient, to the limit of its resources. The purposes of this study were to review of demand and issues of the hospice care programes and to recommand the hospice care approaches in south Korea that using the book-review method. At this point, although at present there is a general unawareness of hospice throughout Korean society, the public will become gradually aware of hospice. This will thus aid the development of hospices. Awareness will come about because of the educational efforts of medical schools, nursing schools, allied health training programs, practicing hospice care giver, universities, and others interested in hospice education. At present, there are many issues of the hospice care program that are hospice resources problems of manpower, facilities, finances, and cost of hospice services, quality of care, and ethics. Additional studies are needed to determine the most efficacious organizational hospice models for varying conditions. They will insist upon reasonable regulatory agency regulations that will promote the hospice idea and. permit adequate remuneration for services provided. More research is needed on health professionals', patients', and others' attitudes towards death.

• 보건교육건강증진학회지
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• 제30권2호
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• pp.23-39
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• 2013

Objectives: This study was conducted to investigate practical experiences of telemedicine of community health practitioners(CHPs). Methods: Qualitative data were collected by in-depth interviews from 10 CHPs who have experiences in managing telemedicine system. All interviews were recorded and transcribed according to qualitative conventional content analysis processes. Results: As a result, 32 themes were deduced and 11 theme clusters and 3 categories were formed and each coding categories were derived directly from the text data. 11 theme clusters derived from the 32 meaningful themes were as follows: Human resources, equipments and systems, computer program (Input resources), human resource management, patient registration and management, medication, laboratory test (Progress), benefits in telemedicine system managing, difficulties in telemedicine system managing, complains in telemedicine system managing, client responses to telemedicine system (Outcome evaluation). 3 categories derived 11 theme clusters were 'input', 'progress', and 'outcome evaluation'. Conclusions: This study has contributed to the understanding of operation of telemedicine by CHPs in community health posts. For more systematic and comprehensive management, further study should be conducted to reflect experience and positions of public health center physicians, collaborative hospital physician and patients.

• 보건교육건강증진학회지
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• 제27권2호
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• pp.37-48
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• 2010

Objectives: In health care setting, patient education and health promotion services are inexpensive and effective initiatives to change health behavior due to use medical service resources and personnel. This study performed to define the responsibilities and competencies of health education specialist in private health care setting. For our suggestion, we reviewed regulatory, recommendation, and programs related to health education and promotion in clinics and hospitals. Results and Conclusion: The health promoting hospital and health services in Europe and innovative hospitals of community health promotion in the U.S. were examples of approaches that supply target groups with health promotion services in health care setting. The National Commission for Health Education Credentialing has suggested the specified responsibilities and competencies of health education specialist in health care setting according to their general duty. Considering the recommendation of the NCHEC, our suggestion included: 1) the three kinds of job scope, 2) the major targets, 3) the specified responsibilities and competencies, and 4) the available health promotion programs in clinic and hospital setting. The suggestion will contribute to the development of job market for health education specialist and to the cooperation with community health resources in health promotion services and comprehensive health care.

• Journal of Hospice and Palliative Care
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• 제10권3호
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• pp.128-136
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• 2007

목적: 본 연구는 전국 보건소에서 실시하고 있는 재가 암환자 관리사업에 대한 현황을 검토하고 사업수행 시의 장애요인을 파악한 후 재가암환자의 효율적 관리방안 개발을 목적으로 수행되었다. 방법: 2006년 7월부터 12월까지 총 6개월 동안 전국 225개 보건소를 직접 방문 및 전화 인터뷰를 통하여 현재 시행하고 있는 재가암환자 관리사업의 내용을 분석 하였다. 결과: 보건소 재가암환자 관리사업의 장애요인으로 환자의 보건소 암환자 관리에 대한 신뢰도 부족, 지역사회 맞춤형 프로그램 부재, 재가 암환자 관리 전담인력 및 차량부족, 재가 암환자 관리사업 담당자의 전문교육, 공중보건의의 문제점, 민간 의료기관과의 연계부족, 암환자 관련한 의료기관 및 호스피스 시설의 부재, 자원봉사자 비표준화 등으로 나타났다. 따라서 효율적 관리방안 중에서 특히 지역여건에 따른 유형별 관리시스템으로 보건소 직접수행 모델, 외부기관 위탁 모델, 외부기관과의 협력 모델을 제안하였다. 결론: 지역 특성에 따른 적절한 사업모델의 수행으로 각 보건소는 지역사회의 인적 물적 가용자원의 효율적 활용이 가능할 것으로 판단된다. 또한 이들 사업모델의 적용과 함께 지역사회 특유의 자체 프로그램의 개발로 재가 암환자 관리 사업의 효율성을 높일 수 있을 것으로 기대된다.

• 대한간호학회지
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• 제47권1호
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• pp.14-24
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• 2017

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Methods: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. Results: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (${\beta}=.84$), hope and cognitive illness representation (${\beta}=.37$ and ${\beta}=.27$) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. Conclusion: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

• 디지털융복합연구
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• 제10권7호
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• pp.193-200
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• 2012

본 연구는 2008년 환자조사 자료를 이용하여 위장질환과 충수염질환을 대상으로 지역간 입원의료이용의 변이정도와 양상을 파악하고, 변이 발생에 영향을 미치는 관련 요인을 분석한 후, 이를 기초로 변이를 최소화하여 의료 이용을 적정화 시킬 수 있는 방안을 모색하기 위해 수행하였다. Extremal Quotient(EQ)와 변이계수(CV) 지표를 사용하여 변이수준을 파악하였고, 다중회귀분석을 통해 입원의료이용의 차이에 영향을 미치는 주요 요인들을 분석하였다. 주요 연구결과는 다음과 같다. 첫째, 위장질환의 소규모 지역별 성 연령 표준화에 따른 입원율의 경우 EQ 15.1, CV 0.4의 변이를 보였으며, 특히 농어촌 지역에서 변이 10대 상위군이 높은 분포를 나타냈다. 또한, 인구만명당 병상수, 의사수, 특수의료장비수에 따라 입원의료이용량이 통계적으로 유의한 양의 관계를 보였다. 둘째, 충수염질환에서는 EQ 12.41, CV 0.4를 나타냈고, 회귀분석을 통해 입원의료이용의 차이에 영향을 미치는 요인을 분석한 결과 통계적으로 유의하지 않았다. 본 연구 결과의 정책적인 함의로는 급성질환자의 입원의료이용의 형평성을 제고할 수 있도록 지역별 병상의 적정한 공급 관리와 효율적인 자원배분 및 의료서비스의 질적 차이를 감소시킬 수 있는 다각적인 정책 방안이 추진되어야 함을 시사해 준다.