• Title/Summary/Keyword: Patient-focused Care

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Improving Physical Therapy Services of Health Centers in Korea (전국 보건소 물리치료실 운영 실태와 활성화 방안)

  • Chang, Eun-Ju
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.1021-1036
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    • 1996
  • The purpose of this study are ( i ) to examine operating situation of physical therapy department and job satisfaction of physical therapists in health centers, (ii) to analyze utilization patterns and patient satisfaction of physical therapy services among health center visitors, and finally, (iii) to suggest policy implications in facilitating improvement on physical therapy services of health centers. The materials are collected from 105 physical therapists among nationwide health centers and 203 patients of 5 health centers in Pusan, Korea. The survey is conducted from February 13 to March 30, 1996 with a structured self - administered questionnaire. Major results of the study are as follows. First, the result of regression analysis between job satisfaction and affecting factors identify following variables as the significant determinants; self-development(+), job itself(+), and co-worker support (+). Second, the current operating situation of physical therapy department shows such problem as; i )shortage and unstable job security of physical therapists, ii )absence of rehabilitation specialist, iii )lack of understanding on physical therapy of co-workers, iv)shortage of physical therapy equipment and facility, v)burdensome task of physical therapists, and vi) inappropriate purchase process of equipment. Third, patient satisfaction for physical therapy services are revealed relatively high. And the result of regression analysis between patient satisfaction and affecting factors identify following variables as the significant determinants; credibility of physical therapist(+), satisfaction for waiting time(+), cleanliness(+). Fourth, the patients appeal about physical therapy services such problem as; i) shortage of physical therapists, physical therapy equipment, and facility, ii) inconvenient administrative procedure for utilization physical therapy services. Fifth and last, recommendations for the improvement of physical therapy services of health centers are as follows; i )recruiting more physical therapists, ii )regular employment of physical therapists instead of daily use employment, iii )re-arrangement of facility for patient's convenience, iv )establishing reasonable purchasing system of equipment for physical therapy, v) reforming administrative procedure for patient focused care.

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A Case Study of Home Health Care for Postpartum Women and their Newborns (산욕부와 신생아의 가정간호 사례연구)

  • Jun, Eun-Mi
    • 모자간호학회지
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    • v.4 no.1
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    • pp.3-11
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    • 1994
  • Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

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The Study of Meaning in Euthanasia and Hospiece Nursing among Nurses (간호사의 안락사와 임종 간호에 대한 의미분석)

  • Kim Ae-Kyung;Park Gye-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.3
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    • pp.379-390
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    • 2000
  • Euthanasia have received considerable attention recentely in medical literature, public discussion, and proposed state legislation. Almost all the discussion in this area has focused on the role of physicians. However, nurse may be in special position to understand the wishes of patients and to act on this understanding. Purpose of this study is to identity the meaning of euthanasia in terminal ill patients on the nurses' veiw. Forcused interveiw design was used to data collection The data were analyzed by semantic analysis, and analysis of the data resulted in identification of 14 categories representing the meaning of euthanasia. 1. The meaning of supported euthanasia is 'free of suffering', 'difficulty of economic status', 'right of patient and family', 'dignity of death', 'organ transplant', 'social legislation'. 2. The meaning of opposited euthanasia is 'artificial death', 'value of life', 'uncertainity', 'guilt feeling' 3. The meaning of care in terminalily ill patients is 'avoidance', 'powerlessness'. 'apathy'. 'passive attitude'. The policy debate about professional roles in action that end of lives of patients must be extended nurses. Nurses must take an active role in discussion and definition of acceptable practice at the end of life.

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Challenges in Korea Hospital Accreditation: Focused on Post-Accreditation Management System (국내 의료기관 인증제의 과제: 사후관리 중심으로)

  • Kim, Ji-Eun;Shin, Kyong-A;Shin, Min-Kyung;Shin, Jae-Joon;Lee, Hyun-Hee
    • Quality Improvement in Health Care
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    • v.24 no.1
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    • pp.1-8
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    • 2018
  • Objectives: The post-accreditation management system should be systematic in order to ensure that the accredited hospital continues to strive for patient safety and quality improvement during the accreditation period. In this study, we compare the post-accreditation management system in four countries (the U.S., Australia, Japan, and Korea) and provide suggestions for improving the post-accreditation management system in Korea. Results: All four countries had the post-accreditation management system, and the basic structure of the system in Korea was similar to that of others. However, there were differences in the practical operation processes and the use of the results. In the operation process, Korea's monitoring relies on voluntary reporting by accredited hospitals. In terms of results utilization, analytical feedback to data submitted by the acrredited hospital is not provided in Korea. Conclusions: It is necessary to establish a continuous monitoring system for post-accreditation changes and provide feedback to accredited hospitals. It is also necessary to perform a survey without advance notice and establish a firm legal basis for monitoring.

The Phenomenological Study on the Experiences of Nasogastric Tube Feeding among Cerebral Stoke Patients with Dysphagia (연하곤란 뇌졸중환자의 비위관으로 영양을 공급 받은 경험에 관한 현상학적 연구)

  • Kim, Ju Yeun;Lee, Young Whee;Cho, Eui Young;Kang, Hye Won
    • Korean Journal of Adult Nursing
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    • v.26 no.5
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    • pp.592-602
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    • 2014
  • Purpose: This study was to provide understanding about the meaning of nasogastric tube feeding experiences by the cerebral stoke patients with dysphagia. Methods: Data were collected through a face to face interview from five cerebral stroke patients who had dysphagia along with a nasogastric tube insertion. The contents of the interviews were analyzed using the hermeneutics phenomenological method developed by van Manen. Results: The experience of having a nasogastric tube was not only limited to physical problems but also was linked to other psychological problems. Many patients reported that they tolerated the nasogastric tube in order to overcome the stroke along with the desire to eventually take food orally. The essential themes associated with the experience of nasogastric tube insertion were: "The loss of pleasure from food", "The loss of human relationship from surrounding table", "Cower and shrink from the different appearance to others" and "Acceptance for life in painful experiences". Conclusion: This study would highlights the importance of not only physical focused care but also psychological and social aspects. Therefore, nurses should consider all factors when providing nursing care to stroke patient with nasogastric tube feeding.

Analysis of Factors Affecting Medication Compliance of Outpatients (의료기관 외래 이용자의 복약순응 관련 요인분석)

  • Lee, Eui-Kyung;Park, Jeong-Young
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.164-175
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    • 2002
  • Background : The purpose of this study was to investigate the current status of medication compliance of outpatients and to analyze the factors contributing to medication non-compliance Methods : Telephone survey was conducted to the 1,000 outpatients who visited medical institutions during the period from January 2002 to April 2002. Subjects were randomly selected from the telephone directories of the nation, and the socio-demographic characteristics of the respondents such as age, gender and region were matched based on those of outpatients in 2001. Results : The results of survey revealed that those who complied with doctors' regimen in the right way accounted for 82.4%. The compliance increased with the strong belief in the medication, less unwanted side effects and inconvenience, more severity of disease, and lower perceived health status. Compliance rate was also higher in the patients group who experienced the drug education by the pharmacists than those who did not. Conclusion : In order to improve drug compliance, drug information on efficacy, adverse reaction, drug interactions, and basic disease information are to be provided to the patients. Drug education needs to be focused not only on providing knowledge of drugs and diseases but also changing attitude on drug use of the patients.

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Patterns of Impatient's Families In the Intensive Care Units (중환자실 입원환자 가족 유형)

  • Kim Kyoung Seon
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.1-12
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    • 2002
  • This study, aimed to categorize pattern of impatient's families in the ICU and to provide useful data for development of family-supportive program was conducted from June, 12 to Aug., 28, using Q-method. After reviewing the literature the researcher proceeded to interview 4 impatient's families in the ICU, developed the statement from consisting of 38 items, and then 30 impatient's families in the ICU were sampled. The collected data were coded after having been scaled from 1 to 9 points, and analyzed using the PC QUANL program. Three types were identified; The first type focused on self-regret about the impatient, the second type of families had some concerns for their health, and the third type was thinking of preparing for their future-lives, such as insurance and savings. It was common to feel powerlessness, regret, compassion, grief and anxiety in all types. They wanted to be given some information, the prognosis of patient and the way to overcome. The study will offer better understanding for family-centered approach and be useful for the system of orientation about impatients and their families.

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Perspectives on Clinical Informatics: Integrating Large-Scale Clinical, Genomic, and Health Information for Clinical Care

  • Choi, In Young;Kim, Tae-Min;Kim, Myung Shin;Mun, Seong K.;Chung, Yeun-Jun
    • Genomics & Informatics
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    • v.11 no.4
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    • pp.186-190
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    • 2013
  • The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.

Development and evaluation of continuing education course in renal nutrition

  • Karavetian, Mirey;Rizk, Rana
    • Nutrition Research and Practice
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    • v.10 no.1
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    • pp.99-107
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    • 2016
  • BACKGROUND/OBJECTIVE: Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS: Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS: Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: $38.75{\pm}17.20%$, post: $62.08{\pm}21.85%$). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION: The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.

Effects of the Supportive Program on the Chronic Arthritis Patients (지지 프로그램이 만성 관절염환자의 생리적, 사회$\cdot$심리적 상태와 건강지각에 미치는 효과)

  • Kim Myung-Ja;Sohng Kyeong-Yae;Kil Suk-Yong
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.203-215
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    • 2000
  • The purpose of this study is to identify the effects of the supportive program for arthritis patients. who are attending a rheumatoid arthritis clinic. To achieve this purpose. this study adopted a quasi-experimental. pre- and post-test research design. comparing experimental group with control one. Supportive program was composed of in-depth. 3 times of direct interview and 2 times of advice using telephone for 8 weeks. The object of these interviews and phone was focused on the improvement of patients' preception for health. During this period. the level of pain, hemato-immunologic indices(ESR, CRP). self-efficacy, depression. and perception for health were measured in both grooups. Data were analysed by $x^2-test$, t-test. repeated measures ANOVA and Pearson's correlations. The results were as follows : 1. There were no significant differences in physiological data. 2. The feeling of self-efficacy was significantly increased in experimental group(P=.012), 3. There was no significant differences in depression. 4. The perception for health status was significantly increased in experimental group(P=.002). Thus, the supportive program. which is focused on the close interpersonal communication. proved to be effective. This result justifies the following suggestion that the role of the nursing professionals in out-patient clinic should be extended for more qualified care for the patients.

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